Pediatric Care Struggles of US Trained International Medical Graduate Pediatricians in COVID-19 Pandemic

Abstract

Background Pediatrician shortage and healthcare access has been a serious issue especially in medically underserved and rural areas aplenty in the USA and has further worsened during the coronavirus disease 2019 (COVID-19) pandemic. Many US trained international medical graduates (IMGs) on a visa status serve these areas to fill in the physician gap. These physicians are usually on a visa and the majority of them have approved immigration petitions. During this pandemic, the sudden changes in immigration policies in addition to the longstanding administrative backlog and processing times had posed new challenges to the pediatricians and the communities served by them. The objective of this study was to determine the demographics, level of training and practice, immigration status, the clinical role they played in the communities they served and the various professional and personal setbacks they faced during the pandemic. Methods A survey was created and data were collected using data collection platform “Survey Monkey”. Screening questions were designed to include only IMG pediatricians on a visa status. Results A total of 267 IMG pediatricians qualified for the survey on a nationwide basis. Of the physicians that participated in the survey, 58.4% were working in either medically underserved or physician shortage areas, 36% of the total physicians were working in a rural setting, 10.6% of the pediatricians had to be quarantined due to exposure to COVID-19, 0.8% were infected with COVID-19 themselves, and 81.3% of the pediatricians had faced hindrance in being able to work at a COVID-19 hotspot due to work site restrictions because of their visa status. Conclusion IMG pediatricians play a valuable role in taking care of the children in medically underserved areas. The challenges surrounding the immigration backlog are contributing to significant hardships for these pediatricians and their families and are causing a hindrance to healthcare access to the children in medically underserved communities during the pandemic especially limiting the pediatricians’ scope and geographic radius of the practice, thus not allowing them to practice to the full extent of their license.

COVID-19 Pandemic Impact on Pediatricians Entering the Pediatric Workforce

“…IMGs who are immigrants may be more severely affected by COVID due to visa-based work restrictions, with some IMGs in our study commenting that “Visa sponsorship is affected by COVID and budget cuts”. 20 , 21 As IMGs are more likely to work in underserved communities, 21 the pandemic may lead to further lack of pediatricians in underserved communities, further widening health disparities. While our multivariate logistic regression model found that Medicine-Pediatrics graduates reported their careers were more likely to be affected by the pandemic, this may reflect adult medicine circumstances, as findings with GP and PH were even more pronounced when categorical pediatric graduates were analyzed separately.…”

Medically underserved areas and International Medical Graduates (IMGs) in the United States: challenges during the COVID-19 era

“…But during these times of national emergency, all the state and federal processes are further delayed and hassle ridden further adding to their burden. Certain specialties like pediatrics where there are far fewer residency positions reflecting onto practicing pediatricians compared to other specialties, these immigration burdens can have an exponential ripple effect [ 23 ]. Some IMGs had to go through additional paperwork just to provide telehealth services in some states.…”

Socioeconomic Factors Associated With the Risk and Prevalence of Dental Caries and Dental Treatment Trends in Children: A Cross-Sectional Analysis of National Survey of Children's Health (NSCH) Data, 2016-2019

“…Early dental care can also help pick up other dental abnormalities with a timely workup and interventions. Physician shortage is a nationwide issue, which includes pediatricians [ 24 ]. According to the Health Resources and Services Administration (HRSA) estimates in 2018, a shortage of 10,802 dentists in the USA was noted with a projection of increase of dentists through 2037 [ 25 ].…”