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Dr. Jona Gorra received a J-1 visa to come to Delaware to practice medicine. Twenty-five years later, she has her own practice, DC Medical Services. | PHOTO COURTESY OF JONA GORRA[/caption]
In 1998, a newly trained physician from the Philippines arrived in southern Delaware. Then, as now, the state faced a shortage of doctors, and Dr. Jona Gorra was part of a visa program that brought young physicians from overseas.
Twenty-five years later, Gorra still serves in Sussex County where the need for physicians remains critical. Gorra started her own practice in Georgetown, DC Medical Services, later expanding it to Seaford and recruiting other doctors from overseas to help fill the local void. She’s even written a how-to guide and memoir called “It’s Only a Bump: Overcoming Challenges in a Small-Town Medical Practice.”
The J-1 visa program that allowed Gorra and many others to remain in the U.S. after their training remains a key part of dealing with a lingering need.
“We’ve got a shortage across the board for primary care as well as different specialties,” said Stacy Naylor, senior physician recruiter at Bayhealth, adding that the nonprofit hospital system is fortunate to be able to apply for international physicians in most of its coverage area.
There aren’t enough young doctors graduating from medical school, according to Wayne Smith, outgoing president of the Delaware Healthcare Association, the trade group for state hospitals.
“The J-1 visa holders provide critical access to care for people,” he said. “They’re part of the fabric of our care delivery system. And I think we could probably very much increase access to care if the federal government would allow a more liberal use of the J-1 visa program.”
In communities struggling with poverty, hospitals face financial challenges to offering primary care, Smith said. Rural areas also pose hurdles, and the J-1 visa holders are an important part of overcoming those, he said.
Those kinds of needs are exactly what the program is intended to address. It allows medical students from overseas to come to the United States to advance their studies. After they finish, they must then go home for at least two years to practice – unless they get a waiver to work in areas of high need. The federal government lists all of Kent and Sussex counties, as well as a swath across the urban centers of New Castle County, as high-need areas.
To get the waiver, the hospitals and physicians commit to a three-year term of service, but the young doctors may choose to stay afterward and often do. Data from the state of Delaware indicates that the bulk of such visa holders work at hospital systems, although some like Gorra also serve in private practice.
Results are encouraging. From 2016-18, nearly 60% of physicians in the J-1 visa program chose to stay after three years, according to state data – although the Department of Health’s Nichole Moxley, who analyzes data statewide, cautions that those numbers aren’t exact.
There’s a catch, and it’s the reason Smith and the DHA advocate for more visa waivers. Each state only gets 30. That means, Naylor noted, that the J-1 visa program has more of an impact in the small state of Delaware than in larger states like Pennsylvania or Texas. And Bayhealth has seen a very high percentage of them stay, she said.
It’s a system with a two-way benefit, Gorra said. She was drawn to study in the United States because of the advanced medical field here and the technology it offered. To give back to the country that gave her this opportunity, she wanted to serve in an area with a lack of doctors.
Others follow the same pattern and help provide a long-term way to address the shortage. Naylor mentioned a Bayhealth physician who told his wife they would be in Delaware for three years, but more than a decade later still practices here and is heavily involved in the hospital’s leadership programs.
Gorra started with zero patients, she said, and now has a practice in Georgetown with two junior partners, both of whom came through the J-1 visa waiver program. Two other doctors at their Seaford practice are also going through the J-1 program.
An ever-growing population downstate keeps up the demand, she said.
“I have started advertising and recruiting for another physician to help us out.” 
