Eric Ruark's picture


  by  Eric Ruark

President Trump has taken significant steps to protect American workers. In June, he extended the immigration pause to include several categories of temporary work visas. This week he signed another executive order to ensure that federal agencies do not layoff American contract workers in order to outsource those jobs to foreign guest workers, as was recently the case involving the Tennessee Valley Authority.

These actions are to be applauded, especially since there is vast opposition in Washington, D.C. to doing anything to help American workers via immigration restriction. Of course, some restrictionists counter that President Trump didn’t go far enough, making demands that fail to recognize limits on executive power (understandable in light of the absurd Supreme Court DACA ruling), or the complexities of immigration law.

Then again, some who call for the President to go further have a valid point. For instance, the June executive order allowed Optional Practical Training (OPT), a program, like DACA, that has no statutory basis, to continue. Foreign students who are working on OPT push recent American graduates out of jobs and can remain in the United States while waiting to receive H-1B guest worker visas.

Another area where it fell short was that the executive order did not affect foreign doctors coming in through the J-1 and H-1B visa programs. The rationale was that there is a need for more medical personnel during the COVID-19 pandemic, though claims of a “doctor shortage” have been around for years. Those claims are false, and the coronavirus has actually resulted in wide-spread lay-offs of health care professionals since normal operations have been shut down.

The problem isn’t a shortage of doctors but a lack of residency slots for doctors in the U.S. Without residency training, doctors can’t practice medicine. Right now, there are 6,750 unmatched doctors in the United States. These individuals have graduated medical school, passed their medical boards, and are searching for a residency match, of which there are far more applicants than spaces available.

This gets virtually no attention from the media. That is because the story of how immigration affects American workers, no matter their education or skill level, is not one the media has an interest in reporting. It takes a lot of time and a lot of organizing to get them interested, and to get the powers-that-be in D.C. to take notice.

Fortunately, we are beginning to see some groups of unmatched (lacking a residency) doctors who are coming together to raise their voices against an unfair system. One of those groups is Unmatched U.S. Doctors.

[To learn more about how and why this is happening, see a recent op-ed in the New York Post by an unmatched doctor.]

The media is almost completely fixated on telling the stories of immigrants and the hardship they will face if the United States does not admit them, or allow them to stay permanently. Some of these stories are compelling, but they do not change the fact that the U.S. immigration system does not exist for the benefit of every foreign national who wants to come to this country. That reality would be easier to grasp for some if the stories of how Americans affected by immigration were told, including those of naturalized citizens, and even green card holders, who are struggling to find employment because of the admission of new immigrants.

Here are a few excerpts from the testimonies collected by Unmatched U.S. Doctors:

In summary, the ECFMG [Educational Commission for Foreign Medical Graduates] states there is a doctor shortage in the USA when there is no doctor shortage. The ECFMG also claims there is a shortage of high quality doctors in the USA and they do this because they make millions every year off of foreign doctors due to fees and etc. being processed by the ECFMG.


After the training, only H1- B visa holders were recruited for jobs with pharmaceutical companies…while myself and a few other Indian Americans who were Caribbean medical grads were denied jobs at these pharmaceutical companies. I later found out these Indian visa holders had to sign contracts committing half of their hourly wages to the Indian recruiting company. American citizens were not tied to such a contract because of it being considered an illegal practice.


I’ve spent over ten thousand dollars applying to residency programs in order to get a job post medical school so I can provide for my family and pay my federal loans. Today, I owe approximately four hundred thousand dollars in federal loans, 400k!!!


Many program directors find new residents relatively docile and expect to extract more “mileage” out of foreign medical graduates by getting them to work longer hours without regard to their rights as might be objected to by American standards, effectively paying the foreign medical graduate a lower wage.


I hope that we, US citizens and green card holders come together once and break this unholy chain of corruption in the residency match. This would not happen unless we all stay united and speak up.


I am not against immigration, obviously, I am an immigrant but I am against the chaos in the selection process. It is a matter of order and arrangement, the United States should help its citizens first, to match and then give out visas for international doctors if needed. Right now we have at least 6000 U.S. citizen unmatched physicians EVERY year, this is totally unfair. No system in any country in the world allows this to its citizens.


For the full testimonies, go to the CFMG Certified U.S. Citizens for US Residencies - Facebook group
Unmatched U.S. doctors- Doctors who are Americans who after application fees of over $4000 to over 200 programs did not get into a residency training program for one of these residency specialties- Family medicine, Internal medicine, Psychiatry, Neurology, ob-gyn, Pediatrics, etc.

ERIC RUARK is the Director of Research for NumbersUSA

Updated: Thu, Aug 20th 2020 @ 9:55pm EDT

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