A request for exemptions and expedited processing for physicians and trainees
Barriers are preventing international medical graduates—students, residents, fellows, researchers, and practicing physicians—from entering the U.S. or remaining in the U.S. lawfully to continue their training or practice.
That was the message of an April 8 letter signed by 24 medical organizations, including the CAP, sent to secretary of state Marco Rubio and Homeland Security secretary Markwayne Mullin.
The 24 organizations urged the State and Homeland Security departments “to use existing authorities to prioritize and expedite immigration adjudications for this highly skilled physician population upon whom so many Americans rely.”
Residency programs are losing trained physicians midyear, they wrote. When a single resident or attending physician is sidelined, rural communities and medically underserved areas lose access to care. Sixty-four percent of foreign-trained physicians practice in medically underserved areas or health professional shortage areas, they noted.
The organizations requested that the two departments take coordinated action to address the crisis by:
- Establishing a formal medical national interest exemption. A special national interest category could exempt physicians and trainees from adjudicative holds or prolonged administrative processing once required security and background checks are completed.
- Implementing mandatory expedited processing for physician cases. Visa and immigration benefit applications filed by physicians and medical trainees should be prioritized for expedited review, they say, with adjudication timelines aligned with fixed academic start dates and patient care obligations.
- Providing guidance to adjudicators and consular officers to clarify that trainees and physicians warrant heightened processing priority and that extended holds should be avoided absent individualized security concerns.
- Improving transparency and communication. Physicians, training programs, and employing hospitals should be able to learn the status of a case, anticipated timelines, and the required steps to resolve pending applications.
With regard to the State Department, “physicians and trainees abroad are encountering extended and unpredictable delays in consular visa processing, particularly administrative processing that stretches for months without clear timelines or pathways for resolution,” the letter said. For trainees, it said, these delays often “result in forfeited residency positions, permanently derailed training, and lost workforce capacity for U.S. hospitals.”
Results published of autonomous robotic phlebotomy use
The Vitestro autonomous robotic phlebotomy device was found in a multicenter trial to have a favorable performance and safety profile (Giesen LFP, et al. Clin Chem. Published online April 10, 2026. doi.org:10.1093/clinchem/hvag029).
The ADOPT trial, funded by Vitestro, had two cohorts. In the first, each enrolled participant underwent manual phlebotomy in addition to autonomous robotic phlebotomy performed by the device (ARPD). Post-phlebotomy handling and analysis were performed according to the local laboratory protocol, and paired samples were processed together. The primary endpoint was test result comparability among the 119 participants (of 153 enrolled) for whom paired samples were available for within-subject comparison.
In the second cohort, venipuncture was performed in 1,633 participants by the ARPD and samples were processed per local laboratory procedures. The primary performance endpoint was first-stick success rate.
In cohort No. 1, “None of the selected laboratory tests showed statistically significant differences in results between ARPD- and manually collected samples, indicating analytical equivalence,” the authors write.
In cohort No. 2, the overall first-stick success rate was 94.5 percent. In participants with difficult venous access, it was 92.7 percent. In participants age 65 and older, it was 93.4 percent, and in obese participants, it was 97.4 percent.
The overall adverse event rate with the ARPD was 0.6 percent; the authors report that all events were self-limiting and of mild severity. The rate of hemolyzed ARPD samples was 0.3 percent, which the authors note is low and “may reflect the standardized nature of the ARPD procedure.”
The ARPD inserts a needle when a suitable vein is identified. In six percent (110) of the 1,743 participants who completed ARPD screening, no suitable vein for automated venipuncture was identified and no venipuncture was performed.
The study was conducted in the outpatient phlebotomy departments of one academic and two regional teaching hospitals in the Netherlands between May 1 and Sept. 30, 2025. All participating laboratories were accredited according to ISO 15189:2022: Medical Laboratories—Requirements for Quality and Competence.