The United States is facing a physician shortage that is worsening by the day, with projections from The Association of American Medical Colleges estimating that the shortage will approach 100,000 physicians by 2036. This shortage is even more acute for non-native English speakers and minority populations, many of whom already live in underserved areas. Physicians licensed abroad can provide culturally and linguistically appropriate care to these communities, but traditional state licensure pathways, which require U.S.-based residency, have historically limited their ability to do so. However, one California program is providing an alternative, showing that international talent can help address the health care needs of the state’s rural Latino population without onerous residency requirements.
According to data from the Health Resources and Services Administration, 76 million Americans live in primary care Health Professional Shortage Areas (HPSAs) across the country, with California having more HPSAs than any other state. In California, 70 percent of those living in HPSAs are Latino, African American, or Native American. For Latinos, California’s largest ethnic group, finding linguistically and culturally appropriate care in these shortage areas is almost impossible.
There are only 62.1 Spanish-speaking physicians for every 100,000 Spanish-only speakers in California, compared to 344 physicians per 100,000 English speakers. In areas where physicians are already scarce, Spanish-speaking patients often face a difficult choice: they must either communicate through translators—many of whom are family members rather than trained professionals—or forgo medical visits altogether. Those who choose the former risk their concerns and care getting lost in translation, and those who choose the latter may never receive any care at all.
To start to address this problem, California has set its sights south of the border. The Licensed Physicians from Mexico Pilot Program (LPMPP) allows the Medical Board of California to issue up to 30 three-year nonrenewable licenses to physicians from Mexico specializing in pediatrics, OB/GYN, family medicine, or internal medicine to practice at nonprofit community health centers. Notably, LPMPP participants are not required to repeat their residencies in order to begin treating patients. Since the first physicians arrived as part of the program in 2021, staff interviews have indicated an increase in patient trust and satisfaction resulting from physicians’ fluency in their native language. Some patients have even reported seeing a doctor for the first time in decades after hearing about the program.
The benefits of the LPMPP, however, go beyond just language congruence. Clinic staff have also observed that the participating physicians bring a cultural awareness to their roles that other physicians may struggle to provide. Because of their years of practice in Mexico, these providers are familiar with the religious beliefs, traditional healing practices, slang terms, and dietary habits of the Latino communities they serve. This familiarity allows them to understand patient complaints, provide treatment recommendations that work within their patients’ cultural backgrounds, and create trust and mutual respect within the physician-patient relationship. If patients trust their providers, they are more likely to be satisfied with their care and follow prescribed treatment plans, improving overall health outcomes.
The demand for culturally competent care extends far beyond California. There are underserved minority communities across the United States that lack access to physicians who speak their language, understand their customs, and can provide quality, trustworthy care. Licensed physicians from around the world already possess the necessary medical, cultural, and linguistic knowledge to meet this need. However, many states still require these experienced professionals to waste valuable time repeating their residency training.
With the growing physician shortage looming, time is something that underserved populations in this country simply do not have. California’s LPMPP provides a blueprint that should be expanded to include additional countries and allow health care facilities across the state to sponsor doctors on a pathway to full licensure. Likewise, other states should follow a similar course to create new licensure pathways for international physicians and bring much-needed culturally competent care to America’s increasingly diverse communities today.
Isabel Soto is the policy director for The LIBRE Initiative. Morgan Lipman is a student at the University of Texas and recently completed a public policy internship with the Cicero Institute.
