I'm not sure I get it, are you saying that wage alone should determine visa eligibility? I'm gonna guess that location is the primary reason here. Do you have any data, for example, on foreign workers that stay versus bail on rural/remote jobs in the long run? My rough guess is that there's more than just looking at the money. Maybe these doctors are picking these jobs as a gateway to later switch to a preferred location and aren't staying, so they are being more picky? (My comment is anecdotal and I have no basis just a hunch)
Fair point. To be clear we aren't saying wage should be the only rule, just that it's weird to see such a huge disconnect. Usually money talks.
Your "gateway" hunch is likely spot on. Most rural docs start on J-1 waivers (mandatory 3 years). If they actually stayed after that, we'd see way more H-1B conversions filed by those rural hospitals to keep them. Since the volume is so low, it suggests once the 3 years are up, they bail for the city. The wage premium just isn't enough to anchor them.
Data: 20,225 H-1B LCA disclosures from DOL, FY2024, healthcare occupations only Analysis: Python (pandas), mapped ZIP → RUCC codes, median wage by volume quintile Key limitation: This is LCA data (intent to hire), not final USCIS approvals
Interesting rabbit holes:
Urban/rural split isn't binary—codes 4-6 show gradient effects
Wage level inversions strongest in codes 7-9 (most rural)
I'm not sure I get it, are you saying that wage alone should determine visa eligibility? I'm gonna guess that location is the primary reason here. Do you have any data, for example, on foreign workers that stay versus bail on rural/remote jobs in the long run? My rough guess is that there's more than just looking at the money. Maybe these doctors are picking these jobs as a gateway to later switch to a preferred location and aren't staying, so they are being more picky? (My comment is anecdotal and I have no basis just a hunch)
Fair point. To be clear we aren't saying wage should be the only rule, just that it's weird to see such a huge disconnect. Usually money talks.
Your "gateway" hunch is likely spot on. Most rural docs start on J-1 waivers (mandatory 3 years). If they actually stayed after that, we'd see way more H-1B conversions filed by those rural hospitals to keep them. Since the volume is so low, it suggests once the 3 years are up, they bail for the city. The wage premium just isn't enough to anchor them.
Author here. Quick methodology notes:
Data: 20,225 H-1B LCA disclosures from DOL, FY2024, healthcare occupations only Analysis: Python (pandas), mapped ZIP → RUCC codes, median wage by volume quintile Key limitation: This is LCA data (intent to hire), not final USCIS approvals
Interesting rabbit holes:
Urban/rural split isn't binary—codes 4-6 show gradient effects
Wage level inversions strongest in codes 7-9 (most rural)
Happy to answer methodology questions.