Immigrant Physicians Filled Crucial Nephrology Roles
A new Migration Policy Institute report details how foreign-trained doctors sustain the U.S. kidney care workforce.
Updated on Oct. 8, 2026 in Nursing Jobs
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Foreign-trained physicians currently account for over 50 percent of the U.S. nephrology workforce, playing a vital role as the nation faces significant specialist shortages. Researchers warn that current immigration policies could exacerbate these gaps as demand for kidney care continues to climb.
Why it matters
The reliance on international medical graduates is essential for rural and underserved areas, yet shifting federal visa and financing policies create uncertainty for future recruitment. With nearly three-quarters of U.S. counties lacking a nephrologist, the stability of this workforce is critical to patient outcomes.
As of 2026, 33.5 percent of nephrology fellowship positions remained unfilled, signaling growing recruitment hurdles. Projections indicate that the total supply of nephrologists will satisfy only 85 percent of national demand by 2038.
The players
Migration Policy Institute
This nonpartisan think tank based in Washington, DC, conducts research and analysis regarding immigration and refugee policy.
The details
The study utilized nephrology as a case study to illustrate broader workforce dynamics, noting that training a specialist requires at least 13 years of post-secondary education. While international medical graduates represent over a quarter of all active physicians in the United States, their concentration is particularly high in fields like nephrology, where they often serve in federally designated Medically Underserved Areas.
Timeline
In 2023, 72 percent of U.S. counties had no nephrologist.
In 2024, foreign-trained doctors made up 54 percent of practicing U.S. nephrologists.
As of late 2025, more than 866,000 people were living with kidney failure.
In 2026, 33.5 percent of nephrology fellowship positions went unfilled.
By 2038, the nephrologist supply is projected to meet only 85 percent of demand.
Market Landscape
This analysis updates the workforce figures previously established by the Migration Policy Institute's physician workforce database. The findings highlight a growing industry dependence on international talent to mitigate domestic physician shortages.
Patients in rural and underserved counties may face longer wait times or travel further for specialized kidney care due to the lack of local practitioners. These workforce gaps also create pressure on hospitals to manage rising caseloads as the number of individuals with kidney failure increases.
The takeaway
The U.S. healthcare system faces a significant challenge in balancing specialized medical demand with a diminishing pipeline of trained professionals. Ensuring the integration of international medical graduates remains a primary strategy for maintaining access to essential treatments.
Further reading
Learn more about the evolving landscape of medical staffing in the United States Nursing Jobs section.
More information
Read the full physicians in changing immigration policy report to understand the current workforce data.
Source note: This article includes information reported by Migrationpolicy.
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