This bill was long overdue that makes sure that the US benefits the most from millions spent to train physicians.
Since the scope of the bill is also "Better align visa terms with residency training and physician practice", the statement of need requirement for J-1 visa is in contradiction to the intent of
this bill and should be looked at it too.
Even though these policy changes have touched the J-1 visa and its associated 2-year HRR rule on some aspects, I feel that there should be further considerations done on
one of the overlooked J1 visa requirement (Physician category), i.e., Statement of need, which is required from the country of residence. It is basically a binding that asks a trainee Physician
to return after the completion of the training. It is surprising that while there is no such requirement by the trainee's country of residence, the United States itself asks for this letter.
This Physician exchange category under J1 visa should be treated differently than other category like summer interns etc., where it can be said that the United States does it for the cultural exchange program;
here huge taxpayer money is spent on specialized training.
There are already some changes going on the issuance of the statement of need in various countries of the world. For example, Canada has set a limit on the number of "Statement of Need" given
every year. While it is of the best interest of United States to get best talent from the world, it might not be the case for the countries that send them. The country that issues the
statement of need can play around to make sure eiher they get back the Physicians or don't send their best. For example, first-come-first-serve policy by Health Canada
doesn't distinguish someone who is going to Mayo Clinic with someone who is going to third-tier program. Another example is of India; it asks the potential trainee to sign a surety bond before the issuance of statement of need
to make him/her return back after the completion of the training, and has stopped issuing "No Objection Letter" (which is not required anymore and not quite relevant here but referred here to point that
the changes are being made under the "reverse brain drain" program in India). I believe the United States "No Objection letter" requirement in case of Physcians was lifted under the same intention.
However, removal of "Statement of Need" requirement is still long overdue.