Impact of current U.S. visa policies on Nigerian medical students and physicians seeking graduate medical education

Abstract

Nigerian medical trainees increasingly pursue graduate medical education abroad. Recent changes in U.S. visa policy, including revised reciprocity rules, may be reshaping migration intentions. Despite widespread concern, empirical evidence on the impact of these policies on Nigerian applicants remains limited. We conducted a descriptive, cross-sectional online survey of Nigerian medical students and graduates preparing for, or expressing interest in, U.S. residency training. Data were analyzed using SPSS v25. Logistic regression was employed to identify predictors of high motivation to pursue U.S. graduate medical education. Among 455 respondents, 71.6% identified U.S. training as a primary career goal. Awareness of the July 2025 visa policy was moderate to high, with 52.1% reporting reduced motivation due to visa restrictions. Approximately 19.1% of examinations were delayed, and 31.6% explored alternative destinations, most frequently Canada and the United Kingdom. Respondents reported substantial financial burdens, and only 5.5% were willing to travel internationally during residency due to concerns about reentry. Symptoms of anxiety were prevalent, with 20% reporting moderate-to-severe levels. High motivation was independently associated with identifying U.S. training as a primary career goal and greater financial investment, whereas prior visa denial was negatively associated with motivation. U.S. policy changes were associated with decreased motivation among Nigerian students and trainees to pursue residency in the United States. These changes were linked to increased psychological distress and diversion toward alternative destinations. Transparent, equitable, and predictable immigration processes may be critical to sustaining recruitment of international medical graduates and supporting global health workforce mobility.