Methods A survey was created using the data collection platform "SurveyMonkey" and sent to IMG physicians practicing on a visa to understand their role and their immigration-related challenges. 
SurveyMonkey
Healthcare Access in Medically Underserved Areas During the COVID-19 Era: An International Medical Graduate Perspective From a Rural State.Background Physician shortage and healthcare access are serious issues in rural states like Kentucky and further worsened during the coronavirus disease 2019 (COVID-19) pandemic.  International Medical Graduates (IMGs) serve the underserved communities of Kentucky to fill in the physician gap.  However, uncertainties surrounding immigration policies added significant challenges to physicians and the rural communities served by them during the pandemic.  Methods A survey was created using the data collection platform "SurveyMonkey" and sent to IMG physicians practicing on a visa to understand their role and their immigration-related challenges.  Only the physicians practicing in Kentucky were included in this study.  Results It was found that 84% practice in primary care specialties like internal medicine, pediatrics, or family medicine, 92.9% practice in Medically Underserved Areas or Health Professional Shortage Areas, and 71.4% practice in rural settings.  Also, 61.5% practice in a "frontline" COVID-19 specialty and 92.3% were involved in direct care of COVID-19 infected or suspected patients.  Of the physicians, 88.5% were in an "immigration backlog"; 92.6% of them were the primary visa holders of their families and 88.9% expressed concern that their families face hardship if they have a disability during the pandemic.  It was reported by 92.3% of them that visa-related restrictions limited them from providing additional coverage in these places.  Conclusions Lack of physician access is a critical issue facing many rural states in America like Kentucky, and IMG physicians play a valuable role in taking care of this underserved population and fighting the COVID-19 pandemic.  The challenges surrounding the immigration backlog are contributing to significant hardships and remain a hurdle to expand healthcare access to the rural and medically underserved communities.
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