My whole life is on pause
In a nation built on the labor of those who arrived from elsewhere, the United States has drawn a narrow exception into its sweeping immigration freeze — allowing physicians to request review of stalled applications, while thousands of researchers, entrepreneurs, and families from dozens of countries remain suspended in legal and human limbo. The concession, won through months of advocacy, acknowledges the irreplaceable role of foreign-trained doctors in communities that would otherwise go without care, yet it offers no guarantee of resolution, no timeline, and no comfort to the many others left behind. It is a small door opened in a very large wall — and even those permitted to knock are not assured anyone will answer.
- Doctors like a Libyan pulmonologist serving rural Indiana face visa expirations in months, with canceled interviews and no government communication despite a promised exemption.
- The exemption allows physicians to request case review but guarantees nothing — no approvals, no deadlines, no protection from detention at immigration appointments.
- An Iranian radiologist who sued the government for a decision received one: a denial she believes was retaliatory, leaving her outside the exemption's reach entirely.
- Thousands of immigrants from 39-plus countries — unable to work, obtain insurance, or leave the US without permanent bars — describe their lives as completely on pause.
- Immigration attorneys say the pattern is deliberate: make legal residency unlivable enough that people choose to leave on their own.
Dr. Faysal Alghoula has spent years as one of the only pulmonologists serving rural communities across Indiana, Illinois, and Kentucky — where patients wait four to five months for a specialist. When the Trump administration suspended immigration processing for dozens of countries deemed high-risk, his green card renewal was caught in the freeze. His visa expires in September.
After months of pressure from medical organizations and immigration lawyers documenting physician shortages, the administration quietly carved out an exception: doctors could request review of their stalled cases. For Alghoula, it seemed like a lifeline. But his June interview was canceled without explanation, he has received no communication from federal officials, and he remains afraid to attend any future appointment after hearing of immigrants detained at renewal interviews. The exemption permits a request — it promises nothing more.
The broader suspension continues for thousands of others from 39-plus countries, including Iran, Afghanistan, and Venezuela. Caught in this limbo, they cannot work legally, cannot obtain health insurance or driver's licenses, and cannot leave the US without triggering permanent deportation bars. The freeze was first imposed after an Afghan citizen attacked two National Guard members; it has since expanded to cover visa applicants from more than 75 countries.
Dr. Zahra Shokri Varniab, an Iranian radiologist and researcher, sued the government for a decision on her green card. A judge ordered a review. Officials reviewed her case — and denied it. She believes it was retaliation. Because her case has already been decided, the physician exemption does not apply to her. She is fighting in court.
For Iranian immigrants, the uncertainty carries an additional weight: their home country is in active conflict, internet blackouts make family contact nearly impossible, and financial support from abroad has dried up. Kaveh Javanshirjavid, a 41-year-old doctoral candidate in agriculture, has been borrowing from friends since January, when a suspended work authorization prevented him from starting a laboratory position. His wife, also Iranian, faces the same wall when she graduates this summer.
An immigration attorney in Memphis described the strategy plainly: the accumulation of bans and suspensions is designed to make legal residency so untenable that people leave voluntarily. The Department of Homeland Security did not respond to questions. The physician exemption, for all its symbolic weight, leaves the essential uncertainty intact — and for the thousands it does not cover, nothing has changed at all.
Dr. Faysal Alghoula, a Libyan-born pulmonologist and intensive care physician, has been treating roughly a thousand patients across rural Indiana, Illinois, and Kentucky for years. But last month, his world narrowed considerably. His green card renewal application has been sitting in bureaucratic limbo since the Trump administration stopped processing residency and visa petitions from dozens of countries deemed high-risk. His current visa expires in September. Without renewal, he cannot legally continue practicing medicine in the region where he is one of the few specialists available—wait times for a pulmonologist there stretch four to five months.
Last week, the administration made a quiet carve-out. Physicians with pending visa or green card applications would be exempted from the freeze. It was a concession won after months of pressure from medical organizations and immigration lawyers, who had documented the severe shortage of doctors in America and the outsized role played by foreign-trained physicians in serving neglected rural and underserved communities. For Alghoula and others like him, the announcement seemed like a lifeline. But the relief is fragile and incomplete.
The exemption allows doctors to request case review. It does not guarantee approval. It does not promise that U.S. Citizenship and Immigration Services will process those requests fast enough to meet visa expiration deadlines. Many physicians have received no communication from the federal government since the announcement was made. Alghoula's scheduled interview for early June was canceled without explanation. He does not know what that means for his application. He is afraid to attend any future appointment, having heard of immigrants detained at renewal interviews. "I still have fear of going to my interview," he said. He has lived in the United States since 2016.
Meanwhile, the broader suspension remains in place for thousands of others. Researchers, entrepreneurs, and skilled workers from 39 countries—including Iran, Afghanistan, and Venezuela—cannot move forward. During this limbo, they cannot work legally. They cannot obtain health insurance or driver's licenses. If they leave the United States, they will not be allowed to return. The administration imposed the freeze last year after an Afghan citizen shot two members of the National Guard, citing the need for better vetting and control. This year, it expanded the suspension to cover visa applications from more than 75 countries, citing concerns that applicants might seek public assistance.
Dr. Zahra Shokri Varniab, an Iranian radiologist who came to the United States three years ago to conduct research, filed a federal lawsuit demanding a decision on her green card application. A judge ordered immigration officials to review her case. They did—and denied it. She believes the denial was retaliation for the lawsuit. The government's lawyers wrote that her application contained inconsistencies about whether she planned to practice medicine or conduct research. She says she intends to do both. "I feel completely confused," she said. The exemption does not appear to apply to her case, since it has already been decided. She is pursuing a remedy in court.
For immigrants from Iran, the stakes feel especially high. The country is engaged in active conflict with American and Israeli forces. Internet blackouts imposed by the Iranian government make regular contact with family nearly impossible. Many cannot receive financial support from home. Kaveh Javanshirjavid arrived from Iran seven years ago to pursue a doctorate in agriculture. He was supposed to begin work at a laboratory in January but needs work authorization. His application is suspended. The 41-year-old is borrowing money from friends to pay rent. He depends on his wife's doctoral fellowship to cover basic expenses. She is also Iranian and will need work authorization after she graduates this summer. "My whole life is on pause," he said.
Greg Siskind, an immigration lawyer based in Memphis, Tennessee, described the pattern plainly: "There are many bans and suspensions in place. It's about making life impossible for people who are legally in the country so they choose to emigrate elsewhere." The Department of Homeland Security, which oversees immigration officials, did not respond to questions about the suspension or the physician exemption. In an email, it indicated that it seeks to ensure applicants are properly evaluated, claiming the previous administration had not done so. No one knows how many doctors have been affected by the freeze. A spokesman for the American Academy of Family Physicians said several have contacted the organization seeking help. The exemption, for all its symbolic weight, leaves the fundamental uncertainty intact: approval is not guaranteed, timelines are unclear, and thousands of other immigrants remain frozen in place.
Citas Notables
The wait for a pulmonologist is four to five months— Dr. Faysal Alghoula, pulmonologist in southwest Indiana
There are many bans and suspensions in place. It's about making life impossible for people who are legally in the country so they choose to emigrate elsewhere— Greg Siskind, immigration lawyer based in Memphis, Tennessee
La Conversación del Hearth Otra perspectiva de la historia
Why did the administration suddenly carve out physicians when it's been so strict about everything else?
The pressure was relentless. Medical organizations and immigration lawyers spent months documenting the crisis—rural areas with four- to five-month wait times for specialists. Foreign-trained doctors do the work Americans won't do in those places. The administration couldn't ignore that without looking callous.
But the exemption doesn't actually guarantee anything, does it?
No. It's permission to ask for review, not a promise of approval. And even if approved, there's no guarantee USCIS can process it before someone's visa expires. Alghoula's interview was canceled with no explanation. He's terrified to reschedule.
What about the others—the researchers, the entrepreneurs from Iran?
Frozen. They can't work, can't get a driver's license, can't leave without being barred from return. If they're from Iran, they can't even reach their families reliably because of internet blackouts. They're trapped.
Is there a legal challenge to all this?
Some have filed lawsuits. Dr. Shokri Varniab sued demanding a decision, got one—a denial—and now believes it was retaliation. She's back in court. But the system moves slowly, and people's visas expire fast.
So the physician exemption is real but fragile?
Exactly. It's a gesture that acknowledges the problem without solving it. Thousands of people remain in limbo, and even the doctors who got the carve-out don't know if they'll actually be approved in time.