Last winter, the Trump administration made a series of moves to limit immigration, immediately throwing into doubt the plans of physicians and medical students around the world planning to come to the US or continue working here. 

The White House paused the processing of visa applications for immigrants from 39 countries, leaving physicians from countries such as Iran, Somalia, and Nigeria in limbo, then added more countries to the list of targeted countries. It also imposed a $100,000 fee on employers who want to hire immigrants via H-1B visas, further disrupting health systems that rely heavily on foreign workers.

Now, a flurry of lawsuits aim to reverse those policies. Advocates for immigrants have notched some wins: Federal judges have struck down restrictions on the initial 39 nations and ruled that the $100,000 visa fee is unlawful. 

Still, the legal landscape remains uncertain, and few immigrants have received immediate relief from the courts.

“International medical graduates are used to overcoming barriers. But there is a difference between a difficult process and an unpredictable one,” said Michael E. Hermosa, chief operating officer of Project IMG, an advocacy organization. 

Timing is especially tight for medical students who have matched into residency programs, he said. 

“If physicians believe they can pass the exams, interview successfully, match or be accepted into residency, and still be unable to report because of visa uncertainty, some will reconsider whether the United States is the best path for them,” he told Medscape Medical News.

Here are five things to know about current challenges facing immigrant physicians. 

Frozen Paperwork Leaves Immigrant Physicians in Limbo

Immigrants must file several levels of paperwork as they seek permission to work and stay in the US. The limitations set by the White House are affecting various parts of the process, leaving a wide variety of physicians in limbo, advocates say. 

Among those affected are medical students who matched into residency programs and cannot obtain the status change needed to begin work, physicians with pending green card applications who cannot obtain work authorization while they wait, doctors who need to change employers but cannot get approval, and applicants for citizenship, said Memphis immigration attorney Greg Siskind, JD, who is challenging the government policies, in an interview.

“It's like all life-cycle stages for physician immigration are impacted,” he said. 

Some immigrant physicians were able to avoid immediate crises by getting 240-day automatic extensions of their temporary work visas. But now, “a lot of people are running out of time, and they need these applications finished, and no one's working on them,” he said.

Some Immigrant Physicians Can’t Leave the US 

Southern California attorney Curtis Morrison, JD, has hundreds of clients seeking relief from the Trump administration’s restrictions on immigration, including many clinicians. But one in particular keeps him awake at night.

The client is an immigrant physician who works at an inner-city hospital and wants to return home. “This physician’s own mother is in her dying days in Africa and needs not only their child’s comfort, but also treatment,” Morrison said. 

The doctor’s green card application is pending, as is an advanced parole application, which would allow them to legally leave and reenter the United States. But the physician is from one of the travel ban countries.

In May 2026, the Trump administration reportedly changed its policy to restart the processing of immigration paperwork for foreign doctors. 

But the physician still can’t go home, Morrison said. 

“A government attorney has confirmed to me that the alleged lift for ‘applications associated with medical professionals’ is not inclusive of advanced parole applications,” Morrison said. This means the physician risks not being allowed back after leaving the US. 

Affected immigrants are suffering, he said. “I’ve seen that our clients are experiencing mental breakdowns, depression, feelings of second-class citizenship, and thoughts of suicide.”

Immigration Attorneys See Little Progress in Application Processing 

Medscape Medical News sent several questions to US Citizenship and Immigration Services regarding the freeze on visa applications and the exception for immigrant physicians. 

The agency didn’t answer most of the questions, nor did it provide the name of the person who responded. Instead, it acknowledged that it is “is now processing certain applications associated with medical physicians.” 

It added that “applications associated with medical physicians will continue processing in the normal course of USCIS adjudications to final decision.”

Several attorneys told Medscape Medical News that they haven’t seen evidence that applications by affected immigrant physicians are being processed despite the supposed new policy. 

The Impact on American Medicine Is Significant

Immigrant physicians often work in rural and underserved areas, and advocates are warning that communities will suffer when they can’t keep their jobs.

In some cases, immigrant physicians must go on administrative leave because they cannot legally see patients due to lapses in paperwork. 

This can be devastating for rural and small hospitals that rely on immigrant physicians, Efrén Manjarrez, MD, associate professor of clinical medicine at University of Miami Miller School of Medicine, told Medscape Medical News. 

“We're talking about facilities where a single hospitalist may be the only inpatient physician covering an entire region overnight,” said Manjarrez, president of the Society of Hospital Medicine.

Jennifer Minear, JD, an immigration attorney based in Charlottesville, Virginia, noted that delays have affected the Exchange Visitor (J-1) Visa Waiver Program, which allows certain immigrant physicians in the US with J-1 visas to avoid a requirement that they return home for at least 2 years when they are done training. 

In exchange, they must commit to work for at least 3 years in a Health Professional Shortage Area of the US. But they need permission from the US Department of Health & Human Services.

“Last year, 750 physicians were placed in US shortage areas under this program,” she said. “But since the new fiscal year started on Oct. 1, 2025, almost no waivers have been recommended by Health & Human Services.”

One of Minear’s clients is from a travel ban country and her J-1 waiver application has stalled. The physician believed that even if her application moved forward, it wouldn’t be approved in time to avoid a lapse in status and she would have to leave the US, Minear said. 

“So she backed out of the job offer, and the hospital lost the doctor,” Minear said.

In a June 2 letter, Democratic US Senator Kirsten Gillibrand of New York called on the Department of Health & Human Services to fix the “bottleneck” in processing of J-1 waivers, noting that more than one-third of the state’s physicians are international medical graduates. 

Courts Take Action but Feds Plan to Appeal 

Immigrants and their advocates have repeatedly gone to court to challenge the Trump administration’s immigration policies.

In a federal lawsuit in Rhode Island, a federal judge in June struck down the freezing of visa applications from 39 travel ban nations, saying the move is illegal and “threw the lives of countless immigrants living in the United States into indeterminate legal limbo.”

According to NBC News, the administration argued that the White House has the right to control immigration policy.

On June 9, a federal judge in Massachusetts struck down the $100,000 H-1B visa fee. But NPR noted that rulings by judges regarding the fee are now in conflict, and multiple appeals courts may weigh in next.

Immigrants have won smaller cases regarding the Trump administration’s policies, said Siskind, the Memphis attorney, with some judges ordering the federal government to resume processing visa applications from specific immigrants. “No one's lost that's sued the government,” he said.

Still, thanks to a recent Supreme Court ruling, it’s now difficult for federal judges to order the federal government to protect a wide swath of people who have not themselves sued, Siskind said. “You just have to file a bunch of lawsuits,” he said, “which is what's happening.”

Another option is asking a court to allow a wider group of people to sue via a class-action lawsuit. This “lengthens the process out,” he said, and “it’s not always easy” to convince a judge to allow a class-action suit to move forward. 

In late May, Southern California attorney Morrison and colleagues filed a class-action lawsuit in federal court on behalf of 398 immigrants from 38 affected “travel ban” countries. The suit challenges the restrictions set in place by the travel ban. 

Charles R. Breyer, a federal judge in San Francisco, is set to hear the case. He was appointed by President Bill Clinton and is the younger brother of former US Supreme Court Justice Stephen Breyer.