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Shortage of Doctors Affects Rural U.S.
As a result, some foreigners are choosing to leave after their commitment is up, or are not applying to come to the U.S. at all.
The number of physicians in training with J-1 visa waivers has fallen by almost half over the past decade, from 11,600 in academic year 1996-97 to fewer than 6,200 in 2004-05, according to the Government Accountability Office. And federal and state requests for J-1s for doctors dropped from 1,374 in 1995 to 1,012 in 2005.
  Dr. Minerva Rasalan of the Philippines, laughs when she talks about her practice at a childrens' clinic in West Point, Miss., on April 25, 2007. Rasalan recalled the difficult process she and other foreign doctors must take to work in the United States. For many foreign trained doctors, practice in the United States provides them better pay and even better working conditions than they might have received had they stayed home. (AP Photo/Rogelio V. Solis) (Rogelio V. Solis - AP)  
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Medical professionals and others have put much of the blame on HHS.
Before 9-11, the Department of Agriculture operated a program that brought more than 1,000 doctors a year to the United States, but it was shut down after 9-11. HHS then took charge of a new program in 2003 with tighter rules, and has approved just 61 J-1 visas since.
But the HHS said the numbers dropped because of a lack of interest among doctors.
"We just aren't getting that many applications because the pool is smaller and the tendency is to go to the states because the rules about what they can do are much broader," said Stephen R. Smith, senior adviser to the Health Resources and Services Administration's administrator at HHS.
The vast majority of J-1s are being issued instead under a 13-year-old program sponsored by Conrad. The Conrad State 30, as it is now called, authorizes 30 J-1s per state per year. But the program will expire unless reauthorized by Congress in 2008.
Some foreign doctors are giving up on the American dream.
Husband-and-wife Drs. Rohit Panchal and Vaishali Shah were heralded on a billboard in Greenwood when they arrived. As a pulmonologist with critical care training and an internist, they treat a patient population with some of the highest rates of lung cancer, diabetes and other grave illnesses.
They find the work rewarding, but when their commitment ends they are considering returning to India instead of trying to obtain permanent residency.
"It's too long and tedious a process. It's too tiring," Panchal said during a break from rounds in the Greenwood Leflore Hospital.
The federal government cannot be blamed for everything, said Dr. Sampatkumar Shivangi, an obstetrician and gynecologist in Jackson, Miss., who is president-elect of the American Association of Physicians of Indian Origin.
He once tried unsuccessfully to help a J-1 physician find a position with a rural Mississippi clinic.
"Some of the physicians in that community didn't want a physician to come and practice there because it would take away patients," Shivangi said.
