Immigration Impact (2025-03-11) “States with Healthcare Shortages Turn to Foreign-Trained Doctors, Showing Bipartisan Immigration Policies Benefit All” is summarized below.

  • In the U.S., a rare area of bipartisan agreement has emerged on expanding licensure pathways for International Medical Graduates (IMGs), physicians trained outside the country. The COVID-19 pandemic highlighted the chronic shortage of qualified physicians, and many states began taking emergency measures to allow IMGs to contribute to healthcare. These temporary actions led to permanent policy changes, simplifying the certification process for IMGs and allowing them to support the healthcare system.
  • Since 2020, states have passed various policies to facilitate IMG licensure, including clinical readiness programs and provisional licenses. In 2025, over 20 bills supporting IMG integration were introduced across states, with bipartisan backing. These policies are improving healthcare access and workforce availability.
  • In addition to state efforts, federal legislation such as the International Medical Graduate Assistance Act aims to address barriers like residency shortages and high re-licensing costs. These policies are modernizing IMG integration, demonstrating that investing in immigrant talent strengthens the healthcare workforce and benefits all Americans.

IMG (International Medical Graduate) refers to physicians who have received their medical education outside of their home country and earned a medical degree. Unlike “foreign doctors” in some countries, IMGs are physicians who are recognized in their home country’s medical system but need to go through certain procedures to practice medicine in another country. In many countries, IMGs need to take certification exams or undergo qualification processes to be recognized as qualified medical practitioners.

The Process for Recognizing and Qualifying IMGs as Medical Professionals

The process for IMGs to practice medicine varies by country but generally follows these steps:

  1. Qualification Review: Medical institutions or regulatory bodies in the receiving country review the medical degree obtained by the IMG to ensure it meets the country’s standards. This process involves validating the degree and confirming that the curriculum in the IMG’s home country aligns with the receiving country’s medical education requirements.
  2. Examination: Many countries require IMGs to take a medical exam to evaluate their knowledge of medical principles and clinical skills. For example, in the United States, IMGs must pass the “USMLE (United States Medical Licensing Examination)” to practice medicine.
  3. Clinical Training (Residency): In some countries, IMGs must undergo clinical training or residency within the local healthcare system. This provides IMGs with the necessary skills and knowledge to adapt to the medical practices and procedures of the host country.
  4. Licensure: Once all requirements are met, IMGs are issued a medical license to practice in the receiving country, officially recognizing them as a qualified medical professional.

The Current Status of IMGs in Japan

In Japan, a foreign-trained physician must obtain a Japanese medical license to practice. To do so, IMGs must go through the following process:

  1. Japanese National Medical Examination: Japan does not automatically accept foreign medical qualifications. IMGs must pass Japan’s national medical exam, which is conducted in Japanese and includes content tailored to Japan’s medical system, making the process challenging for IMGs.
  2. Japanese Language Proficiency: In order to practice medicine in Japan, high Japanese language proficiency is required. Effective communication with patients and colleagues is essential, and IMGs must demonstrate fluency in Japanese to pass language proficiency tests.
  3. Recognition of Foreign Medical Qualifications: Japan has a qualification review system to evaluate foreign medical credentials. If an IMG’s degree does not meet Japanese standards, additional education or exams may be required.
  4. Specialized Training and Clinical Practice: IMGs often need to undergo additional clinical training or internship in Japan’s medical institutions to ensure they are familiar with the local medical system and practices.

The Applicability of IMGs in Japan

Japan is facing a significant shortage of physicians, particularly in rural and underserved areas. This shortage is exacerbated by the aging population, and there is an increasing need to address the demand for healthcare workers. One potential solution is the integration of IMGs into Japan’s healthcare workforce. Other countries have successfully implemented policies to attract IMGs, and Japan can draw from these examples to create policies to harness the skills of international medical professionals.

1. Benefits of Accepting IMGs

  • Solving Physician Shortages: Japan faces severe physician shortages, particularly in rural areas. By accepting IMGs, Japan could bolster the healthcare workforce in these underserved regions, improving access to medical care.
  • Diverse Medical Knowledge: IMGs bring a wealth of experience from different countries, contributing to the diversity of medical knowledge and practices. This can introduce new medical techniques and insights into Japan’s healthcare system, improving overall medical care.
  • Building International Medical Networks: Accepting IMGs can foster international collaboration in medical research and patient care. It enhances Japan’s position in global healthcare networks, promoting knowledge exchange and cooperation with other nations.

2. Challenges of Accepting IMGs

  • Japanese Language and Cultural Adaptation: Proficiency in the Japanese language is essential for effective communication with patients and other healthcare professionals. IMGs must navigate not only the language barrier but also cultural differences in medical practice, making adaptation challenging.
  • Difficulty of Medical Licensure Exams: Japan’s medical licensure exam is challenging for IMGs, as it focuses on Japan’s medical practices, which may differ from those in the IMG’s home country. IMGs may need substantial additional preparation to pass these exams.
  • Establishing Adequate Support Systems: For IMGs to succeed in Japan’s healthcare system, there needs to be a robust support system in place. This includes mentorship programs, language assistance, and guidance on adapting to Japan’s medical practices and culture.

3. Specific Measures for Accepting IMGs

  • Development of Specialized Training Programs: Creating programs that help IMGs learn the Japanese language and medical system would facilitate their integration into Japan’s healthcare workforce. Additionally, specialized training programs would help IMGs gain the skills necessary to succeed in Japan.
  • Revising Exam Content: Japan could consider revising its medical licensure exams to make them more accessible to IMGs. Tailoring the exams to ensure they reflect both the knowledge required to practice medicine and the local healthcare system would help IMGs pass the exams more easily.
  • Strengthening Rural Healthcare: IMGs could be deployed in rural areas where there is a critical shortage of physicians. By targeting areas in need, Japan could alleviate physician shortages and improve healthcare access for underserved populations.

Conclusion

Accepting IMGs into Japan’s medical workforce is a promising solution to the growing physician shortage. While there are challenges, such as language barriers and the difficulty of licensure exams, the benefits of integrating IMGs outweigh these obstacles. By providing targeted training, revising exam requirements, and creating a strong support system, Japan can harness the skills of IMGs to meet the healthcare demands of the country. Integrating IMGs would not only address the physician shortage but also improve the overall quality of healthcare in Japan.

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