U.S. Immigrant Integration Policy in Light of the COVID‐19 Pandemic

• Published date: 01 November 2021
• Author: Saltanat Liebert
• Date: 01 November 2021
• DOI: http://doi.org/10.1111/puar.13331

U.S. Immigrant Integration Policy in Light of the COVID-19 Pandemic 1197

Public Administration Review,

Vol. 81, Iss. 6, pp. 1197–1203. © 2021 by

The American Society for Public Administration.

DOI: 10.1111/puar.13331.

U.S. Immigrant Integration Policy in Light of the COVID-19

Pandemic

Abstract: The COVID-19 pandemic has highlighted a critical shortage of medical personnel in the United States.

Yet, there is an untapped pool of an estimated 263,000 immigrant physicians, nurses, and health-care technicians who

are not using their training in the United States. This essay provides a brief explanation of the factors that result in

underutilization of immigrants’ skills. Connecting theory with practice, it then proposes potential policy solutions to the

shortage of medical personnel through strategic immigration initiatives.

Evidence for Practice

• There is an untapped pool of an estimated 263,000 immigrant physicians, nurses, and health-care

technicians who are not using their training in the United States. With appropriate integration programs,

they could be employed in health-related fields, alleviating significant labor shortages.

• There are currently no formal integration programs for immigrants who arrive in the United States.

• Integration programs for internationally trained medical professionals should include assistance with

credential recognition and certification, apprenticeship/internship program with a strong mentorship

component, cultural and language training, and skills upgrade training.

• Such integration programs could be funded through public-private partnerships and use the existing

infrastructure and the know-how of universities and community colleges that offer nursing and/or allied

health professions education.

The COVID-19 pandemic has highlighted

a critical shortage of medical personnel in

the United States. In 2018, there were 13

open healthcare job openings for every available

unemployed healthcare worker (New American

Economy Research Fund 2020). Today, this need is

even greater. Immigrants and minorities have been

among the hardest hit by the pandemic (Centers

for Disease Control and Prevention 2020), and

linguistic and cultural competencies that foreign-

trained medical professionals possess are valuable in

preventing the disease and treating these communities.

They could also be critical in addressing the need for

239,714 contact tracers nationwide (as of September

2020) (George Washington University 2020).

Immigrants play an important role in alleviating

shortages in healthcare: 29 percent of physicians, 38

percent of home health aides, 22 percent of nursing

assistants, and 23 percent of retail-store pharmacists in

2018 were immigrants (Gelatt 2020; Mathema 2020).

Their contribution is particularly critical in medically

underserved areas, where immigrant physicians

often work due to conditions of the J-1 visa waiver,

which enables many of them to pursue residency

or fellowship training in the United States (Brooks,

Mardon, and Clawson 2003). Yet, there is an

untapped pool of an estimated 263,000 immigrant

physicians, nurses, and health-care technicians who

are not using their training in the United States

(Batalova and Fix 2020). Many are employed in low-

skilled jobs that do not require a college (or even a

high-school) degree. Why are not these immigrants,

holding undergraduate degrees in health-related fields,

employed in their professions after immigration? A

key factor explaining why such underutilization of this

significant human capital is taking place is a lack of

cohesive immigrant integration policy in the United

States. This commentary provides a brief explanation

of the factors that result in underutilization of

immigrants’ skills and proposes potential policy

solutions to the shortage of medical personnel

through strategic immigration initiatives.

Background on the U.S. Immigration System

The United States is the largest immigrant-receiving

country in the world: More than 44 million

immigrants live here, comprising 13.6 percent of

the population (Radford 2019). At present, the

Immigration and Nationality Act (INA) of 1952

Saltanat Liebert

Virginia Commonwealth University

Saltanat Liebert is an associate

professor at the L. Douglas Wilder School

of Government & Public Affairs at Virginia

Commonwealth University in Richmond,

VA. Her research focuses on immigration

policy and comparative governance. She is

the author of

Irregular Migration from the

Former Soviet Union to the United States

(Routledge, 2009) and is the coeditor of

Public Administration in Post-Communist

Countries: Former Soviet Union

,

Central

and Eastern Europe

, and

Mongolia

(CRC

Press, 2013).

Email: sliebert@vcu.edu

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Stephen E. Condrey

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