The Texas legislature passed HB 20238, known as the DOCTOR Act, to address a shortage of physicians in Texas due to population growth and an aging population of retiring doctors.
Starting this year, requirements for foreign doctors have changed as Texas joins 17 other states by waiving the secondary residency requirement designed to bring more doctors to the state.
The new pathway laws appear to run counter to the GOP push to keep immigrants without a clear path to work legally out of the US, but for decades, foreign doctors have been a critical piece of US healthcare in rural and underserved regions.
Of the 100,000 licensed doctors in Texas, about one fourth were trained the U.S. Texas predicts the state will see a shortage of 10,000 doctors by 2032, a shortage which Texas medical schools can’t make up for. The DOCTOR Act is intended to create an easier pathway for military veterans and U.S. and foreign doctors who may have graduated but not completed a residency program in the U.S.
Last month, the Texas Medical Board approved rules for a provisional medical license for doctors who fit the new HB 2038 category, which go into effect this week. Those who are accepted will be supervised by a license physician for two years instead of completing that second medical residency to qualify for a provisional license. After four years, they will be eligible to apply for a regular Texas medical license.
To qualify, they must have five years of experience working as a doctor before coming to the U.S, be proficient in English, be in good standing and free of disciplinary action and pass the required parts of the U.S. licensing exam. In addition, the new law requires these provisionally licensed doctors to work another two years under supervision in health care deserts, typically more rural communities with too few doctors. Afterward, these doctors would qualify for a regular Texas medical license.
The new law may attract foreign and military doctors already in the U.S, but working in other fields due to not completing the required residency. Some employers may prefer these doctors to avoid paying the cost of an A-1B visa for new incoming foreign doctors need to work in the U.S, a fee Trump raised to $100,000. Thus far the Chamber of Commerce and Association of American Universities, which sued the Department of Homeland Security arguing only Congress could set the fee, and not the president, have been unable to overturn the fee.
Should the fee remain in place, employment groups may require the $100,000 feed be covered in return for 4-to-6-year commitments.
Some medical professionals say there isn’t a physician shortage, but the lack of money to pay for healthcare. Others say the program is intended to attract more doctors who can be paid less by hospitals, medical practice and insurers to keep their own costs down.