COVID-19 Physician Workforce Impacts

June 17, 2020

GNYHA has been communicating with member hospitals regarding their concerns about the ability of physicians to begin their scheduled work assignments in the coming weeks due to the impact of COVID-19. Disruptions related to COVID-19 could impact member hospitals’ ability to maintain the physician workforce they need now and in the case of a future spike in COVID-19 cases. Issues we are discussing with stakeholders include disruptions to the administration of the United States Medical Licensing Examination (USMLE) and delays in visa processing or international travel for foreign national physicians. GNYHA is writing to highlight some of these issues and requests that you inform us of any additional issues that you encounter.

USMLE Testing Centers Closure

Concerns about the spread of COVID-19 have resulted in the temporary closure of testing centers that administer the USMLE. The USMLE is a three-step assessment: Steps 1 and 3 are computer-based; Step 2 includes both a computer-based test and a person-to-person evaluation component, the Clinical Skills exam. While a phased reopening of computer-based testing centers began in May, administration of the Clinical Skills exam may remain suspended for 12 to 18 months, according to USMLE.

Implications for Residency Trainee Recruitment

International medical graduates (IMGs) and foreign national physicians use the USMLE to meet certain regulatory requirements to train in US residency programs. For example, certification by the Educational Commission for Foreign Medical Graduates (ECFMG) is a requirement for IMGs seeking positions in accredited US residency programs. GNYHA understands that incoming resident IMGs (beginning on July 1, 2020) have already attained ECFMG certification by passing the USMLE Step 1 and both components of the Step 2 exam. While there is no direct impact on the incoming class of residents, we have heard concerns regarding upcoming recruitment if testing is not fully resumed in time for interviewing the next class of residents. USMLE is exploring suitable alternatives.

Implications for Clinical Clerkships

Step 1 of the USMLE is also required for certain international medical schools to send students to New York hospitals for clerkship training. The New York State Education Department (SED) requires completion of Step 1 for students from international medical schools not registered with SED to participate in clerkship training in New York hospitals. We understand that certain schools have discussed concerns with SED regarding the impact of delays on Step 1 testing. GNYHA has been in discussions with SED, and we have noted our support for identifying an alternative means of satisfying this requirement due to the current circumstances.

Visa Processing Delays and Travel Restrictions

Temporary closures of US consulates in countries around the world in response to the COVID-19 pandemic have delayed visa processing for physicians and other members of the health care workforce. The ECFMG, which sponsors the J-1 visa commonly used by residents in training programs, has been working closely with the US Department of State to address these delays. While consulates are beginning to open, we understand that demand for visa appointments continues to outpace availability.

In addition, GNYHA is aware that certain travel restrictions imposed by countries have led to challenges for incoming residents currently living outside of the U.S. While commercial air travel is beginning to increase, the reduced number of flights before the start of the academic year is an ongoing concern.

Contact Information

GNYHA will continue to communicate regularly with the ECFMG, SED, the New York State Department of Health, and other stakeholders as we work on these issues. GNYHA is also monitoring the ongoing international travel situation and will keep members apprised of any new developments regarding that issue.