A critical program used to help Mississippi and other state’s fill open positions across various businesses
While there has been controversy over the H-1B visa program that allows skilled professionals from other countries to take jobs in the U.S. in areas where there are shortages, it is hard to imagine what healthcare—already suffering from not enough workers—would look like without physicians and other healthcare workers born in other countries. Currently, it is estimated that about 29% of physicians in the U.S. were born in another country.
“Mississippi hospitals are facing critical workforce shortages that threaten access to care, especially in our rural communities,” said T. Richard Roberson, President and CEO, Mississippi Hospital Association. “While we continue to focus on recruiting and retaining homegrown talent, the reality is that we compete with other states for medical talent, and Mississippi can’t win every recruiting battle.”
Roberson said the H-1B visa program is another tool in the tool belt to help hospitals and other healthcare providers recruit qualified healthcare professionals, particularly physicians, including specialists, nurses and other health care providers essential to keeping our communities healthy.
“The program is part of a broader workforce strategy to ensure every Mississippian has access to the care they need when and where they need it,” Roberson said.
According to a report at www.myvisajobs, the University of Mississippi Medical Center has the top number of H-1B Visa holders in 2024 at 59 with an average salary of $166,988. A spokesman said UMMC considers all eligible applicants for job vacancies and fills them with the most qualified candidates.
Barry J. Walker, Walker Immigration Law Firm, Tupelo, said because Mississippi has some of the most severe healthcare worker shortages in the country, the state’s hospitals, clinics and academic medical centers have to rely heavily on foreign medical graduates. These are doctors, nurses or other medical workers who earned initial degrees in foreign countries and then came to U.S. to do residency or fellowship training.
“When they finish training in the U.S., if they want to stay and practice, there are specialized procedures for going from training to work status,” said Walker. “All the large hospitals in Mississippi employ foreign medical graduates, as do many small hospitals in the state. At UMMC, they rely on foreign graduates for faculty and clinical positions.”
Walker said if you go to see a physician these days, there is a better than a one in four chance it will be a doctor born in a foreign country. India trains huge numbers of doctors, and those make up a large percentage of Walker’s clients.
Foreign medical students come to the U.S. on J-1 visas, and then have an obligation to return to their country for two years after graduation. But they can obtain a waiver of the two-year requirement if they sign a contract and are sponsored by a hospital or clinic to work in a healthcare worker shortage area designated by the federal government. In addition to those being common in rural areas, the Veterans Administration also hires a lot of foreign-born physicians.
“Most of these foreign docs have a really good work ethic and seem to enjoy making people well,” said Walker.
The H-1B visa is also used extensively in the U.S. to meet the need for IT—computer and software development—workers.
“The H-1Bs visas are divided up into those jobs subject to annual limitations of 85,000 per year, and those jobs that are not subject to the annual limitation,” said Walker. “That is the real bottleneck. Most of the doctors are going to be working for employers exempt from the cap such as non-profit universities or medical centers. But with a U.S. population of 350 million, we create more than 85,000 jobs in a month. Large staffing companies use up half of the 85,000 and then sub those out to large employers like Amazon, Microsoft, Walmart—the big users of IT workers. Typically between 300,000 and 400,000 people apply for the 85,000 H-1B visas, so applicants have only about a one in five chance of capturing an H-1B registration.”
H-1B visas require applicants to have a minimum bachelor degree. Many Registered Nurses don’t qualify because they have an Associate Nursing Degree. Because there are no H-1B visas for most nurses, there is no quick visa for foreign nurses. Employers want to hire foreign nurses because of a huge nursing shortage, but it can take three to four years for them to obtain a green card.
“In a country where there is an exploding demand for nurses and doctors because of our aging population, that is a bottleneck in our immigration process that is hurting our country,” said Walker.
Green cards that allow foreign born residents to work legally in the U.S. are also difficult to obtain and limited to 400,000 per year. Even highly-skilled specialists such as oncologists, endocrinologists and oncologists can wait 15 years to get a green card or a H-1B visa.
“Our economy and population have outgrown an immigration system that was last really redesigned in 1990,” said Walker. “I advocate U.S. immigration should be more than one million people a year either through legal family visas for spouses, children and parents of U.S. citizens or employment-based visas. Our country could justify those numbers of immigrants. Since we have zero population growth—as many Americans dying as are being born—the only way our economy can really grow is through immigration.”
Another issue is the average age of Americans is increasing leaving fewer people of working age who generate taxes to fund Social Security and FICA (Federal Insurance Contributions Acts).
“At some point, we won’t have enough workers to support our entitlement system,” said Walker. “For all those reasons, we need to increase our levels of lawful immigration, but it seems our political system is pretty far away from that at this point. I know the foreign student population is very concerned right now with the political situation particularly since the government has been preemptively revoking the status of some foreign students through SEVIS (Student and Exchange Visitor Information System). There was litigation recently that challenged revocation of the student visas, and immigration backed up and re-instated about 1,500 students.”
Some people—even those with legal visas—have become concerned about increased harassment, undue scrutiny and reported misbehavior by some Customs and Border Protection officers intimidating visa holders entering the country.
“All of my clients—even those here for many years—are really frightened,” said Walker. “They are concerned about being removed from the country.”
H-1B workers also play an important role in education. According to MyVisaJobs.com, the top schools in the state using H-1B workers in 2024 include Mississippi Valley State University, the Jackson Public School District, The University of Mississippi, Southern Miss and Jackson State University. Top health related companies in the top ten include Blue Cross and Blue Shield of Mississippi, the North Mississippi Medical Center and Hattiesburg Clinic. Teknowit, a tech services company that provides cloud solutions and AI services, is also on the top ten list.
According to the Pew Research Center, the fate of the H-1B program has divided influential Republicans. Tech leaders like Elon Musk strongly support the program, while other Republicans question its impact on American workers. President Donald Trump imposed restrictions on the program in his first term, but his current policy agenda on H-1Bs remains under discussion.
“Meanwhile, bipartisan calls for H-1B reforms advocate for more oversight to protect American workers while addressing skill shortages,” the Pew Research Center said.