The United States depends on immigrants.
Tens of thousands of us would die without them. Nearly one in four doctors in the U.S. is foreign-born—many from South Asia—and they often serve in rural and underserved urban communities where American physicians are scarce and where immigrants are frequently met with suspicion. In The Care of Foreigners: How Immigrant Physicians Changed US Healthcare (Johns Hopkins University Press; Oct 14, 2025), Harvard Professor Eram Alam reveals the hidden backbone of American medicine: the immigrant doctors who have long shouldered the care of patients in places others won’t go. Alam traces the global and domestic forces that made this dependency not only possible but profitable for the U.S.
Alam explores the paradox of foreign doctors being both celebrated as essential and subjected to intense scrutiny and bias. And she confronts the ethical costs of recruiting medical talent from abroad while systematically failing to train enough doctors at home. In the end, Alam shows how the U.S. has built a healthcare system that relies on immigrant physicians—yet remains deeply ambivalent, even hostile, toward them.
We've needed a book like this for a long time, and it has been worth the wait! Brilliantly researched and beautifully written, The Care of Foreigners is a major contribution to the histories of migration and medicine.
I have long wished for a book that comprehensively explored the history, the political machinations, and the personal experiences of foreign-trained physicians like me. The Care of Foreigners is that book. Alam's writing is clear, her research thorough, and her conclusions deeply insightful.
