This July, hundreds of health residents are set to begin their graduate training in hospitals and clinics across Alabama. It’s a crucial transition for the state, ensuring that healthcare continues in both busy areas and rural communities. However, this year, a crisis looms that could disrupt this process, which would be particularly harmful for communities already facing challenges in accessing care.

Alabama’s residency programs, especially those focused on primary care and rural medicine, heavily depend on international medical graduates (IMGs). These doctors, similar to my experience seven years ago, are eager to enter the US training system and serve in areas where care is most needed after significant preparation. They arrive on J-1 or H-1B visas, offering invaluable services to communities that would otherwise lack them.

This year, though, the US has postponed or halted visa interviews for many incoming residents, which threatens the planned start on July 1. Without urgent action, numerous Alabama residency programs might not have the physicians who have invested time and effort waiting for opportunities. This isn’t just an issue confined to coastal states or major academic hospitals; it’s an urgent crisis in places like Selma, Dothan, Demopolis, Anniston, and other towns throughout the state.

Speaking from personal experience, I moved to Alabama from Canada to train in family medicine. Much to my surprise, Alabama has become my home. My wife, one of the few spinal cord injury specialists in the state, and I decided to settle here and build our lives. I’m thankful for the chance to practice in a state that has given me so much.

But now, Alabama, like so many other states, risks losing the next wave of doctors who want to contribute in the same way.

Data from the Accreditation Council for Graduate Medical Education (ACGME) for the upcoming year shows that nearly 22% of incoming residents are IMGs. Many of them are graduates of US or osteopathic medical schools, eager to serve in rural and underserved areas. If even a fraction of these trainees can’t begin on schedule, the effects will be swift: extended wait times, fewer services, and worsening health disparities.

The long-term consequences could be devastating for Alabama, where over half of the state’s physicians are IMGs.

This situation isn’t abstract. I’m aware of multiple programs facing uncertainty. Rural patients in Alabama will be the most affected. We simply can’t afford to lose talented and enthusiastic doctors over bureaucratic delays.

Immediate action is needed.

The US State Department must promptly address the processing delays obstructing incoming physicians from beginning their residency programs. Our state’s federal representatives need to engage with the State Department by July 1 to address this crisis.

If you are a patient, healthcare provider, or hospital administrator, you can make a difference. Highlight this issue, share your experiences, contact your leaders, engage with the media, and participate in professional organizations or local meetings. It’s vital for others to understand how a lack of access to critical healthcare will affect our community.

Healthcare in Alabama is at risk. Delayed resident doctors today mean fewer providers for tomorrow’s clinics, hospitals, and emergency services. We cannot afford to be passive and worsen the doctor shortage. Time is of the essence.