The Labor Department’s inspector general has asked Rochester Regional Health to “show us the numbers” on how many of Rochester General Hospital’s residency slots went to doctors on H-1B and J-1 visas. An Immigration Analytics review of Labor Department and USCIS records shows what the public data can answer: in the first three quarters of fiscal 2026, the hospital’s largest group of H-1B filings was for registered nurses, not residents, and none of its 22 resident H-1B positions was listed as a new hire.
Inspector General Anthony D’Esposito posted on X on September 27 asking Rochester Regional Health to “show us the numbers” on visa-sponsored hires. According to Becker’s Hospital Review, the post asked how many residency slots at Rochester General Hospital went to H-1B and J-1 visa holders and whether American applicants received a fair chance, and tied the question to President Trump’s September 18 executive order on visa abuse. News10NBC (WHEC) and Forbes also reported on the inquiry.
The disputed “80 of 82” figure
The inspector general was reacting to a post from an anonymous account called “Expose H1B Fraud,” which claimed that 80 of the hospital’s 82 incoming residents are foreign doctors on H-1B or J-1 visas. That figure has not been verified.
Rochester Regional Health disputes the premise. According to WROC (Rochester First), the health system said the webpage cited in the original post was not a list of incoming residents but a roster of residents across multiple years of training. It also noted that where a doctor attended medical school does not show their citizenship or visa status, since many U.S. citizens study medicine abroad. The system did not provide its own breakdown. Rochester General’s internal medicine residency website currently lists 78 residents across all training years, 24 of them in their first year.
A spokesperson for the Labor Department’s Office of Inspector General told Becker’s that the office does not comment on ongoing investigations but is taking what she called the exploitation of American jobs very seriously. Rochester Regional Health told Becker’s it had received no official communication from the Labor Department. The system said it is proud to recruit and train qualified physicians and pointed to physician and nursing shortages nationwide. According to Forbes, State Sen. Jeremy Cooney, who represents Rochester, called the inquiry “racist and ridiculous.”
How foreign doctors train in the U.S.
Foreign medical graduates usually enter U.S. residency programs in one of two ways.
Most come on J-1 exchange visitor visas. The only sponsor for J-1 physicians in clinical training is ECFMG (the Educational Commission for Foreign Medical Graduates), the nonprofit that also certifies international medical graduates for U.S. residency. The J-1 program is large: ECFMG sponsored 17,486 J-1 physicians in U.S. residency and fellowship programs in 2025, including 2,853 in New York, more than any other state. J-1 physicians generally must return home for two years after training unless they obtain a waiver.
Others train on H-1B visas. An H-1B resident does not need a full, unrestricted medical license, but the H-1B is not the easier route. A graduate of a foreign medical school must generally have passed all three steps of the U.S. Medical Licensing Examination, including Step 3, which J-1 residents do not need, and must hold ECFMG certification. The resident must also have whatever license or other authorization the state requires. In New York, residents in approved hospital training programs can practice under supervision without a license under state education law.
In both cases, the hospital is the resident’s employer. It recruits the doctor, usually through the national residency match, and pays and supervises them. The difference lies in the paperwork. For an H-1B resident, the hospital must file a labor condition application with the Labor Department, pay at least the required wage, and keep public records that the Department can review. J-1 residents are sponsored through ECFMG and the State Department, with no comparable Labor Department filing.
There is also no prevailing wage requirement for J-1 residents. The Labor Department’s wage rules come with the labor condition application, which J-1 residents do not have, so federal law sets no minimum pay rate for them. In practice, residency programs usually pay all residents on the same salary scale by year of training, regardless of visa status, and Rochester Regional Health publishes a single resident salary structure by training year. The hospital’s registered nurses are unionized, and their contract sets the wage rate cited on its nurse LCAs. We found no indication that Rochester General’s residents are covered by a union contract.
Government’s own records show as follows:
For H-1B workers, some of the numbers the inspector general asked for are already public.
The latest data available from USCIS show that it approved H-1B petitions for 31 workers at Rochester General Hospital between October 1, 2025, and June 30, 2026, the first three quarters of fiscal 2026. That compares with 72 workers approved in fiscal 2023, 62 in fiscal 2024 and 147 in fiscal 2025. These counts include new H-1B workers as well as extensions, amendments and transfers for workers already in H-1B status, in all job categories.
Before an employer can file an H-1B petition, it must obtain a certified labor condition application (LCA) from the Labor Department. The latest LCA data, covering the same October 2025 through June 2026 period, show 40 certified LCAs for Rochester General covering 91 positions:
| Category | LCAs | Positions | Listed as new employment | Pay rate |
|---|---|---|---|---|
| Registered nurses | 9 | 51 | 51 | $37.18–$47.58/hour |
| Resident physicians | 13 | 22 | 0 | $76,000–$98,000/year (most $88,000) |
| Chief resident | 1 | 1 | 0 | $103,210–$132,077/year |
| Attending physicians | 14 | 14 | 3 | $93,205–$266,000/year |
| Research, IT and analyst roles | 3 | 3 | 2 | $48,526–$91,800/year |
| Total | 40 | 91 | 56 |
Nearly all positions are at the hospital’s main campus on Portland Avenue in Rochester, with a few at Rochester-area clinics and one part-time hospitalist role in Potsdam.
Readers should note that not every certified LCA becomes an H-1B petition. An LCA allows an employer to sponsor workers for a position, but the employer may file fewer petitions than the LCA permits, or none at all. That is why 91 LCA positions in this period compare with 31 USCIS approvals.
A single LCA can also cover more than one worker, and Rochester General used several that way. One LCA covered 22 registered nurses, another covered nine, and a third covered 10 resident physicians for a short period in June 2026.
The largest group in the LCA data is registered nurses, not residents: 51 nursing positions, all listed by the hospital as new employment. The hospital classified all 22 resident positions as continuing employment, changes of employer or amendments rather than new hires. Every LCA offered at least the prevailing wage. For most resident positions, the prevailing wage came from a national survey of resident stipends.These records answer only part of the inspector general’s question. They cover H-1B workers only. Residents on J-1 visas do not appear in Labor Department or USCIS H-1B data.
Rochester General appears to be exempt from the annual H-1B cap. Under federal law, universities and nonprofit organizations related to or affiliated with them are not subject to the 85,000 annual H-1B limit or the lottery, and can file petitions at any time of year. Cap exemption did not shield employers from the $100,000 payment required by the September 2025 presidential proclamation, which applied to new H-1B petitions for workers outside the United States regardless of employer type.
The $ 100,000 fee has been currently stayed by a Court but immigration lawyers report that USCIS is holding petitions affected by the fee without deciding them, including cases filed with premium processing, leaving employers and workers in limbo despite the court ruling. On September 18, the President extended the proclamation through September 2027.
The episode comes during a period of heavy federal attention on the H-1B program. This month Immigration Analytics reported on the Labor Department’s action against Cognizant and Cloudera and on an executive order directing agencies to weigh employer layoffs in H-1B cases.
Sources: News10NBC (WHEC), Sept. 29, 2026; Becker’s Hospital Review, Sept. 29, 2026; Forbes, Sept. 29, 2026; WROC (Rochester First), Sept. 29, 2026; State attorneys general comment letter on DHS Docket No. USCIS-2026-0298, Sept. 24, 2026; DHS proposed rule, “Fee for Certain H-1B Petitions,” Federal Register, Aug. 25, 2026; Presidential proclamation extending Proclamation 10973, Sept. 18, 2026; U.S. Department of Labor, Office of Foreign Labor Certification, LCA Disclosure Data, FY2026 Q3; USCIS H-1B Employer Data Hub, FY2026 (through Q3); Intealth/ECFMG, J-1 physician sponsorship data, 2025; 8 C.F.R. § 214.2(h)(4)(viii).
This article is for general information and is not legal advice.
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