13 May, 2019
Tarkeshwar Tiwary works at a hospital in central Pennsylvania. He is a doctor and specializes in treating diseases involving the lungs.
Tiwary is among the nearly 50,000 licensed Indian doctors working in the United States. He is also one of more than 300,000 Indian immigrants waiting for legal permanent residency under an employment-based visa.
The 45-year-old doctor says he feels invested in the rural Pennsylvania community where he works. However, the wait for a green card — a pathway to becoming a U.S. citizen — is taking too long.
Tiwary told VOA, "What was promised to me was that if I intend to immigrate, I will be immigrating in a reasonable period of time. If I had gone to any other country, like Canada or Australia, I would have been a citizen much, much earlier."
One common path to permanent residency is through an H-1B visa. That visa is open to those with a "specialty occupation."
About 75 percent of all H-1B visa holders are Indian nationals. Most of them work in computer-related jobs. But a 7 percent per-country, per-year limit on employment-based green cards has increased wait times across all occupations.
David Bier is an immigration policy expert with the CATO Institute research center. He notes that wait times have been increasing since 2003-2004. He added that for a time, it seemed liked the U.S. government's Citizenship and Immigration Services stopped processing visa requests. Since then, he said, lots of people have given up.
Rural communities hit hardest
If Tiwary and other Indian doctors decide to leave the United States, the move would affect rural communities across Pennsylvania, West Virginia and Maryland. Many people living there travel more than an hour to receive specialized care.
Joanne Cochran is president and chief executive officer at Keystone Health, a health care provider in the city of Chambersburg, Pennsylvania. She notes that nearly one in five patients in the Chambersburg area lives in poverty. About 65 percent of pediatric patients receive medical assistance. Keystone counts heavily on foreign-born family doctors, many of them from India on H-1B and J-1 exchange visitor visas.
Cochran told VOA, "We have Indian doctors in family medicine, psychiatry... pediatrics, internal medicine, infectious disease, urgent care...It would be a huge hardship [if they were to leave]."
Mohamed Abdus Samad is also waiting for a permanent residency card. He is a medical doctor and specializes in kidney care and diseases of the kidneys.
Samad works at Chambersburg Hospital. Some of his patients travel 80 to 100 kilometers to see him. As the need for kidney specialists increases and his ties with patients grow stronger, the decision to wait for a green card becomes harder.
"They (the patients) are grateful for the care that they get, but it also puts pressure on me," said the 32-year-old doctor. "If I want to make any move, I have to think about what will happen to those patients."
Christine Newman is one of Samad's patients. She worries it could take months to get an appointment at another hospital if Samad and other doctors with similar visa issues were to leave.
"They're doing what they're supposed to," Newman said. "[The U.S. government] should cut through that red tape and get them in."
Indian doctors also face other issues.
The Department of Homeland Security wants to change the rules of an employment program created during the presidency of Barack Obama. The program enables wives or husbands of H-1B visa workers to gain employment. If the rules change, it would affect about 90,000 people, mostly highly educated Indian women.
I'm Jonathan Evans.
Ramon Taylor reported this story for VOA News. Jonathan Evans adapted his report for Learning English. George Grow was the editor.
Words in this Story
licensed – adj. having official permission to have or do something;
pediatric – adj. of or relating to the medical care or illnesses of children
residency – n. legal permission to live in a place
red tape – n. a series of actions or complicated tasks that seem unnecessary but that a government or organization requires you to do in order to get or do something