Mind the Gaps

Before the U.S. Department of Homeland Security finalized changes on July 17, 2026, certain visa holders could remain in the country for the duration of their training without requiring additional approvals. Since many medical residency, doctoral, and postdoctoral programs often take longer to complete, this flexibility has been vital. Now, every individual will need to apply and be approved for an Extension of Status to continue training after four years.

In her recent book “The Care of Foreigners: How Immigrant Physicians Changed U.S. Healthcare," Harvard Associate Professor Eram Alam--of the History of Science Department—explores the history of foreign physicians’ migration to the U.S. Based on interviews with hundreds of immigrant doctors, she covers topics ranging from cultural adaptation challenges to collective power in the workplace.

A residency program, a teaching hospital, mentors, and patients all invest in a physician. If that physician ultimately leaves—not because of clinical performance, but because the legal pathway is too uncertain—the system loses years of training, continuity of care, institutional knowledge, and future capacity.