Foreign Medical Residents have gotten through medical school. They’ve applied to residency programs and been offered a job at a US hospital.

But for some of the 3,814 non-US citizens who graduated from foreign schools and who won coveted residencies in the United States, it’s unclear whether they’ll be able to start work on time in the summer.

That’s because a program that allows employers to fast-track H-1B visa applications for their employees has been suspended as of Monday. US immigration officials announced the change just a month ago — and Match Day, when new residents learn where they will be placed was March 17 — leaving some hospitals rushing to figure out who needed this kind of visa and to apply before “premium processing” would no longer be an option.

“They are battling against the clock,” said Claire Ayer of her staff in the Partners HealthCare Office for International and Professional Students, which handles visa applications for the international staff and students of its Boston-area hospitals, including Massachusetts General and Brigham and Women’s. She said they have been working evenings, weekends, and early mornings to get “premium processing” for as many international residents as possible before Monday.

The faster turn-around costs $1,225 per applicant, but it makes a difference. With “premium processing,” a visa application is answered in 15 days. Without it, the evaluation can take more than six months — and the government does not allow you to apply for an H-1B visa more than six months in advance.

The change comes on the heels of President Trump’s executive orders imposing a temporary travel ban on people from a handful of majority-Muslim countries, actions that have been put on hold by federal judges. Some medical students with Iranian citizenship who had been hoping to do their residency training in the United States “have changed their destination to Canada or European countries as coming to the US seems almost impossible from now on,” said Dr. Sanaz Attaripour, a neurology resident at Drexel University, who founded a Facebook group for Iranians applying for American residencies.

Overall this year, slightly fewer foreign medical school graduates applied to US residency programs.

“I’ve been doing immigration for a long time, and I’ve never seen a more inhospitable environment,” said Ayer.

The irony is that the U.S. Citizen and Immigration Services says it is suspending “premium processing” for the exact reason that people like it so much: the long wait times of the normal H-1B process. The suspension, the agency suggested, would allow its staff to process those applications that have been left by the wayside as “premium processing” cases get first dibs, creating a backlog.

But some say the move’s timing was either tone-deaf or punitive.

“It’s the busiest time of hiring,” said Brain Groves, director of the International Students and Scholars Office at the University of California, San Francisco. “Reasonably, if they wanted to work on the backlog, the time to do it would be during a slow period, not when going into the busiest time.”

Not all international medical residents come to the United States on an H-1B visa. Most get a J-1, which offers “cultural or educational exchange opportunities.” But some either aren’t eligible for a J-1, or don’t want that type of visa because it requires that you return to your home country at the end of your training for two years. And the only way to get around the mandatory trip back home is to work in an underserved community — which in turn requires that you get an H-1B.

“There’s likely going to be many rural clinics that are going to have staffing problems,” said Groves.

A CIS spokesperson told STAT that the agency can still expedite an application if it is an emergency situation, if a delay will cause severe financial loss, or if the application involves a non-profit and the request will further American “cultural and social interests,” among other criteria.

Immigration officials would like to see all wait times reduced — according to CIS, H-1B visas take, for example, more than eight months to process in California, and more than 11 in Vermont — but some worry about the consequences of the suspension.

Even international medical students who have come to American medical schools could be affected. They often use an extension on their student visa for their first year of residency before transitioning to an H-1B for their second. And if residents at any stage aren’t able to start work when they are supposed to, that could potentially cause staffing problems in hospitals.

“How are you going to cover their patients?” Ayer asked.

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