Foreign Doctors Can Help Rural Georgians; Duplicative Residency Requirements Don’t

This piece was authored by Nico Zviovich, a Metro Atlanta-based contributor for Young Voices. Peach Pundit does accept opinion pieces based on subject interest. If you have a piece you’d like published, let us know.

As Georgia’s population gets older and more physicians retire, its rural population is facing a looming physician shortage. To combat this problem, state policymakers should look to a group willing to fill that shortage: foreign doctors.  

Rural Georgia is in dire need of doctors, and COVID-19 has only exacerbated this problem. Rural hospitals are seeing a surge in patients, without a corresponding surge in providers. By 2030, the state is projected to face an overwhelming shortage of more than 8,000 physicians.

There is a huge disparity between doctors practicing in urban areas versus those practicing in rural areas. While almost half of Georgia’s physicians treat a quarter of the state’s population (specifically those living in the Metro-Atlanta area), throughout the rest of the state, doctors can be few and far between.

According to the Georgia Board of Healthcare Workers, 60 of the state’s 159 counties have no pediatrician; 76 have no practicing OB/GYN, and 74 counties have no general surgeon. There are whole swaths of the state without any specialists at all. And there are nine counties, all rural, that have no doctor of any kind. 

Georgians living in rural communities are often 30 miles or more from their nearest medical provider, which prevents many from receiving basic health care. When folks in rural areas need to see a specialist, they may need to travel much further. 

Georgia’s policymakers have flirted with all kinds of innovative solutions to ease the provider shortfall, from investing to create new residency slots in rural hospitals, to establishing rural hospital tax credits, to expanding telehealth access in rural areas. But when it has come to recruiting foreign doctors, an obvious solution given the sheer number of foreign physicians lining up to enter the country, they’ve not been as innovative.

It’s up to the federal government to streamline visa processes — there’s little Georgia can do to pick up the pace at which foreign medical graduates get in the door. But there are reforms the Peach State can make to get those doctors to work more quickly once their visas are approved. In a recent report, the Cicero Institute proposed a state-level solution that could address Georgia’s provider shortfall: reform duplicative residency requirements. 

In order for foreign medical graduates to practice in the state of Georgia, they must complete 3 years of residency in the United States, even if they completed a similar residency in their home country. That makes Georgia a lot less likely to attract foreign doctors than, say, Canada, where specialists from a number of countries can bypass residency requirements for certain specialties.

The Georgia General Assembly can eliminate duplicative residency requirements by allowing the state’s Composite Medical Board to gauge foreign residency programs on a program by program basis using the same criteria it uses to evaluate residency programs in the United States — particularly, those used by the Accreditation Council for Graduate Medical Education. 

Today, duplicative requirements are keeping more than 65,000 foreign-trained physicians from practicing in the United States. Some of them are taking their much-needed skills to countries like Canada that already allow certain specialists to bypass duplicative residency requirements. 

When it comes to geriatric care, most Americans rely on foreign doctors. More than 52% of all geriatric specialists are foreign medical graduates. As more young people in rural areas are moving to big cities, the average age of rural Georgians is bound to increase, increasing the scope and nature of health problems faced by people outside of big cities. In 2030, the Census Bureau estimates that more than 20 percent of the state’s residents will be 60 or older. That’s almost a 34 percent increase from 2012. Even with its duplicative residency requirements, Georgia has already come to rely on foreign physicians to help treat members of its most vulnerable populations. In fact, foreign doctors make up 17% of the state’s physician workforce.

The reality is that Georgia’s residency requirements inhibit rather than improve rural health care access. If the state is serious about addressing this inadequacy, it must work with health boards throughout the state to allow more qualified foreign physicians to practice in rural healthcare facilities. 

With the COVID-19 pandemic still affecting its rural residents on a daily basis, Georgia needs every physician it can get, regardless of their national origin. 

Nico Zviovich is a Young Voices contributor based out of Atlanta, Georgia.