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The Association for Advancing Physician and Provider Recruitment (AAPPR) is redefining recruitment to retention and is the only professional organization where physician and provider recruitment leaders and others who influence recruitment, onboarding and retention can connect, learn and advance their careers.
The federal government is open again after a 43‑day shutdown. It is the longest shutdown in U.S. history, and the deal to reopen the government failed to resolve the key issue raised by Democrats: the expiring Affordable Care Act (ACA) tax credits. The deal extended funding through January 30, 2026, giving Congress just over two months to pass FY26 appropriations bills and address pending policy items, which include several major health policies beyond the ACA credits, such as telehealth flexibilities. The sharp increase in health costs will also be a topic of intense debate. We cover this and more in the November update below.
As you are aware, the President’s proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” imposes a $100,000 fee upon applying for an H‑1B visa. This proposal jolted the healthcare industry, given international medical graduates are critically important to upholding healthcare access, and it will make staffing more challenging.
As it currently stands, most healthcare hires changing status in the U.S. are not subject to the administration’s $100,000 fee under current guidance. This includes residents and fellows moving from J‑1 or F‑1 to H‑1B, as well as H‑1B extensions and transfers. However, the fee still applies to new H‑1B hires coming from abroad.
We have been working with congressional offices on a letter to the administration that would exempt all healthcare providers from the fee. Only four percent of approved H‑1B workers were in medicine or health occupations, meaning exempting such providers would not upend the broader policy aims. We appreciate congressional offices weighing in on this important issue and will continue to encourage offices to reach out to ensure this policy does not place undue constraints on healthcare recruitment.
As part of the deal to reopen the government, Senate Republicans agreed to a vote on a one‑year ACA subsidy extension in mid‑December. There is no guarantee this will pass the Senate, but a growing number of members realize the pitfalls of letting the tax credits expire without a clear path forward.
In fact, a small but key group of moderate House Republicans would like to help the Senate craft an ACA subsidy extension that can also pass the House. The challenge is that the majority of House Republicans are against extending the subsidies without significant changes. While there are risks for Speaker Johnson in jamming House Republicans on this vote, most lawmakers and observers recognize that rising health costs are a bigger risk to their majority than a short‑term extension of the tax credits.
We will continue to monitor the debate on extending ACA tax credits, as well as discussions of a broader health reform package.
Last month, CMS finalized separate payment rate updates for 2026 under the Medicare Physician Fee Schedule. Physicians in value‑based models (APM “Qualifying Participants”) will have a conversion factor increase of 3.77%, and other clinicians will have a conversion factor increase 3.26%. In plain terms, this means modest across‑the‑board increases intended to support access to care.
AAPPR advocated for more predictable, sustainable payment updates and highlighted downstream workforce impacts in its comment letter to the proposed rule.
Last month, AAPPR hosted a webinar on the upcoming Medicaid changes contained in the One Big Beautiful Bill Act. The webinar unpacked the policy implications—from Medicaid redeterminations to provider taxes—and what states and health systems should expect. You can listen to the webinar by clicking here: You can listen to the webinar by clicking here.
We’ll continue to share updates and track developments on this pivotal issue as we head into 2026.
When a physician signs a contract, in-house physician and provider recruiters may breathe a sigh of relief and shift their attention to one of the many other searches they are likely managing. However, a new study from Jackson Physician Search and the Medical Group Management Association (MGMA), “From Contract to Connection: How Authentic Relationships Foster Early-Career Loyalty and Retention,” reveals that this hands-off approach may be undermining long-term retention efforts. While 69% of administrators expect new physicians to stay six or more years, more than half (59%) of physician respondents reported leaving their first job within three years.
The report explores the factors driving new physicians to leave their first jobs so soon (spoiler alert: compensation doesn’t top the list), and while the reasons are complex, some of the solutions are surprisingly simple. For example, the study reveals that the pre-boarding phase—the median 180 days between signing and starting—is one of the most influential periods for building a foundation of loyalty and engagement. So, rather than stepping back after the contract is signed, recruiters must step up to ensure the relationship continues to grow during this critical window.
The in-house recruiter is uniquely positioned to serve as the consistent thread connecting all pre-boarding touchpoints. After all, recruiters have already established rapport during the search process. Candidates trust them. They know how to reach them. The relationship already exists; it simply needs to be intentionally sustained. Keep reading as we explore exactly what this looks like.
The Jackson Physician Search and MGMA report identifies a “loyalty formula” centered on respect and communication, fair workload policies, and compensation with clarity. As the recruiter, you can model that formula during pre-boarding and ensure the new hire experiences it from day one.
Within 24 hours of contract signing, send a personal message that goes beyond congratulations. Acknowledge the significance of their decision, reaffirm why they’re a great fit, and outline what they can expect in terms of communication frequency and next steps. If you will not be their primary contact, let them know who they will be hearing from going forward and reinforce that you will remain accessible to them throughout the transition.
The study found that regular check-ins—even brief ones—significantly improved physician preparedness and cultural alignment. In the report, 76% of physicians who received weekly communication rated their pre-boarding experience as “excellent” or “good” compared to 24% who received communication rarely. Those who received weekly or monthly communication reported feeling more prepared for the non-clinical aspects of the job.
Create a communication calendar that includes weekly emails during the first month, transitioning to bi-weekly touchpoints. Schedule monthly phone or video calls to address questions and maintain a personal connection, and be sure to communicate key events, such as credentialing completion or the 30-day countdown to the start date. Consistency matters more than length. A five-minute call every two weeks builds more trust than a single hour-long conversation three months before the start date.
More than two-thirds of physicians in the study said peer relationships were the most influential factor in their decision to stay. Recruiters can facilitate these early connections by arranging informal virtual coffee meetings with future colleagues, sharing team rosters with brief bios, coordinating pre-start shadow days or site visits, and creating opportunities for the new hire’s family to connect with other physician families in the community. Your role is to orchestrate these touchpoints, not necessarily to be present for each one. Follow up afterward to ensure they happened as planned and were a valuable use of time.
New physicians are simultaneously navigating credentialing, licensing, relocation, and life transitions. They also may be making decisions about schools, housing, and spousal employment. While they may not ask for help with these matters, offering resources demonstrates that the organization understands and cares about them as people, not just providers. Create a resource package that includes moving company recommendations, school district information, spouse career resources, local physician testimonials, and answers to common logistical questions. Share this early in the pre-boarding process, then check in periodically to see if they need additional support.
Credentialing, IT setup, and compliance requirements are necessary but notoriously frustrating. Rather than simply forwarding emails from other departments, add context and empathy. Explain why each step matters, provide realistic timelines and who to contact with issues, acknowledge when processes are cumbersome, and check in when you know they’re waiting on approvals. Simple messages like “I know credentialing feels like a black hole—I checked in with the team and your application is moving along as expected” can prevent anxiety and demonstrate that someone is watching out for them.
Pre-boarding isn’t just a “nice-to-have.” Research shows it’s a strong predictor of long-term engagement. Every interaction between signing and day one either builds trust or erodes it. Of course, recruiters are already juggling multiple responsibilities, and may not have the bandwidth to develop and manage a high-touch pre-boarding program. The data in the new report will help you make the case for investing time in this process. If you need to outsource less critical tasks or expand your capacity with a physician recruitment partner, the impact of pre-boarding on retention makes it a strategic imperative.
When you show up consistently during pre-boarding, you 1) validate the candidate’s decision to choose your organization over others, 2) model the communication and respect they can expect from leadership, 3) surface and address concerns before they become reasons to reconsider, and 4) build a foundation of trust that will carry through into their first years.
Consider developing a formal pre-boarding program that includes:
The recruitment process doesn’t end at contract signing—it extends through the entire pre-boarding period. In-house recruiters have both the skills and the relationships to ensure this critical window becomes a competitive advantage rather than a missed opportunity.
By maintaining consistent, personal, strategic communication during pre-boarding, you transform your role from talent finder to retention champion. You prove that the organization does what it says it will do. And you give every new physician a powerful reason to stay, long before they see their first patient. If we hope to lengthen the average tenure for early-career physicians, the 180-day investment in consistent pre-boarding communication isn’t optional—it’s essential.
As recruitment professionals, we all juggle shifting timelines, rising demand, and leaders who want answers. In the past, I relied heavily on instincts and experience but the moment I started using AAPPR’s Benchmarking Report(s), everything clicked. Data didn’t just validate what I “felt”; it made my decisions stronger, my conversations clearer, and my team’s strategy sharper. If you haven’t unlocked this year’s benchmarking data, you’re leaving game-changing insights on the table, here’s why every industry professional should be using it.
Before benchmarking, our annual planning felt a bit like educated guesswork. Now, the Search Dynamics report is the backbone of the entire process.
Key metrics like days-to-fill and specialty shortages allow us to set realistic goals, forecast challenges, and align resources with actual market conditions. For example, when the report showed APC days-to-fill increasing nationwide, it helped us explain to leadership that longer timelines weren’t performance issues, they were industry trends. That shifted the conversation from pressure to planning.
Every recruiter deserves targets that reflect the reality of their role. The benchmarking bundle makes that possible.
Using the Advanced Search Tool, we can filter by organization size, specialty, and geography so we’re comparing ourselves with true peers—not broad national averages that don’t reflect our environment. This lets us celebrate wins where we’re excelling, and pinpoint very specific areas—like offer acceptance rates or candidate pipeline strength, where we may need improvement.
It has brought more transparency, fairness, and buy-in across the team.
Here are the three metrics that consistently get leadership’s attention:
Days-to-Fill by Specialty
These metrics translate directly into organizational dollars. Showing leaders how a 60-day gap in days-to-fill impacts revenue or how high CPS might be tied to agency dependence turns recruitment into a business case, not just an operational task.
And the Compensation Report? It has been essential for advocating for equitable recruiter pay and retaining high performers.
One of the most impactful changes we made came from retention data. Even though our primary care days-to-fill matched national averages, our 24-month retention lagged behind peer organizations.
That insight redirected our entire strategy.
We realized the issue wasn’t recruitment at all, it was integration. Benchmarking gave us the evidence to build a year-long Provider Integration Program with mentorship, ramp-up support, and belonging initiatives. The result? Better retention and less pressure on our recruiters to re-fill the same roles.
Start with your strengths.
Use the calculators.
Pay attention to trends.
From shortening recruitment cycles to identifying burnout through locums spend to assessing your team’s diversity and belonging goals, the data shapes solutions you can implement now, not someday.
Bottom line? Benchmarking turned us from reactive recruiters into proactive workforce planners.
If you’re a recruitment professional who wants stronger leadership alignment, data-driven KPIs, and a clearer picture of what’s possible for your team, the benchmarking bundle is one of the most valuable tools you’ll use all year. To learn more about the AAPPR Benchmarking Reports visit aappr.org/benchmarking
Last Updated: October 28, 2025
Effective September 2025, a new policy imposes a $100,000 fee on certain new H-1B petitions. The H-1B visa allows companies to temporarily hire nonimmigrant foreign workers for certain roles, such as computer-related software development, architecture, engineering, and healthcare, among other fields. Computer-related technology jobs make up the majority (64%) of all H-1B visas issued, compared to just 4% in the healthcare sector in FY2024.
As of October 21, 2025, most healthcare hires changing status inside the U.S. (e.g., residents/fellows moving from J-1 or F-1 to H-1B, or H-1B extensions/transfers) are not subject to this fee under current guidance. The fee would apply primarily to new H-1B hires coming from abroad.
H-1B physicians keep doors open in communities where recruiting is hardest. A $100,000 fee on new petitions would sideline hires that hospitals and practices cannot afford, leading to longer vacancies, reduced services, and longer waits for patients. With demand rising faster than we can train new doctors, this policy deepens shortages and pushes costs higher for everyone.
– 64% of foreign-trained physicians practicing in Medically Underserved Areas or Health Professional Shortage Areas in 2021.
– Over the last 25 years, nearly 23,000 H-1B physicians worked in underserved communities.
– The average economic output generated by each physician nationwide is $3.2 million.
As of October 21, 2025, federal guidance says the $100,000 fee does not apply to people who are already living in the United States when you file. That includes amendments, changes of status, and extensions. It also does not apply if those same individuals later travel abroad for visa stamping or re enter on a valid H-1B based on the approved petition.
In practical terms, employers do not pay the fee for most in country cases—such as international medical graduates finishing residency or fellowship and changing to H-1B, or current H-1B employees extending or transferring.
The fee does still apply to new H-1B hires who are outside the United States and need to come to the U.S. to start work or training.
AAPPR is working with lawmakers and national health stakeholders to request the Department of Homeland Security issue clarifying guidance that all H-1B trainees and physicians should be exempted from this fee. While there have been media reports that all physicians might be exempt from this new, higher H-1B filing fee, this has not yet been confirmed and this latest guidance did not fully alleviate concerns from the healthcare sector.
There are two lawsuits challenging the proclamation which are currently ongoing in federal court. Global Nurse Force v. Trump alleges the Administration exceeded its authority under Section 212(f) and 215(a) by imposing the $100,000 fee. The second suit – Chamber of Commerce v. Department of Homeland Security – alleges the Administration exceeded its lawful authority by imposing this fee on the H-1B program that are typically set by Congress or through notice-and-comment rulemaking. Both cases are expected to play out over several months leading to uncertainty for employers.
There have been numerous reports of health systems and hospitals pausing their recruitment of H-1B physicians. This is an unfortunate, yet understandable response to this higher fee on H-1B visas, which most healthcare organizations cannot absorb. The consequences of longer hiring timelines or, worse, cutting back services will directly and negatively harm patients. AAPPR encourages your organizations to reach out with any questions or concerns with the proposal or interest in engaging at the federal level to info@aappr.org.
Please share this update with your internal teams and legal counsel who are navigating this issue for your organizations. We will continue to provide updates and are available to answer any questions or partner on ways to elevate this important issue and the significant disruption it will cause to health organizations.
The government shutdown is taking up all the oxygen in Washington D.C. as it stretches now into the third week of October. Democrats are making this shutdown about the expiring Affordable Care Act premium tax credits, which have helped millions of Americans maintain health coverage the last five years. The reality of this shutdown is that it is about the minority party seat at the negotiating table. This is a fundamental issue and a concern that goes back to the early days of the Republic. We will spare you the history lesson today, but you can read more about these latest political dynamics by clicking here.
Once the government reopens, there will be a flurry of activity on the legislative and regulatory side, including finalizing rules on Medicare payment for 2026 and addressing the lapsed authorization for various Medicare programs, including telehealth flexibilities.
Last month, President Trump signed a proclamation imposing a $100,000 fee for each new H-1B visa, arguing the new fee will encourage companies to hire more American workers. The H-1B program allows employers to hire nonimmigrant foreign professionals in specialty positions, and is used successfully by health systems, hospitals, and other health settings to address acute workforce shortages in areas that struggle to recruit American health workers.
The proposal set off immediate pushback, with concerns from hospitals that such a fee would be uniquely disadvantage the health industry, or worse, stop the recruiting of H-1B physicians with no suitable short-term alternative. We have joined stakeholders and Members of Congress highlighting the need for exemptions for the health care sector.
A lawsuit was filed by a group of unions and other organizations earlier this month challenging the decision to charge $100,000 fee, highlighting the disruption is far wider than just health or tech. We will continue to closely monitor this case and provide updates on this issue.
We have had discussions with congressional offices and other stakeholders this summer about ways to improve the Conrad 30 program. The Conrad 30 program grants each state 30 waivers each year to recruit international medical graduates (IMGs) completing their medical residency program on a J-1 visa. As a condition of their visa, these IMGs must practice in a rural or underserved area for at least three years. Each state may use up to 10 ‘flex’ waivers for sites outside designated shortage areas, provided those sites serve patients who reside in underserved areas.
We have discussed targeted flexibility for rural and other low utilization states that routinely use all 10 flex waivers but do not reach their overall cap of 30. Allowing such states a limited number of additional flex waivers the following year would better align the program with the realities of sparsely populated regions and persistent provider shortages.
We will continue to explore and discuss other flexibilities to strengthen this program and improve recruitment and retention of physicians. Please reach out if you have any ideas or questions!
AAPPR is continuing to advocate for improving Medicare reimbursement long-term, increasing the number of Graduate Medical Education (GME) slots, and improving the pipeline of physicians through leveraging international medical graduates (IMGs).
These latest announcements around changes to the H-1B program present serious obstacles, but they are being challenged in court while we and other stakeholders pursue carveouts for the healthcare industry. All this attention on how this impact the health care workforce is an opportunity to educate policymakers and others about the reality of confronting health workforce shortages. We will continue to elevate these issues and ensure our collective voices are heard.
Stay tuned for more updates across these issues.
If you’ve been in recruitment for any amount of time, you know the feeling. The constant demands. The pressure from leadership to fill roles yesterday. The late nights spent smoothing out onboarding details or making sure retention strategies actually stick.
We’ve all been there before. Feeling burned out, running on empty, wondering how long I could keep it up. And I know I’m not alone. Burnout among recruitment professionals is real, and it’s taking a toll on our teams and our organizations.
The turning point for us came when we realized something simple but critical: our recruitment, onboarding, and retention teams weren’t being compensated in a way that reflected the weight of their work.
We were competing with other health systems not only for physicians and providers, but also for skilled recruiters. Without competitive pay, transparency, and flexibility, we risked losing the very people who keep the entire system running.
So, we made the choice to reexamine our compensation structure. We turned to benchmarking data to understand where we stood. Seeing the 50th percentile numbers gave us the clarity we needed. It wasn’t about guesswork anymore; it was about facts.
We introduced more transparent salary ranges. We created incentive opportunities tied to meaningful goals. We put structures in place that allowed recruiters to feel recognized and rewarded.
But just like with providers, we knew compensation alone wouldn’t solve everything.
Here are a few things we tried that made a difference for our recruitment team:
These changes didn’t magically eliminate burnout, but they gave our teams breathing room.
We saw an immediate shift. Feedback from recruitment professionals turned positive. Leadership started noticing improved retention within our team. And most importantly, we stopped losing great people to burnout quite as quickly.
The lesson? You can’t build sustainable recruitment teams without a clear picture of what fair compensation and support really look like.
That’s why I believe so strongly in the 2025 AAPPR Recruitment Team Professional Compensation Benchmarking Report. It shines a light on industry trends that matter, where compensation stands today, what benefits are being offered, and how organizations are supporting the people behind recruitment, onboarding, and retention.
This report gives you the data you need to make the case for fair compensation, create systems that keep recruiters engaged and supported, and show leadership that investing in the recruitment, onboarding, and retention teams isn’t optional – it’s essential.
The healthcare recruitment landscape is evolving – and so are the expectations and compensation realities for physician and provider recruitment professionals. AAPPR’s 2025 Recruitment Team Professional Compensation Benchmarking Report offers timely insights into how organizations are attracting and retaining top recruitment talent.
Here are four key trends you need to know from the report, along with some data-driven highlights to help you evaluate your own strategies for compensation, incentives and other factors driving recruitment teams’ satisfaction.
Recruiter salaries are on the rise. In 2024, the median total cash compensation for internal recruiters reached $91,000, marking a slight increase from the previous year. However, experience is the most decisive factor in driving salary growth:
Interestingly, education level had minimal impact on compensation, showing that real-world experience often matters more than advanced degrees in this field.
Incentive bonuses are gaining traction in the recruitment space:
This uneven distribution suggests that many organizations have room to better recognize and reward the contributions of front-line recruitment staff, not just leadership.
The ability to work remotely has become a standard expectation among recruitment professionals, and it’s showing a measurable impact on both satisfaction and compensation.
When it comes to turnover, flexibility may help, but team structure matters too. In 2024, the average recruiter turnover rate was 20%, but that rate nearly doubled for departments with only one recruiter, highlighting the importance of support and collaboration in retention.
While experience remains the strongest predictor of recruiter pay, other factors are quietly shaping today’s compensation landscape:
Together, these findings highlight that compensation is not just a function of role or tenure. Where you work, how you work and the responsibilities you take on all play a measurable role in shaping your earning potential.
Recruitment teams are on the front lines of healthcare workforce development, and understanding these compensation trends is essential for attracting top talent, retaining experienced professionals, and ensuring team satisfaction and performance.
To purchase the full Compensation Report with detailed data, explore customized compensation benchmarks, and access tools like the Advanced Search, Compensation Calculator and infographics, visit the AAPPR Benchmarking Portal: www.aapprbenchmarking.com.
A new report from the Association for Advancing Physician and Provider Recruitment (AAPPR), Jackson Physician Search and LocumTenens.com reveals that in-house physician recruiters — those on the front lines of staffing healthcare organizations — are driven by purpose but often face systemic challenges that can hinder their ability to fully realize their mission.
The report, The Heart Behind the Hire: Exploring the Role of Purpose Among In-house Physician Recruiters, is a companion to an earlier study by Jackson Physician Search and LocumTenens.com, Is Medicine Still a Calling? Exploring Physician Attitudes About Purpose in Medicine. The recruiter research was conducted in July 2025, in partnership with AAPPR, and captures the voices of nearly 200 recruiters working inside healthcare organizations.
“Healthcare starts with hiring, and this research proves what we’ve long believed — our in-house physician and provider recruiters are not just administrative support; they are champions of patient access, community well-being and organizational culture,” said Carey Goryl, CEO, AAPPR. “With 87% feeling called to this work, recruiting and retention are most effective when these advocates for clinicians have a seat at the table.”
What recruiters need now
Surveyed recruiters identified three key enablers that would improve their ability to recruit and retain clinicians:
Additionally, in-house recruiters may benefit from recruiting partners who can extend the team’s capacity and provide tactical support in pursuit of shared goals.
“These findings aren’t just data points — they’re a call to action,” shared Tara Osseck, regional vice president, Jackson Physician Search. “Recruiters play a vital role as problem solvers, ambassadors and connectors. To maximize their impact, it’s important to include them early in strategic discussions, ensuring they have both visibility and voice in shaping hiring approaches, rather than being brought in only after decisions are made.”
The recruiter’s perspective is strategic — not transactional
As recruiting challenges intensify, leaders would be wise to treat recruiters as essential partners, not just service providers. That means surfacing insights beyond the usual metrics.
“Reporting activity is important, but sharing insights — such as why candidates decline offers, where we see drop-off in the process, and what pipeline data reveals — adds valuable context,” added Osseck. “That kind of transparency helps connect recruiting efforts to broader business outcomes, building trust and credibility with the C-suite.”
Creative solutions require collaborative leadership
Caroline Grounds, account director at LocumTenens.com, emphasized that a shift in mindset — both from recruiters and administrators — can unlock real innovation.
“We’re seeing recruiters who act not just as matchmakers, but as true strategic partners,” Grounds said. “The most effective ones are anticipating needs, building proactive pipelines and offering creative solutions. That kind of impact is amplified when leaders actively engage recruiters in broader planning and give them the room to contribute beyond transactional tasks.”
A hopeful blueprint
Despite systemic challenges, the research shows that internal recruiters remain hopeful:
“Every successful placement means better access for patients and continuity for communities,” noted Grounds. “Closing care gaps and improving outcomes is truly a shared mission, from the recruiter’s desk to the boardroom. Alignment across all levels of leadership helps deliver on that mission.”
The Heart Behind the Hire: Exploring the Role of Purpose Among In-house Physician Recruiters can be downloaded from the AAPPR website here.
About AAPPR
The Association for Advancing Physician and Provider Recruitment (AAPPR) is a nationally recognized leader in healthcare provider recruitment, onboarding, and retention. For more than 30 years, AAPPR has empowered physician and advanced practice provider recruitment leaders to transform care delivery in their communities by providing best-in-class practices, up-to-date industry knowledge, and evolving innovative approaches for hiring, onboarding, and retaining exceptional clinical talent. To learn more or to become an organizational member of AAPPR, please visit https://aappr.org/join-now.
About Jackson Physician Search
Jackson Physician Search is an established industry leader in physician recruitment and pioneered the recruitment methodologies standard in the industry today. The firm specializes in the permanent recruitment of physicians, physician executives and advanced practice providers for hospitals, health systems, academic medical centers and medical groups across the United States. Headquartered in Alpharetta, Ga., the company is recognized for its track record of results built on client trust and transparency of processes and fees. Jackson Physician Search is part of the Jackson Healthcare® family of companies. For more information, visit www.jacksonphysiciansearch.com.
About LocumTenens.com
LocumTenens.com specializes in optimizing healthcare staffing operations with flexible, hybrid and temporary placement of physicians, advanced practitioners, social workers and psychologists. With a presence in more than 90% of the nation’s top healthcare facilities and supporting 150 medical specialties, LocumTenens.com is dedicated to improving healthcare through innovative staffing solutions, connecting clients and clinicians to deliver exceptional and uninterrupted patient care. Founded in 1995, LocumTenens.com is the largest provider of locum tenens services in the U.S and a leader in the healthcare staffing industry, placing more than 7,000 clinicians annually who deliver care to more than 10 million patients. Headquartered in Alpharetta, Georgia, LocumTenens.com is part of the Jackson Healthcare® family of companies. Learn more at www.LocumTenens.com.
For More Information, Contact:
Kristen Myers for Jackson Physician Search
kmyers@jacksonphysiciansearch.com
Kelly Street for LocumTenens.com
Alysia Gradney for AAPPR
Last week, Senators Dick Durbin (IL) and Kevin Cramer (ND) re-introduced the Healthcare Workforce Resilience Act. HWRA would recapture up to 40,000 previously authorized but unused visas, allocating 25,000 for nurses and 15,000 for physicians. These visas would not be subject to per-country caps and would be issued based on priority date. This bill aims to help address nursing shortages across the country and assist doctors who are already practicing in the U.S. but have been affected by the green card backlog for over a decade.
AAPPR endorsed the legislation and a quote from Chief Executive Officer Carey Goryl was included in the press release and subsequent press. You can view the press release by clicking here.
Last month, Senators Joni Ernst (IA) and Amy Klobuchar (MN) re-introduced the DOCTORS Act. The DOCTORS Act requires states to report their unused physician waiver slots each year. The Secretary of State will total these unused waivers and redistribute them equally among states that reached their maximum cap (30) the previous year, with the total divided by three. This process helps retain foreign physicians in the U.S. without increasing the overall number of visas.
We supported this bill because we think it would more effectively increase the total number of IMGs practicing in the U.S. via the Conrad 30 program, and are working with the sponsors of the Conrad 30 bill to include this language in the bill.
Last month, the Department of Homeland Security (DHS) proposed a rule that would drastically change the way J-1 visa status is managed for physicians. Under the proposal, J-1 physicians would be admitted for a fixed period—up to the program end date or a maximum of four years—and would be required to file separate extension applications with USCIS for any additional training, transfers, or leaves, replacing the current system of automatic renewals.
For employers, this means facing new administrative and financial burdens, as well as the risk of training interruptions and disruptions to patient care due to potential processing delays. These changes are particularly concerning given that J-1 physicians already undergo extensive vetting and monitoring through their participation in accredited training programs, making the proposed additional USCIS oversight duplicative and potentially destabilizing for the healthcare workforce.
We are closely monitoring this proposal and encourage you to reach out if you or your organizations have any questions.
AAPPR submitted comments last week to CMS on the proposed 2026 Medicare Physician Fee Schedule. This annual rule sets Medicare reimbursement rates for the upcoming year and makes other changes that impact health delivery, such as to telehealth and hospital services costs. Our comments emphasized the need for sustainable, inflation-adjusted physician reimbursement to address ongoing workforce shortages and ensure access to care for Medicare beneficiaries.
We also urged CMS and Congress to adopt permanent reforms that will help recruit and retain physicians, particularly in rural and underserved areas, and safeguard the long-term stability of the Medicare program.
We will share our comments with members and also work closely with Capitol Hill offices and stakeholders to keep this issue top of mind for congressional leadership.
In today’s competitive physician recruitment landscape, early engagement isn’t just a strategy. As leaders in recruitment, we must prioritize building relationships with medical students (UME), residents, and fellows (GME) long before they’re ready to sign a contract. The new generation of Medical Students, Residents and Fellows eager to connect with organizations that align with their values and career aspirations.
As a physician recruitment leader, I’ve made it a strategic priority to build strong, early relationships with medical trainees starting in medical school (UME) and continuing through residency and fellowship (GME). Our approach is rooted in data, personalization, and long-term relationship-building.
We use physician workforce data such as specialty demand projections, geographic retention trends, and internal turnover analytics to identify high-need areas and proactively engage trainees in those specialties. For those of us working in academic settings, it’s essential to leverage internal resources program directors, coordinators, and GME leadership to initiate and maintain connections with trainees throughout their education.
We also collect qualitative data from conversations with trainees about their career intentions, visa needs, and geographic preferences. This information is regularly reported back to Senior Leadership to inform strategic planning and allow time to adjust recruitment strategies accordingly.
Case in point: We identified a Neurology fellow we hoped to retain post-training. Due to his visa status, we initially weren’t sure if a J-1 waiver was feasible. After assessing his prior international experience, we pivoted to pursue an O-1 visa, which required a strong portfolio. Over two years, we mentored him intensively encouraging research, publications, and collaborations with senior faculty to build a compelling case. This proactive, long-term strategy not only supported visa success but also deepened his integration into our system.
We’ve found that early engagement is most effective when it’s personal and consistent. Our outreach includes:
One example: we began engaging a third-year medical student through mentorship and informal meetups. By the time she entered residency, she was already aligned with our organization’s values and goals. This early relationship ultimately led to a successful hire post-residency, with a significantly shortened recruitment timeline.
We’ve seen a clear uptick in residents transitioning directly into full-time roles. Early engagement builds familiarity and trust, making our organization a natural choice when trainees begin evaluating job offers.
To further support retention, we’ve started offering signing bonuses and stipends during training, and we include committed trainees in clinical faculty processes early. This helps them feel part of the team well before their official start date boosting both morale and long-term retention.
Let’s face it: many trainees prefer to have their lives planned early. Signing them during training allows them to focus on education without the stress of a future job hunt.
To streamline outreach and transitions, we use:
Start early and start with relationships. Engage medical students and residents through meaningful, personalized interactions. Use internal academic partnerships to stay connected throughout training. Offer value beyond job opportunities and ensure your onboarding and transition processes are seamless. For international trainees, plan ahead for visa pathways and build strong mentorship portfolios. The earlier you build trust, the stronger your pipeline will be and the more likely you are to retain top talent.
Let’s face it: most trainees want their future mapped out early. When we engage them thoughtfully and consistently, we give them the confidence to focus on training, knowing their next step is secure. The extra effort and cost involved in early engagement are invaluable in today’s market, where waiting often means losing top talent to other organizations.
Beyond recruitment, this approach allows our organization to plan more effectively for retirement, growth, new service lines, and expanded patient care because at the end of the day, that’s the mission of every healthcare system: delivering exceptional care to the communities we serve.
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