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Nick Mark MD
@nickmmark
This will be absolutely devastating in the medical field. ~30% residents are international medical graduates & ~10k of 43k residency spots are filled by docs with H1-B visas. Previously the h-1B fee was <$5,000. No hospital will pay a $100k fee for a $55k resident salary.
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Aaron Rupar
@atrupar
Trump signs an EO on H-1Bs raising "the fee that companies pay to sponsor H1-B applicants to $100,000"
0:03 / 1:00
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David Watson 🥑
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Nick Mark MD
@nickmmark
No exception for the medical profession in Trump’s “proclamation” about H1-Bs. This will be an absolute disaster for medical education & rural hospitals in particular.
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Aaron Reichlin-Melnick
@ReichlinMelnick
NEW: I got a copy of the H-1B proclamation. It's a 212(f) travel ban proclamation banning the entry into the US of H-1B visa holders who haven't paid the United States $100,000. It appears to go into effect IMMEDIATELY, despite the US having no system to accept such payments. x.com/atrupar/status…
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Nick Mark MD
@nickmmark
Sources: In 2016 there were 10,500 H1B holding physicians in the US (JAMA) pmc.ncbi.nlm.nih.gov/articles/PMC58 In the 2025 Match, 9,761 International Medical Graduates (IMGs) secured first-year residency positions in the U.S (NRMP) nrmp.org/about/news/202
Distribution of Physicians With H-1B Visas By State and Sponsoring Employer
From pmc.ncbi.nlm.nih.gov
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Ivana Krumi
@IvanaKrumi
Great, because residency is the biggest bottleneck for American medical graduates, many of whom can’t find a residency match
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Nick Mark MD
@nickmmark
The match rate for US MD seniors was 93.5% in 2025. Even if every unmatched person wanted a residency spot in an underserved rural hospital that wouldn’t address the shortage.
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Value Maverick
@valuemaverick1
Or maybe it will encourage more Americans to study medicine since they know they will get a job vs someone else because labor cost is cheaper for the for profit hospital for a long time, don’t tell me those hospitals don’t exploit immigrants either. I think this targets tech
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Nick Mark MD
@nickmmark
The math doesn’t work. There are 28k US medical school grads each year and 43k residency spots. Even if the schools magically & immediately increased capacity, it would take 4 years for those students to graduate. 4 very BAD years for rural healthcare.
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Nick Mark MD
@nickmmark
Correct. It’s a “proclamation” not a change in law. Maybe this gets overturned by the courts… eventually. But if they just stop issuing H1Bs unless you pay it de facto kills the program & rural medicine.
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Nick Mark MD
@nickmmark
There are ~10,000 residents on H1-B visas. Not every resident spot is funded but even for the ones that are the hospital will still have to come up with $100k to comply with this “proclamation.”
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masterlongevity.
@masterlongevity
h1B docs also fill in gaps in rural communities and we have a severe physician shortage. no community practice in rural poor red states will be able to support this.
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Kristoph
@ikristoph
Only about 40% of American kids who want to study medicine are offered that opportunity. The reason for this is principally the limited number of residency placements. While this will negatively impact international applicants it will dramatically improve the opportunity for US
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Colin Sharpe
@ColinJSharpe
Paying new American MDs at fair market rate is apparently “absolutely devastating for the medical field”. You don’t hate H-1B/mass migration shills enough.
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special k | 🍂 ceo of pumpkin spice maxxing era
@specialkdelslay
A win for the patients tho
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Rich 🐺
@heywildrich
friend went to the doctor today -- saw a new Indian woman doc at the practice instead of his usual doctor. he said she kept coughing, touching her face, not wearing gloves, then touching him. didn't wash her hands once, not even when she first came in - as is rather customary.
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Ankur Goel
@AnkurGoel
There will be be a hawala-style system to cover the cost. (Indentured service). Basically, the immigrant will contract with a lender to cover the $100k, and they will cover it eventually. Indians know how to deal with this.
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Bob Butler
@marcusp_cato
Are you saying that American kids can’t fill that gap? I don’t believe that. These schools make more money from foreign students, that’s why they’re there.
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459 Crimes
@459Crimes
Exactly. They will now start to pay for scholarships for Americans to go to University instead of visas for foreigners.
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jon
@jdlee
It's glorious. Finally Americans will be employed first
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Sandeep Neel
@SanUvacha
This provision will not impact students currently enrolled at U.S. universities. It applies solely to individuals seeking to enter the United States directly on an H-1B visa. Foreign students who are already in the U.S. on F-1 student status would instead undergo a change of
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ConnecttheDots
@movedabitnorth
Agreed. Maybe US medical schools will begin accepting a higher percentage of American students. Until then, they can renew the current visas to bridge the gap.
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Zackery Parker📌
@mistman78
There's plenty of Americans with sky high IQs we can train to be doctors. For too long we have did everything besides nuture our homegrown best and brightest.
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ZotBot
@M_Zot_ike
Nope they will need to hire American people as they always should have. Yes in the next few months this will wreak havoc but I’m 100% sure the medical industry will come back 100x stronger. Don’t tell me these medical facilities couldn’t pay fair wages… they could… I spent
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Dr. S
@drsprs
Strongly benefits American students who study at Caribbean or other international medical schools though. Right?
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CJ
@leclerks
On track to ruin a lot of people's dreams of working here as nurses and doctors. What the fuck is wrong with this admin?
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Vierd 🇺🇸
@Vierd1
Sounds like we should train Americans. We should have always been doing that.
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Mike Herbert
@Mike_J_Herbert
Why don’t you open positions for Americans. I recently watched a daughter of a friend struggle to get into any medical school and she was a Berkeley grad with high grades, extremely high test scores, and interned as an EMT. The system is rigged against young Americans. Young
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K.G Ballard
@kronstadtgracie
For sure. Wouldn't it increase the demand for american doctors? So pay goes up and more people want to be doctors again instead of everyone wanting to be a finance crypto bro? There should obviously be a rollout so people dont fucking die in the short term
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Danny
@DNAlienPrime
Every single day, I am more and more convinced that this is more than idiocy. This man is carrying out, step by step, a playbook designed to reduce America to ashes. Destroy our place on the world stage, and grind the quality of our civil life to dust. And he's done it for cash.
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Bad Dad From The Top Rope
@GungaGalungaAce
Get more American residents. I’m in the medical field. There is ZERO reason we can recruit more Americans and there is zero reason why we need to be training doctors in other countries. Plus, I have a strong suspicion that they’ll find a way to get international residents here
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Joe Bishop
@obmed11
Now tell the whole story, the government subsidizes the hospitals to the tune of $150,000 a resident.
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TalaMamma
@TalaMamma46225
Why are they doing this , is this part of the fascist playbook, is it because Elon likes H1B visas, to use the common phrase, someone explain it to me like I’m five please?
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Me
@Me36181491
And this is on top of what they did to student loans, which will be a barrier to anyone who even thought of going to medical school
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Kelley Ranch
@kelley_ranch
And yet AGAIN: Ready. Fire. Aim. Absolutely ridiculous. He’s looking at this as immediate ca$h-in for HIMSELF, not the long-term impact on the COUNTRY & her PEOPLE.
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E
@ArizonaSarahRat
Well there's no reason we kept medical schools and residencies so low. There are a lot more qualified people who want to be doctors than there are spaces for them in schools and residences.
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Kate Henry
@KateHenry31989
So, does that mean that he will have to pay $100,000 for each of the bartenders, waiters, housekeeping and landscaping personnel who work at his golf courses, or will he get an exemption?
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Eddie
@EddiesRobe
It would seem we need to focus on educating our own people and not those from other countries.
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DJ MFS
@DJ_MFS
Hey
@grok
… will this EO raise the cost of healthcare that even insurance companies won’t pay for?
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Recherche
@R3ch3rch3
There is no physician shortage in the US. MD wages have been depressed with this cheap foreign labor. They're all going back.
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12th Ward News and Commentary
@cizcodo
Fuck it, H1-B has been devastating for the American worker.. now the workplace will have a ceiling to invest in the American work, they could probably train a lot of people with that money.
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Dave
@WFDave
Most h1-b medical professionals work in rural and undeserved communities, many of which are in red states and districts. I'd say Republicans are cutting off the nose to spite the face, but they can't bc they no longer have a surgeon within 200 miles.
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Lawrence Shields
@Larshields
I imagine that the International medical graduates are predominantly recruited to fill residency spots in rural hospitals and inner city hospitals where grads from elite US medical schools would less likely apply.
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Chrys
@ChrysGoDawgs
So many comments in this thread are so confident in how little they know about healthcare.
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jeffintokyo
@jeffintokyo1
This is the evil brilliance of Trump... There certainly are abuses with H-1B and they should be scrutinized and eliminated. But instead of subtlety that would be good for the US, he does this stupid (but macho looking) shit that will fuck up the US big time. Utter insanity
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dis
@fakebk12
If they were that important, the hospital would pay the premium for a foreigner to take a potential american job lmao
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Wander
@wanderlustFTW
We need to put the extra 50k per Visa into a scholarship fund for Americans as a way to attract more into medical school.
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Summer Mollo
@rsweetchaos613
Then universities can stop gate keeping their programs to allow more students. Its not like we don't have enough people wanting in the medical field..they all sit on waiting lists.
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Jules
@julesbelieves1
Maybe they should consider having larger medical school classes and making it more affordable for Americans
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abe
@AbelAmos
they probably will because there are no alternatives. no resident should have been getting 55k in the 1st place
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🏴|🚫👮‍♂️
@srart25
Gonna end up with them being indentured servant so they can pay it back. Don't mind that the bosses have your passports, they just wanna keep them safe for you.
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ElTeorista
@ElTeorista
Most of these hospitals use these IMG residents as cheap labor. They can afford to hire American attending physicians. This is a good thing.
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SB
@Me38557133
Try to dismantle your country’s healthcare infrastructure without being sued for trying to dismantle your country’s healthcare infrastructure.
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FredaLS
@ls_freda
I went to USA on an H1B visa. Registered Nurse, shortage of nurses in USA. More than 10 of my graduating class went also.
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LameKarma
@lame_karma
Amazingly rural places where there is shortage of physicians and nurses will suffer.most and those are the voters who predominantly vote for Republicans.
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Akbar Hasan
@S_AkbarHasan
This is terrible tbh in medicine - DO schools are far more common and the bottleneck is now residency slots, Not medical schools.
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post_p
@Streatrage
This single executive order devastates the US and hands the future to India and China.
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Paisley Dreamz
@DreamzPaisley
When he does things like this particular video it really makes me think that the people around him are trying to get rid of him to put Vance in I’m not a conspiracy type person but $100,000 that’s just crazy
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Dead Pixel 🇨🇦
@SBCBasher
Between this and everything that RFK is doing, I expect American life expectancy averages are about to go off a cliff.
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Sher
@SherSlyc
Great 😌 Healthcare’s already too expensive even with insurance. Now this? I swear every new EO this goon signs puts another nail in our collective coffin.
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MaryKistler
@dante1955
I’m a retired RN that worked at an excellent large hospital. (Number 1 in the world 🤔). I’m sure this will hurt. 😭
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Ice Cream 🍭🍫
@frank_geor43841
Good. We start educating and training Americans to become Doctors. The problem is that Americans have been locked out of a lot of opportunities. Americans can’t get Assistantships because of the foreign preference.
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Tonk
@thisyrsmdl
No company will pay it. US tech will shrivel. Medical care will be harder to get and performed by less qualified people.
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Aaron M. Long
@AaronMLong
Then I guess they'll have to make do with Americans instead of poaching the talent of every developing country on Earth.
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J
@Cincinotus
Man, looks like we better fund some more public medical schools. There are plenty of extremely bright aspiring doctors in the USA, if only we can make tuition affordable and create spaces for them.
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L A
@lat654
GOOD. Make residencies have to vie for residents and not the other way around. This is good for medical education. Bad residencies will close.
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S
@TheShrike88
America is for Americans. American jobs of every single type are also for Americans. We sink or swim based on our people. Enough selling our people's birthright.
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Dannie
@SeminoleYoda
Almost every doctor I’ve interacted with in the last year at our local hospital (there have been many) has been internationally trained.
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marybl
@marybl62
As usual they have no idea what they are doing and the rest of us will suffer for it 😡
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MsMatisse
@MatisseMs
Once again Trump doesn't know what he doesn't know. He'll be carving out an exception as soon as HE KNOWS.
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Jerry Kempe
@jerry_kempe
This will mostly affect the rural areas, who are already losing, hospitals, clinics and pharmacies. Not so much in the Democratic leaning cities. Maybe it is all going to someone’s anti immigrant plan.
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👀
@makcuk
Thousand magtards will jump and replace them. Right now they are waiting jobless
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LBfromPrison
@Prison_LB
If it’s all the same to you. I dont need a dothead doctor. If we gave the same breaks on medical school to our best and brightest US citizens we could more than cover our need for physicians. But no. We want to import people who get free school and then pay them less.
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Antiheroes
@AversionFx
Only the left could spin a move that encourages higher educational attainment AT HOME rather than importing the third world.
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Aaron Silberman
@silbermanaaron1
Hire American, train American, invest in the future of America. Nobody will cry over Indian and Pakistani med residents. In fact, their own countries need their skills more than us.
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Joey Knish
@KSB2215
Crazy considering the hospital will charge you $74,000 just for breathing their air. Where's the money going?
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G WINNA
@GWINNA18
So sick of this mutherfukker. Saw 3 elderly WHITE folks working in retail this week. He’s destroying his own people.
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JOHN GRONDELSKI
@JGrondelski
Where are the American doctors? Why don't we have Americans studying medicine rather than "transgender intersectional gender studies" and other voodoo?
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Brendan Fox
@brendan_fo94078
Oh my goodness...you mean the US might actually have to stop limiting & bottlenecking the number of doctors it educates every year? The horror...the horror
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JetSetGent
@JetSetGent
So maybe we will start admitting fewer international medical students and more Americans? Wouldn’t that be nice 👍
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Tim
@NASA_Tim
You are so very close to getting it. Keep thinking about what you said, and I bet the solution will dawn on you.
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Cielo
@cherrycielox
so we’re just gonna let sick people die because america’s scared of smart immigrants now cool cool
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RawMilk4theWin
@R57SaltySailor
That's the point of home grown doctors. Remember when Walmart a few weeks ago was busted in a pay for visa scam? He is eliminating corporate greed by having American doctors thus increasing the value of being a MD
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Chopra TP
@ChopraTP
May be you should hire your local American boys as medical residents. Medical degree or not. That will show them.
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Derek Whittom
@whittomd
Lets be blunt here. Medicine is a sinecure. Doctors don't do their jobs. You have to see them for things a nurse or PA should be able to resolve, at enormous expense. Here in Mexico, you can see a doctor in 5 minutes for $50 and 9/10 times your problem is resolved, if not more
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Lex Talionis
@Marcus_orly
This is actually a good thing for American healthcare. There are many, many medical students who do not match into residency every year, and protecting these spots (which are paid for by Medicare dollars) for Americans is good.
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