By Jay Greene, PhD | Heritage Foundation
What would happen if the U.S. military needed 1 million people in the Armed Forces but decided to cap domestic enlistment at 750,000 U.S. citizens and to recruit the rest abroad? Or what would happen if U.S. policy was designed to import 25 percent of its lawyers or teachers from elsewhere in the world, not because this country lacks people who are interested in and capable of pursuing those professions, but simply because the U.S. would rather hire foreigners for those jobs? That would be absurd—and it happens to be exactly how the system for training and hiring doctors in America operates today.
To become a board-certified and licensed doctor in the United States, one must complete medical school and then be placed in a residency program for at least one year of clinical training. In 1981, only 9 percent of medical residents came from foreign medical schools. In 2024, 25 percent of medical residents came from abroad. That is, a quarter of the people becoming doctors in the U.S. obtained their medical education abroad.
Of course, there are many skilled and caring physicians working in the U.S. who attended medical school in other countries. They are not at fault for wanting to become doctors and serving patients in the United States. But a system for producing doctors that favors foreign-trained doctors while blocking qualified Americans is strange and problematic.