Foreign-educated and foreign-born health professionals fill important gaps in the US health care workforce, particularly among primary care physicians, nurses in hospital settings and other areas of worker shortages. However, continuing to rely on foreign-educated and foreign-born workers may reduce incentives for the nation to address problems such as inadequate supply of primary care physicians and lead to a less stable US health care workforce, according to recent study results published in Health Affairs.
Researchers from the RAND Corporation reviewed the distribution of foreign-educated and foreign-born workers and their country of origin and summarized the literature concerning their contributions to US health care.
Overall, study results showed physicians who were educated outside the US accounted for 25% of the US physician workforce, with the largest groups from India, the Philippines, Pakistan, Mexico and the Dominican Republic. Foreign-born registered nurses account for 12% to 15% of the total registered nurses in the US. Approximately 5% of registered nurses are both foreign-born and foreign-educated, and the largest number of registered nurses are from the Philippines, followed by Canada, India, the United Kingdom and Nigeria. Foreign-born individuals also account for 20% to 24% of direct care workers with the largest numbers from Mexico, the Philippines, Jamaica, Haiti and the Dominican Republic. The researchers estimated 20% of direct care workers are undocumented immigrants.
Although four major categories of visas allow legal admission to the United States for health professionals, researchers pointed out none is exclusive to health care workers. Foreign-born and foreign-educated health workers say they face problems such as unethical recruitment practices, discrimination and difficulties navigating cultural differences, according to the study. US policymakers may want to consider immigration changes to make it easier to recruit needed health professionals, such as direct care workers, while domestic health care organizations need to commit to improving recruiting practices and workplace conditions for migrants, the researchers said.
“There is no cohesive national policy that outlines a strategy for how to incorporate foreign-born and foreign-trained health professionals into the US workforce,” Peggy G. Chen, MD, an associate natural scientist at RAND, stated in the release. “Policy changes could increase the stability of the nation’s health care workforce, while also improving the experiences of foreign-born health workers.”
For more information:
Chen PG. Health Affairs. 2013;32:1906-1913.
Disclosure: Chen is employed by RAND Corporation.