Washington, June 3 : Hundreds of foreign-trained doctors could be forced to leave the United States because of delays in processing J-1 visa waivers, worsening physician shortages in rural communities, Senator Kirsten Gillibrand has warned.

In a letter to Health and Human Services Secretary Robert F. Kennedy Jr., the New York Democrat said an administrative backlog at the Department of Health and Human Services (HHS) is preventing qualified international medical graduates from taking up jobs at hospitals across the country, including in some of New York's most underserved areas.

â??The current administrative bottleneck within the Office of Global Affairs (OGA) is preventing hundreds of qualified, foreign-trained physicians from beginning their service around the United States, including at healthcare facilities in some of New Yorkâ??s most rural and medically underserved areas,â?? Gillibrand wrote.

The issue could have particular significance for India, which is one of the largest sources of international medical graduates working in the United States.

Gillibrand said New York relies heavily on overseas-trained physicians to fill staffing gaps, especially in rural communities struggling to recruit doctors.

â??International medical graduates are absolutely critical to New Yorkâ??s physician workforce, especially in rural areas of our state,â?? she said. â??New Yorkâ??s healthcare providers cannot afford to lose qualified doctors to administrative red tape.â??

According to the senator, international medical graduates account for more than one-third of New York's physician workforce, a higher proportion than in nearly every other state.

She cited a 2025 report showing severe healthcare shortages across rural New York.

â??A 2025 report highlights that 16 of the stateâ??s rural counties face alarming gaps in care, with several counties lacking even a single pediatrician or OB-GYN. On average, these counties have only four primary care physicians per 10,000 residents, which is less than half the statewide ratio,â?? Gillibrand wrote.

Hospitals in those communities often depend on the J-1 visa waiver programme, which allows foreign physicians to remain in the United States if they agree to work in federally designated Health Professional Shortage Areas.

Gillibrand said months-long delays in processing waiver recommendations are preventing doctors from beginning work and creating uncertainty for hospitals planning staffing levels for the coming year.

â??My office has received multiple reports from New York hospitals and constituent physicians who have received employment offers from major hospital systems but have remained in administrative limbo for months without clear guidance from HHS,â?? she wrote.

â??These administrative hurdles are not merely inconvenient; they threaten the stability of our healthcare system and the well-being of New Yorkers who face delays in treatment or an inability to access care altogether.â??

The senator warned that the delays are becoming increasingly urgent because many physicians completing residency programmes face a July 30 deadline to avoid being required to return to their home countries.

â??If their waivers are not recommended by HHS in time for subsequent processing by the State Department and U.S. Citizenship and Immigration Services, these doctors may be forced to leave the country and New Yorkers will bear the consequences,â?? she wrote.

Gillibrand also noted that HHS had informed her office in April that the Office of Global Affairs was processing a large volume of applications while implementing procedural improvements. However, she said the agency had not provided a timetable for resolving the backlog.

She asked HHS to provide answers by June 15 on the number of pending applications, processing times and whether expedited reviews would be considered for physicians with contracts in high-need areas.

The J-1 visa waiver programme has long served as a pipeline for international medical graduates willing to work in medically underserved parts of the United States. Many rural hospitals rely on the programme to recruit physicians in primary care and other hard-to-fill specialties.

/IANS