The MeidasTouch Podcast Meidas Health: Dr. Nick Mark on H-1B Visas and The Future of American Medicine
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Sep 28, 2025 Dr. Nick Mark, a critical care physician and educator, dives deep into how H-1B visa policies, particularly those implemented during the Trump era, threaten U.S. medical systems. He highlights the reliance on international medical graduates, who fill 10,000 out of 38,000 residency spots, and explains how rising visa fees could push rural hospitals towards financial ruin. Nick debunks myths surrounding IMGs and discusses their crucial role in primary care, all while emphasizing the need for factual education to combat misinformation.
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Residency Gap Drives Reliance On IMGs
- About 28,000 MDs/DOs graduate each year but there are 38,000 residency slots in the U.S. each year, creating reliance on international medical graduates to fill the gap.
- These international graduates disproportionately enter primary care and serve rural and underserved communities.
Residents Are Critical Low-Cost Labor
- Resident physicians provide core hospital labor while earning about $55,000 annually and often work long hours.
- A sudden H-1B fee increase to ~ $100,000 per resident would create unsustainable costs for hospitals, especially rural ones.
Visa Costs Threaten Vulnerable Rural Hospitals
- Nearly half of rural hospitals operate at a loss and many are vulnerable to financial shocks.
- Increased visa costs threaten these fragile hospitals by dramatically raising staffing expenses and risking closures or service reductions.