As Health-Care Sector Seeks to Fill Pressing Labor Needs, New MPI Brief Examines Untapped Immigrant Talent Pool

WASHINGTON — The United States is facing a record 11.3 million job vacancies, with labor shortages in the health-care sector growing more acute as pandemic-imposed pressures on doctors, nurses and other medical staff add to longstanding mismatches in the supply and demand for these workers.

Even as growing concern is focusing on the country’s unfilled jobs across sectors and what this means for its economic competitiveness, there is an untapped pool of highly skilled immigrant professionals already in the United States who could help address gaps in the health-care sector. The Migration Policy Institute (MPI) estimates there are 270,000 immigrants with a medical or health undergraduate degree who are either working below their skill level or are out of the workforce, often because of barriers to the recognition of academic and professional credentials earned before they came to the United States.

In a new issue brief, MPI researchers explore the extent and nature of this skill underutilization—often dubbed “brain waste”—in Illinois, a state with the sixth largest immigrant population in the country and that boasts a long history of innovative immigrant integration efforts. While immigrants represent 14 percent of the Illinois population, they make up 37 percent of its physicians and 19 percent of its registered nurses.

Drawing on analysis of U.S. Census Bureau data and interviews with national, Illinois and Chicago experts from health professional organizations, workforce development, immigrant advocacy and education, MPI researchers Jeanne Batalova and Michael Fix find that Illinois presents a paradox. While immigrants play a vital role at all levels in the state’s health-care workforce, MPI estimates that 12,000 immigrants with health or medical degrees remain underemployed or out of work. Half of these underemployed immigrants live in Cook County.

The brief sketches the urgency of finding solutions to growing health-care workforce needs, noting that even as the Illinois population is aging, its health-care professionals are aging as well. Almost half of doctors in rural Illinois are age 55 or older, and statewide, about one-fifth of physicians and nurses are within ten years of retirement age. Pre-pandemic, projections indicated that Illinois would face a shortage of 6,200 physicians and 14,000 registered nurses by 2030. With medical personnel indicating high degrees of burnout and stress from the pandemic, those projected shortages likely will grow larger.

Among the study’s other findings:

• About 60 percent of Illinois’ underutilized immigrant health-care professionals obtained their degrees (typically in nursing) abroad, and 80 percent are women. About half of these underemployed immigrants are naturalized U.S. citizens, about one-fifth are green-card holders and slightly less than 10 percent are on various temporary work-related visas. One-quarter are unauthorized immigrants.
• Underemployed immigrant health professionals bring valuable cultural and linguistic competencies. The Philippines, India and Mexico are the top three countries of birth for underemployed immigrant health-care professionals in Illinois. About two-thirds are fully proficient in English, and most are bilingual, speaking languages including Tagalog, Spanish, Arabic, Polish and Chinese that are also spoken by Illinois residents who are Limited English Proficient and may encounter language barriers when seeking access to health care.

“This research points to several institutional and legislative opportunities to address the needs of underemployed, highly skilled immigrants in the health-care field,” Batalova and Fix conclude. “These approaches include supporting programs and internships that boost immigrants’ work skills and English proficiency in U.S. professional settings, expanding the options for internationally trained health professionals to work with restricted licenses and offering alternative career counseling for those who could pursue rewarding careers in adjacent fields such as clinical research.”

To tap the skills of immigrant health-care professionals, the Illinois government issued an emergency proclamation in January that would enable internationally trained doctors to serve in direct clinical roles, permitting them to practice under the supervision of a U.S. licensed physician through the duration of the COVID-19 emergency. And in March, the Illinois Legislature approved a bill creating a task force to examine ways to remove barriers to licensure and practice for licensed international health-care professionals and to increase the supply of culturally competent health-care providers statewide.

Read the issue brief, supported through a grant from the Walder Foundation, here: www.migrationpolicy.org/research/immigrant-health-professionals-illinois.

For a related dataset offering estimates of skill underutilization among adults with college degrees in medical and health sciences and services for the United States and select states, by nativity, race/ethnicity, gender, legal status, country of origin and proficiency in languages other than English, click here.

For all of MPI’s work on brain waste, visit: www.migrationpolicy.org/topics/brain-waste-credential-recognition.