The Trump administration has launched an inquiry into allegations that a New York hospital system awarded the overwhelming majority of its medical residency positions to foreign workers while leaving American applicants with minimal opportunities.
U.S. Department of Labor Inspector General Anthony D’Esposito has publicly demanded that Rochester Regional Health provide a complete accounting of its residency hiring practices following claims that 80 of 82 residency positions went to doctors holding H-1B or J-1 visas.
“Show us the numbers,” D’Esposito stated. “How many residency slots went to H-1B and J-1 visa holders? How many American applicants got a fair shot?”
The Inspector General indicated that President Trump’s executive order on visa programs has placed such practices under heightened federal scrutiny. He further stated that if evidence emerges that the system is being manipulated, his office will coordinate with Vice President Vance’s White House Task Force to Eliminate Fraud to address the matter.
While the specific claim regarding the 80-to-2 ratio has not been independently verified, available data suggests Rochester Regional Health maintains substantial reliance on foreign medical professionals. Department of Labor records indicate Rochester General Hospital filed 95 H-1B Labor Condition Applications in 2025 and an additional 39 in 2026.
Since 2016, the hospital has filed 421 H-1B applications covering 634 positions, according to data compiled by federal disclosure databases. These positions include classifications such as Medical Resident Physician, Medical Resident, and Medical Fellow Physician. The records show 156 Medical Resident Physician positions and 43 Medical Resident positions among the hospital’s H-1B-sponsored roles.
According to the American Medical Association’s residency database, Rochester General Hospital’s Internal Medicine residency program maintains 72 residents, distributed as 24 residents in each postgraduate year. The program explicitly lists J-1 visa sponsorship for international physicians.
The hospital system’s dependence on foreign workers extends beyond physician positions. Earlier this year, approximately 150 international nurses had relocated to Rochester through the hospital’s recruitment program, with another 80 awaiting visa processing. Hospital officials have described international recruitment as a fundamental component of their workforce strategy.
The controversy raises broader questions about whether American medical graduates are being systematically disadvantaged in the residency matching process. Medical residencies represent a critical bottleneck in physician training, as doctors cannot practice independently without completing this postgraduate training.
Critics of current visa programs argue that hospitals may prefer foreign workers due to lower salary expectations or extended service commitments tied to visa sponsorship. Supporters contend that international medical graduates help fill positions in underserved areas and specialties where American applicants are insufficient.
Rochester Regional Health has not yet responded to requests for comment or provided the detailed breakdown of residency hiring that federal officials have demanded. The administration’s investigation will determine whether the hospital’s practices violate the intent of visa programs designed to address genuine labor shortages rather than substitute for American workers.
Related: GoFundMe Shuts Down Campaign for Elderly Texas Couple After Raising Nearly $290,000
