The Centers for Medicare & Medicaid Services (CMS) has announced the award of 400 additional Medicare-funded residency positions to 135 hospitals across 37 states. While this development is primarily focused on physicians, it has significant implications for hospitals, healthcare staffing strategies, and international nurses seeking to build careers in the United States.
At VisaMadeEZ, an immigration law firm dedicated to helping healthcare organizations hire international nurses, we closely monitor these policy changes because they directly affect workforce planning, sponsorship strategies, and long-term talent pipelines.
CMS Residency Expansion: The Big Picture
The newly awarded 400 residency slots are part of a broader federal initiative to address the growing physician shortage in the United States. According to CMS, about 62% of these new positions will support primary care and psychiatry programs. This distribution is particularly important because:
- Primary care physicians are often the first point of contact for patients.
- Psychiatrists are in critically short supply nationwide, especially in rural and underserved areas.
These newly funded positions fall under the Consolidated Appropriations Act of 2021, with this being the fourth round of graduate medical education (GME) positions funded under that legislation and the first allocation under the 2023 version. With this latest round, CMS has now awarded more than half of the 1,200 new residency positions authorized by Congress.
The Physician Shortage and Why It Matters for Nursing
The Association of American Medical Colleges (AAMC) projects that the U.S. could face a shortage of up to 86,000 physicians by 2036. This looming gap is fueled by:
- An aging population with higher healthcare needs
- A significant portion of the current physician workforce nearing retirement
- Limited residency positions relative to medical school graduates
While physician training is the focus of these CMS-funded residency slots, the downstream impact on the entire healthcare system including nurses is substantial. When hospitals lack sufficient physicians, nurses often shoulder increased responsibilities, higher patient ratios, and more complex care coordination.
As U.S. hospitals expand their residency programs, many will simultaneously reassess their overall staffing models. That means demand for skilled registered nurses, including international nurses, will remain strong, especially in:
- Acute care hospitals
- Rural and medically underserved communities
- Behavioral health and psychiatric settings
- Primary care–aligned outpatient and community clinics
Medicare’s Role in Residency Funding and the Financial Pressure on Hospitals
Residency programs are a mandatory step in the training of physicians, but they are expensive to operate. While Medicare helps finance graduate medical education, it only covers part of the cost. Hospitals are left to:
- Fund a portion of the residency training themselves
- Absorb or supplement the cost of positions that exceed their Medicare cap
- Balance investments in physician training with their nursing workforce and other clinical staff
For healthcare executives, this creates a complex budgeting environment. Expanding residency programs can increase long-term physician supply, but it does not immediately solve staffing shortages. As a result, many facilities turn to international nurse recruitment as a more immediate and sustainable strategy to stabilize patient care.
Resident Physician Shortage Reduction Act of 2025: A Parallel Legislative Push
Industry groups and academic medical centers are urging Congress to pass the Resident Physician Shortage Reduction Act of 2025, which would:
- Add 14,000 Medicare-supported residency slots
- Phase in these positions over seven years
- Further expand training capacity, particularly in areas with the most severe shortages
If enacted, this law would significantly expand the physician pipeline. However, even with increased residency positions, training a physician takes many years. In contrast, international nurse recruitment can often provide hospitals with qualified, experienced nurses within a much shorter timeframe, especially when supported by streamlined immigration strategies and proper legal guidance.
What This Means for International Nurses
For internationally educated nurses, these policy shifts highlight a key reality: the United States has long-term, system-wide workforce shortages not just in nursing, but across the entire care team. The physician shortage, combined with an aging nursing workforce and increasing patient demand, ensures that:
- The need for international registered nurses in the U.S. will remain strong for the foreseeable future.
- Hospitals will continue to rely on international nurse recruitment to maintain safe staffing levels while physician training capacity slowly expands.
- Healthcare organizations that build a stable pipeline of global nursing talent will be better positioned to weather ongoing workforce challenges.
If you are an international nurse considering a U.S. nursing career, this environment may provide:
- More opportunities with hospitals willing to sponsor qualified foreign nurses
- Positions in a variety of settings, from large academic medical centers to community hospitals
- Long-term career stability in a high-demand profession
What This Means for U.S. Hospitals and Healthcare Employers
For hospitals and health systems, the CMS expansion of residency slots and the proposed Resident Physician Shortage Reduction Act are important but partial solutions. They address physician supply over the long term, but they do not resolve immediate staffing pressures on nursing units.
Many organizations are already:
- Expanding international nurse recruitment programs
- Partnering with immigration law firms that specialize in healthcare, like VisaMadeEZ
- Using a blended staffing model that combines domestically trained nurses, international nurses, and gradually increasing numbers of resident physicians
From an operational and legal standpoint, healthcare employers must navigate:
- Visa categories suitable for international nurses (such as immigrant visas/EB-3)
- Prevailing wage, credential evaluation, and licensure requirements
- Complex timelines that intersect with broader workforce planning and residency expansion
A strategic, well-managed immigration program allows healthcare organizations to:
- Stabilize nurse staffing even as physician workforce plans evolve
- Improve continuity of care, patient satisfaction, and quality metrics
- Reduce long-term reliance on costly temporary staffing arrangements
How VisaMadeEZ Supports Healthcare Organizations and International Nurses
As an immigration law firm focused on helping healthcare organizations hire international nurses, VisaMadeEZ is uniquely positioned to support both sides of this evolving landscape.
For healthcare employers, we:
- Design comprehensive immigration strategies aligned with workforce and residency expansion goals
- Assist with recruitment-driven immigration planning, including EB-3 immigrant visas for nurses
- Provide end-to-end case management, from petition filing to consular processing and onboarding
- Help ensure regulatory compliance throughout the immigration process
For international nurses, we:
- Offer guidance on U.S. immigration options for nurses
- Collaborate with employers to facilitate sponsorship and placement
- Explain each step of the process in clear, practical terms
- Help you understand how your nursing career fits into the broader U.S. healthcare system
Looking Ahead: A Dual Path to Solving Workforce Shortages
The latest CMS allocation of 400 new Medicare-funded residency positions is one more step toward expanding the physician workforce. Legislative initiatives like the Resident Physician Shortage Reduction Act of 2025 may further increase residency opportunities and strengthen the long-term physician pipeline.
However, these measures do not diminish the immediate and enduring need for international nurses. Instead, they underscore that solving America’s healthcare workforce crisis requires a dual strategy:
1. Grow the number of U.S.-trained physicians and residents.
2. Build a robust, sustainable pipeline of skilled international nurses to support hospitals and patients now.
VisaMadeEZ stands at the intersection of immigration law and healthcare staffing, helping hospitals bridge critical gaps while offering international nurses a pathway to build rewarding careers in the United States.
Need Help Hiring International Nurses or Starting Your U.S. Journey?
If you’re a healthcare organization seeking to hire international nurses, or an overseas nurse interested in working in the U.S., our team is ready to help.
Contact VisaMadeEZ to discuss:
- Immigration options for international nurses
- Sponsorship strategies for hospitals and health systems
- How to align your staffing plans with broader changes in U.S. healthcare policy
Together, we can turn today’s workforce challenges into long-term opportunities for hospitals, nurses, and the patients who depend on them.
