In 2009-2012, over 3,000 Indian doctors went abroad for higher studies but did not return to India. Records show that, between 1989 and 2000, 53% of India's premier medical college graduates left the country — most of them migrated to the US.

This outflow of medical doctors is attributed to low salary, poor working conditions, and limited availability of seats for postgraduate degrees. Thus, Indian medical graduates, and even post-graduates, pursue prospects abroad where better work opportunities, environment, and compensation are assured.

In order to boost the low-supply pool of medical practitioners, in 2014, the Indian government stopped issuing the no obligation to return to India (NORI) certificate to medical students and doctors travelling to US — in essence ensuring that medical students and doctors will have to return to India on completion of their higher studies or training in US.

Trumpification of H1B visas

US President Trump’s administration has introduced a bill titled “Protect and Grow American Jobs Act” which focuses on reducing the immigrant worker flow to the US, thereby increasing the available jobs pool for American citizens. It proposes a hike in annual salary of H1B visa holders from USD 60,000 per annum to USD 130,000 per annum along with an advanced degree cap or master’s degree quota.

Neutral Impact On Indian Medical Fraternity

The changes implemented for issuance of the H1B visa are likely to have a neutral impact on Indian medical fraternity. With tightening of regulations the practice of multiple applications, for the same candidate, by IT companies will cease. Consequently, under the current lottery system of granting visas to eligible candidates, reduction in visas allotted to IT professionals could prove to be a boon for other professionals including doctors.

Moreover, an Indian medical professional seeking to study or work in the US can apply for visa under several categories, namely H1B, O-1 or J-1, depending on the nature of their employment. Despite speculation regarding the termination of the J-1 visa jobs program, at present no such initiative has been announced.

H1B visa, primarily processed through the employer, permits a foreign physician to be direct patient care providers in the US.

O-1 visa is for physicians with extraordinary publication record and who is considered to have made outstanding contributions to his/her field of medicine.

J-1 visa allows physicians to work as resident doctors under education exchange programs but they have to return to home country for a minimum of 2 years post 3 years of residency.

Lastly, even though most of medical graduates prefer to pursue higher studies and professional prospects in US, opportunities abound elsewhere — UK, Australia, and Canada as well as Philippines, Ukraine, Caribbean, UAE, Nepal, and China.