Donald Trump is at it again, making reckless, ill-conceived policy changes that threaten to cripple American institutions. This time, he’s set his sights on healthcare. In a move that can only be described as catastrophic, Trump’s administration is jacking up the cost of an H1-B visa from under $5,000 to a staggering $100,000 annual fee. And in an already strained medical system, that’s a death blow.
On the latest episode of Meidas Health, host Dr. Vin Gupta sat down with his longtime colleague and friend Dr. Nick Mark to unpack what this means in practice. Dr. Mark is not just an ICU physician—he’s a respected educator and communicator whose viral tweet on the policy has already been viewed more than 8.5 million times. His warning was stark: “This will be absolutely devastating in the medical field. ~30% of residents are international medical graduates & ~10k of 43k residency spots are filled by docs with H1-B visas. Previously the H1-B fee was <$5,000. No hospital will pay a $100k fee for a $55k resident salary.”
For those unfamiliar with how U.S. medical training works, residency is the critical stage after medical school where doctors in training provide frontline care while honing their skills. Every year, about 28,000 U.S. medical graduates compete for roughly 38,000 residency positions. That 10,000-person gap? It’s filled by international medical graduates, many of them on H1-B visas.
Without them, hospitals, particularly rural and underserved ones, would simply collapse. These international doctors disproportionately enter primary care fields like family medicine and pediatrics, where U.S.-trained doctors often shy away because of lower pay and grueling hours. In many small towns, the only pediatrician or family doctor available is a foreign-trained physician.
Now Trump wants to impose a six-figure toll just to allow these doctors to work in America. For a hospital paying a resident a $55,000 salary, a $100,000 visa fee isn’t just absurd. It’s impossible.
Dr. Mark and Dr. Gupta laid out the dire financial landscape hospitals are facing. Nearly half of rural hospitals in America are already in the red. Hundreds more are teetering on the edge of closure. Medicaid cuts have slashed their budgets, while large corporate hospital chains and venture capital firms are consolidating the industry, stripping pediatric wards and prioritizing profit over patients.
Add Trump’s new H1-B policy on top of this, and you’re talking about a system-wide implosion. Hospitals would be forced to slash residency programs, turn away foreign doctors, and ultimately close their doors. That means fewer doctors in ERs, fewer pediatricians, fewer family doctors—and longer waits, sicker patients, and needless deaths.
Predictably, the MAGA chorus has responded with its usual mix of racism, nativism, and ignorance. Some claim international doctors are “taking spots” from Americans. Others sneer that foreign medical graduates are less qualified. Both are lies.
Dr. Mark dismantled these myths with facts. Foreign-trained doctors don’t take medical school spots. U.S. medical schools overwhelmingly admit U.S. citizens and residents. International doctors face a harder path, with stricter competition for residency slots and extra training requirements. Many have already completed residencies abroad, making them more experienced than their U.S. counterparts. And the spots they fill are overwhelmingly in underserved areas and in primary care, jobs many U.S. grads simply don’t want.
In short, America doesn’t just benefit from these doctors. We depend on them.
Even Trump’s own administration seems unsure of what it’s doing. First they floated applying the $100K fee across the board. Then they suggested maybe it would only hit new visas. Now there are rumors physicians might be excluded, but no clarity, no consistency, and no plan.
As Dr. Mark observed, this is Trumpism in a nutshell: “They’re kind of making it up as they go along.” And while they fumble, lives hang in the balance.
This isn’t happening in a vacuum. It’s part of a broader assault on science, medicine, and public health. From rolling back vaccine programs to gutting clean water protections, Trump has made clear he’s willing to sacrifice decades of progress in exchange for short-term political gain and xenophobic applause lines.
What’s at stake here isn’t just the careers of foreign doctors. It’s whether your child has a pediatrician. Whether your grandmother can see a family doctor in her rural town. Whether the ER has enough residents on call when you show up with chest pain at 2 a.m.
Trump doesn’t care about any of that. He cares about soundbites, scapegoats, and stoking resentment.
The conversation between Dr. Gupta and Dr. Mark underscored why independent platforms like Meidas Health exist. While the federal government is run by people who couldn’t pass a freshman biology class, true experts are stepping up to explain the stakes, debunk the lies, and fight for patients.
Dr. Mark’s viral tweet struck a nerve because it was clear, factual, and terrifyingly real. Millions of Americans saw it and understood: Trump’s reckless policy isn’t just about immigration. It’s about whether you or your loved ones can get medical care when you need it.
And that’s why we can’t afford silence. Every one of us has a stake in this fight. If Trump’s scheme succeeds, it won’t just be foreign doctors who suffer. It will be every patient in America.
Watch our report above or listen on the MeidasTouch Podcast on Apple Podcasts and Spotify. Support initiatives like Meidas Health by joining right now as a paid subscriber to this Substack. Scroll down for links to all past episodes of Meidas Health.
Emergency Bonus Episode - Trump Purges CDC: YouTube | Substack
Emergency Bonus Episode - Trump Panel Blows Up: Apple | Spotify | YouTube
Emergency Bonus Episode - Trump’s Deadly Autism Lies: YouTube
Dr. Nick Mark on H-1B Visas and The Future of American Medicine: Apple | Spotify
