According to Nyapati Raghu Rao, an Indian-born chairman of psychiatry at Nassau University Medical Center and former chairman of the American Medical Association's international medical graduates governing council said, "It doesn't cost the taxpayers a penny because these doctors come fully trained," and also "It is doubtful that the U.S. can respond to the massive shortages without the participation of international medical graduates. But we're basically ignoring them in this discussion and I don't know why that is."

Another challenge every immigrant physician faces is obtaining the residency permit. This process is said to begin by submitting an application to a private nonprofit organization to verify medical school transcripts and diplomas. There is test to check English language skills; this is a must for every foreign national physician. Along with this the candidates must appear for three of the United States Medical Licensing Examination, also have to get a recommendation letter which can be obtained after volunteering or working in a hospital, clinic or research organization. These things might fetch them a resident visa or a work visa. This whole process can go up to a decade, for the lucky few who make it through the whole process.

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