Several hospitals in the United States are experiencing critical staffing shortages as international medical graduates face delays in obtaining their visas. These doctors were scheduled to begin their residency programs, but visa complications have put their arrival on hold.

“The residents are the backbone of the entire hospital,” said Dr. Zaid Alrashid from Brookdale University Hospital and Medical Center in New York, which has medical residents from almost every continent. Most received their visas prior to the pause but a few were caught up in delays.

Two residents from India who spoke on condition of anonymity have not been able to get an appointment at any U.S. embassies there despite the J-1 visa pause being lifted.

Another resident from Egypt just secured a visa appointment for mid-August but is worried her program may not be willing to wait for her. She’s already paid her security deposit for an apartment in Texas to live during her residency.

“I don’t know when this situation will be resolved,” said the resident, who spoke on condition of anonymity, adding she hasn’t been eating or sleeping well.

Hospitals Grapple with Resident Arrival Delays

“The residents are the backbone of the entire hospital.”

In California, leaders at two graduate medical education programs said they have a small number of residents caught up in J-1 visa delays. Both spoke on condition of anonymity due to concerns for the doctors who are still trying to get visas.

A residency leader at one large health care system said two doctors in its 150-resident program are delayed, adding they could start late or defer to next year. A 135-person program at a California public health system told the AP that one resident has yet to arrive, though he was finally scheduled for a visa interview.

“We are not going to breathe easy until he’s hear in our hospital,” the second leader said.

As of Wednesday, Lamb’s matching program had received fewer than 20 requests to defer or cancel residency contracts.

Worried about losing their spots if they defer, many foreign medical residents may keep trying to get to the U.S. and start their residencies late, said Dr. Sabesan Karuppiah, a past member of the American Medical Association’s International Medical Graduates Governing Council and former director of a large residency program.

Some hospitals may struggle at this point to replace the residents who don’t make it, leaving fewer people to care for the same number of patients, said Kimberly Pierce Burke, executive director of the Alliance of Independent Academic Medical Centers.

Foreign medical trainees who’ve made it into the U.S. remain on edge about their situations, Karuppiah said.

“I can tell you the word on the street is: ‘Do not leave the country,'” he said, adding that people are missing out on important events, seeing sick parents or even getting married. “Everybody’s scared to just leave, not knowing what’s going to happen.”