Major H-1B Visa Changes

President Trump has instituted a $100,000 fee for H-1B visas, effectively ending the H-1B program and critical pipeline of healthcare workers. Learn about potential doctor exemptions, J-1 visa changes, and impacts on international medical graduates.

$100,000 Fee Implementation: President Trump has instituted a $100,000 fee for H-1B visas, announced in a Sept. 19, 2025 presidential proclamation, which in practice will end the H-1B program and with it, a critical pipeline of health care workers White Coat InvestorStatnews.

Potential Doctor Exemptions: Doctors could qualify for exemptions from the Trump administration's new $100,000 fee for high-skilled H-1B visa applications, the White House said Monday, after some of the biggest medical bodies called out the risk to rural America White House Floats Doctor Exemptions for $100,000 Visa Fee.

Healthcare Impact: The $100,000 fee for H-1B visas "risks shutting off the pipeline of highly trained physicians that patients depend on, especially in rural and underserved communities," said American Medical Association President Bobby Mukkamala 'Patients will wait longer:' $100,000 visa fee risks worsening doctor shortage.

J-1 Visa Changes

Appointment Restrictions Lifted: The U.S. Department of State has lifted the pause on new visa appointments—and has directed U.S. embassies and consulates to prioritize J-1 physicians for visa interview scheduling ECFMG News | Visa Appointment Pause Lifted and J-1 Physicians Prioritized (as of June 2025).

Previous Suspension: In May, the Trump administration suspended new interview appointments for foreign individuals applying for J-1 visas — something that has jeopardized hundreds of international doctors ahead of their residencies at U.S. hospitals New visa restrictions threaten hundreds of doctors' US residencies.

Canadian Medical Graduate Changes

Individuals who graduate from Canadian medical schools on or after July 1, 2025 will require ECFMG Certification in order to be eligible for sponsorship as J-1 physicians Reference Guide for J-1 Physicians Exchange Visitor Sponsorship Program (EVSP).

H-1B Rule Clarifications

The rule clarifies that a specialty occupation requires a directly related degree to the job duties. For physicians, this means an M.D. or D.O. degree remains a qualifying degree, and the requirement for passing USMLE Steps 1 How does the January 17 H-1B rule affect H-1B visas for Physicians continues.

These changes represent significant challenges for international medical graduates seeking to practice in the U.S., with the H-1B fee increase being particularly impactful for physicians transitioning from J-1 to H-1B status after completing their residency requirements.