IMPRINT: Immigrant Professional Integration

Generating Long-Term Change Through Effective Legislation

The COVID-19 pandemic has exposed the existing strains on the U.S. health care system and underscored the critical need to integrate qualified immigrants and refugees into the health workforce. 

Across the country, an estimated 263,000 immigrants and refugees with health care training are unable to obtain licensure in the U.S.  Of these165,000 people earned their credentials outside the U.S. but must meet onerous, time-consuming, and costly requirements, including in some cases repeating years of training and clinical experience.*

Six governors have already taken emergency steps to address the health care needs arising from the pandemic by adapting licensing requirements to temporarily allow health care professionals licensed outside the U.S. to treat COVID-19 patients.

Read more about state emergency orders and policy updates on the IMPRINT coalition’s page Opening Pathways for Immigrant and Refugee Health Professionals

States should now work to create permanent solutions to increase health care capacity. Several states including Minnesota, Washington, and Massachusetts have established task forces to examine barriers to employment for internationally trained health workers. Some of the policies recommended by task forces include: developing standardized assessment and certification programs to determine the clinical readiness of internationally trained health care professionalsdedicated residency slots for international medical graduates, and funding for support services to help internationally trained health workers navigate the relicensing process in the U.S. 

At the federal level, lawmakers have introduced several legislative proposals aimed at expanding the pool of health care professionals in the U.S. by better integrating internationally trained immigrants and refugees: 

In May, U.S. Representative Debbie MucarselPowell (FL-26) introduced H.R.6686, the Bringing Additional Nurses to the Fight Act, which would appropriate $30 million for U.S. nursing schools to establish or expand accelerated nursing programs for eligible applicants, including individuals with international training. While the measure makes some headwayadditional steps could be takenFor example, federal funding for targeted singlecourse bridge programs could provide a solution for immigrants and refugees who have completed their nursing training outside the U.S. but are missing specific U.S. requirements.  

The Healthcare Workforce Resilience Act (S.3599)introduced by Senators Perdue (R-GA), Young (R-IN), Cornyn (R-TX), Durbin (D-IL), Coons (D-DE), and Leahy (D-VT) in early May, would recapture 40,000 unused immigrant visas for internationally trained health care professionalsThe bill recognizes that internationally trained nurses and doctors play a vital role in our healthcare system, especially in medically underserved communities, yet it fails to acknowledge the 263,000 internationally trained health care workers in the U.S. who are under- or unemployed. For these internationally trained health professionals already in the U.S., the central obstacle remains: the lack of recognition of the international education and training they already have. 

In April, U.S. Representative Tony Cárdenas (CA29) and nine co-sponsors introduced H.R. 6432, establishing a task force to study physician shortages, including identifying and examining barriers to employment for international medical graduates. H.R. 6432 demonstrates an important step the federal government could take to address the under- and unemployment of skilled immigrants and refugees ready and willing to support the response to COVID-19 and fill the projected increase in shortages of health care providers in the U.S. National leadership of this sort, focusing on the need to end under- and unemployment among talented immigrant and refugee health professionals, is urgently needed and would support states in their response to COVID-19.  

The COVID-19 crisis has brought a newfound sense of urgency to addressing shortages in the U.S. health workforce. Long-term comprehensive solutions to these shortages should involve all available pools of talent, including internationally trained health workers. Despite efforts underway at both the state and federal levels to bolster the U.S. health workforce, legislation must address the obstacles faced by international medical graduates and other internationally trained health workers who are unable to re-enter their professions in the U.S. due to systemic barriers in the licensing process. 

Migration Policy Institute, “As U.S. Health-Care System Buckles under Pandemic, Immigrant & Refugee Professionals Could Represent a Critical Resource,” (April 7, 2020), available at:

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