The policy change could significantly affect international medical trainees, who make up about 10% of U.S. residency and fellowship programs. Regions heavily reliant on J-1 visa holders, such as the Upper Midwest and Appalachia, may face exacerbated physician shortages. The new rule could also increase administrative costs and delays, potentially disrupting training programs and healthcare delivery. Medical specialties with existing workforce shortages and underserved areas may experience further strain, as J-1 physicians often work in these high-need regions after completing their training.