International medical graduates (IMGs) play a critical role in the United States physician workforce and are essential to sustaining access to surgical care, particularly in underserved communities. Despite their contributions, IMGs pursuing surgical training continue to face significant systemic, financial, cultural, and institutional barriers. To examine the historical role, workforce contributions, challenges, and future implications of IMGs within the U.S. surgical workforce and identify opportunities to better support their integration into surgical training and practice. IMGs comprise a substantial portion of the U.S. physician workforce but remain underrepresented in many surgical specialties. Persistent barriers include licensing requirements, financial burden, limited access to clinical and research opportunities, visa restrictions, bias within training environments, and reduced match success rates compared with U.S. medical graduates. This article synthesizes presentations from the American Surgical Association Inclusive Excellence Forum and incorporates current literature regarding IMG participation in U.S. surgical education, workforce trends, residency training, and professional advancement. IMGs contribute significantly to clinical care, academic medicine, healthcare leadership, and culturally competent patient care. However, structural barriers within recruitment, credentialing, residency training pathways, and immigration processes continue to limit equitable access to surgical careers. Preliminary surgical positions, visa-related constraints, and cultural bias remain major challenges affecting IMG trainees and practicing surgeons. IMGs are indispensable to the future of the U.S. surgical workforce. Institutional support, mentorship, equitable recruitment practices, expanded residency opportunities, and immigration policy reform are necessary to strengthen IMG integration and ensure continued access to high-quality surgical care.

Diverse refugee, immigrant, and migrant (RIM) populations in the United States face complex mental health needs that are shaped by migration experiences, cultural transitions, and structural barriers to accessing care. Although RIM populations have different legal statuses, cultural backgrounds, and lengths of U.S. residence, many encounter common stressors related to uncertain immigration policies, economic instability, and limited access to culturally responsive services. Recent federal actions-including suspension of the U.S. Refugee Admissions Program and revocation of "protected areas" policies-have intensified fears and mental health vulnerabilities among these populations. Using a multilevel, biopsychosocial approach, the authors aimed to provide clinical guidance on the biological, structural, sociocultural, and health care system factors that affect mental health care delivery for RIM populations. This article provides evidence-based clinical guidance and actionable recommendations that allow clinicians to selectively apply interventions (e.g., trauma-informed practices, low-barrier care models, medical-legal partnerships, and culturally responsive approaches that respect alternative healing frameworks) on the basis of individual patient circumstances. Key recommendations pertain to working with professional interpreters, navigating diagnostic ambiguity, and interfacing with immigration enforcement.

ABSTRACT Japan has significantly expanded its migration framework over the past decade. The introduction of the Specified Skilled Worker (SSW) system was the most pivotal shift, formally enabling broader labour migration with a pathway to citizenship. Despite these developments, the Japanese government continues to deny the existence of immigration policy. Drawing on institutionalist perspectives, this paper argues that the disconnect between Japan's expanding migration policies and its no-immigration narrative represents a case of decoupling, a strategy through which organisations manage tensions between cultural expectations and operational demands by dissociating formal policy from its implementation. This paper reconceptualizes decoupling as a discursive strategy through which the migration state contains the implications of its policies to navigate a tension between material national interests and national self-image. Japan's demographic crisis and the centrality of ethnic homogeneity to national identity make it a compelling case for examining this dilemma. Based on thematic content analysis of National Diet minutes from 2015 to 2024, this study identifies four discursive strategies employed to dissociate migration from nationhood: obfuscation, externalisation, compartmentalisation, and provisionality. The decoupling of migration from nationhood, it argues, serves as a political device to delegitimize migrants’ claims to belonging and institutionalise their exclusion.

ABSTRACT Immigration policy and international higher education policy were traditionally distinct domains in Australia, yet they have become intertwined over the last quarter century. Australia has expanded international student migration as both a key part of higher education and a funding source, while shifting from facilitating two-step pathways to skilled immigration to imposing strict barriers. Taking a medium-term analysis from 2001 to now, we assess these policy trends through boundary spanning theory, noting that once discernible policy areas have undergone periods of convergence. We outline the policy benefits and disadvantages of such trends, reflecting on the implications for other major Commonwealth Nations.

This study sought to understand the relationship between skilled immigration policy objectives and employer hiring practices using an online survey of 706 private sector hiring managers across Canada. The findings show that recruitment and selection decisions are complex; decisions to hire skilled newcomers (or not) are more related to organizational norms, cultural distinctions and hiring manager competence, confidence, demographics and risk perceptions than they are to assessments of newcomers’ skills. Regardless of whether a skilled immigrant candidate was recently hired, hiring manager assessments of immigrants’ knowledge, skills and abilities were, on average, favorable. Given that governments prioritize skills in immigration policy, while employers’ hiring decisions are much more strongly influenced by other factors, there is a clear misalignment between policy objectives and employer practices. To address this gap and advance social resilience, this study finds governments and employers must assume greater responsibility for the workforce integration of skilled immigrants.

Given the unprecedented global volume of forced migration, ensuring equitable access to healthcare for refugees has become a pressing global health priority. This comparative case study examined country-level determinants that influence healthcare access and social determinants of health among refugees in Australia, South Korea, and the United States. We conducted a comparative case study to identify country-level factors influencing refugee healthcare access in Australia, South Korea, and the United States. Countries were selected to capture diversity in geographic context, immigration and integration policies, and healthcare system structures. Data sources included a comprehensive review of laws, policies, and peer-reviewed literature, as well as in-depth interviews with refugees, healthcare providers, resettlement agency staff, and legal professionals. We used framework analysis guided by a conceptual model, incorporating both deductive and inductive coding. This study focused on cross-case themes emerging from the synthesis of all data sources. Findings revealed that, while refugees in all three host countries generally view health services as superior to those in their countries of origin, significant disparities persisted in access across various factors. The availability of culturally and linguistically appropriate care, legal frameworks, insurance systems, and social supports varied widely, contributing to health disparities. In the United States, complex healthcare navigation and insurance gaps posed substantial barriers, while in South Korea, legal mandates for interpretation services were lacking, and health insurance coverage was limited for certain refugee groups. Australia's universal health coverage and government-funded language and interpretation services supported more inclusive access, although barriers existed for vulnerable subgroups. This study underscores the significance of national policies, culturally competent care, and long-term integration support in promoting health equity for refugees. It also highlights the need for targeted, context-sensitive strategies to address persistent barriers and calls for better-tailored policies to support the health and well-being of refugees in host countries and beyond.

ABSTRACT This article examines the implementation of immigrant integration policy in the Israeli education system, focusing on variations across secondary schools. Based on qualitative data, the study shows that although the Ministry of Education formally supports immigrant student integration, the policy remains largely declarative and fragmented, resulting in divergent school-level enactments. Using an interpretive qualitative approach, the research combines content analysis of Ministry of Education policy documents with in-depth interviews with 20 teachers, principals, and municipal officials from four high schools serving immigrant populations of 10%–35%. Drawing on the street-level bureaucracy framework (Lipsky 1980), the findings identify four dimensions shaping implementation: school leadership and organisational culture, policy interpretation, local authority capacity, and the involvement of external organisations. The study underscores educators’ central role as active policy agents in multicultural school contexts.

Immigrant parents in the US face unique challenges related to immigration policy and structural inequities. Although stress interventions exist for parents in general, little is known about those targeting US immigrant parents. This scoping review aimed to map the intervention and participant characteristics of stress intervention trials targeting US immigrant parents. The JBI conduct standards, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, and the Population, Concept, and Context framework guided the review. A comprehensive literature search was conducted across APA PsycINFO, PsycARTICLES, CINAHL Plus, ERIC, Embase, MEDLINE, the International Bibliography of Social Sciences, and the Cochrane Library. Peer-reviewed, English-language articles were included without date limits. Five independent reviewers screened studies and extracted data. Of 7,989 records screened, 13 trials were included. Most trials were pilot or feasibility studies (62%) and employed randomized controlled trial designs (62%), with 69% published in the past decade. Interventions primarily focused on stress management or reduction (85%) and were largely adapted from existing programs (92%); all (100%) utilized language adaptations, but only half (50%) incorporated immigrant-specific experiences. Target populations were predominantly Latino/Hispanic parents (69%). Interventions were most often delivered in community (46%) or home (31%) settings, using in-person group formats (69%), commonly combining social support (92%) with parenting skill development (85%). Stress outcomes most frequently assessed parenting stress (69%) or general stress (31%), while immigration-related stress was infrequently measured (15%). Although most trials (77%) used stress measures validated in populations sharing the same racial, cultural, or ethnic background, only four studies (31%) employed tools validated in US immigrant samples. Among the 11 trials reporting group-level outcomes, six (55%) reported improvements. Slightly more than half of the trials enrolled 50 or fewer participants (61%) and primarily involved parents with a mean age between 30 and 39 years (62%). Many trials involved parents of children with a mean age in the preschool-kindergarten (23%) and elementary school (46%) ranges. Over two-thirds of trials (77%) reported participation of parents with low education. While female parents were reported in all trials, fathers' participation was reported in fewer than half of studies (46%). Among these, no trials reported samples with ≥ 50% fathers, and only two reported ≥ 25% fathers. No trials reported participation of non-biological or non-residential parents. Despite the heightened stress faced by US immigrant parents, few targeted intervention trials have been published. Key gaps in the existing literature include reliance on adapted interventions that emphasize social support and parenting skills, limited use of stress measures validated for US immigrant parent populations, and underrepresentation of diverse immigrant groups. Future research should broaden populations and settings, diversify intervention strategies, and assess immigration-related stress and stressors using validated measures.

Examining the determinants of overseas migration among Filipino STEM professionals: The role of policies, quality of life, personal and social factors.

Social media platforms increasingly mediate political information exposure, yet the role of algorithmic curation in shaping political exposure remains contested1,2. This question is difficult to resolve on platforms in which users retain substantial control over their feeds3,4. The 'For You' feed of TikTok, which delivers content almost entirely through algorithmic recommendation, offers a setting in which user agency is sharply constrained. Here we show, through 323 audit experiments with controlled 'sock puppet' accounts seeded with Democratic or Republican content across three US states, that accounts seeded with partisan content exhibited systematic, asymmetric differences in partisan exposure. Across more than 280,000 recommendations collected over 27 weeks during the 2024 US presidential election campaign, Republican-seeded accounts received about 11.5% more co-partisan content than Democratic-seeded accounts, whereas Democratic-seeded accounts were exposed to about 7.5% more cross-partisan content-largely anti-Democratic material-even after adjusting for engagement metrics. These asymmetries are concentrated among high-reach Republican channels and in specific policy domains, including immigration, crime and foreign policy for Democrats, and abortion for Republicans. Our findings show partisan imbalances in political information exposure on a platform dominated by algorithmic recommendations, with implications for platform governance and democratic discourse.

Restrictive immigration policies limit maternity care access and exacerbate poverty and isolation among migrant women. In the UK, many migrant women face No Recourse to Public Funds (NRPF), restricting welfare access and making them liable for maternity care charges. Population-level evidence on perinatal outcomes remains limited. To examine perinatal outcomes among migrant women with NRPF compared with UK-born women, migrants with recourse to public funds, and migrants with unknown visa status in an ethnically diverse urban UK population. We conducted a retrospective analysis of linked maternity and neonatal electronic health records (eLIXIR -Born In South London) from 2018 to 2023, including 44,634 pregnancies. Multivariable regression estimated adjusted risk ratios (aRR) controlling for sociodemographic and clinical characteristics. Migrant women with NRPF had higher risks of adverse maternal outcomes (emergency caesarean aRR 1.74, 95% CI 1.55-1.95; severe maternal morbidity 1.49, 1.33-1.67). Their infants were more likely to have low Apgar scores (1.53, 1.07-2.16) and less likely to receive skin-to-skin contact (0.92, 0.88-0.97). Infants of women with NRPF did not show higher risk of neonatal death (1.44, 0.85-2.29), whereas infants of women with unknown visa status had the highest risks of preterm birth (1.24, 1.13-1.35), low birthweight (1.28, 1.17-1.39), and neonatal death (2.27, 1.81-2.86). Migrant women with NRPF and infants of women with unknown visa status face disproportionate risks of adverse outcomes. Addressing these inequities requires inclusive maternity care, accurate migration data collection, and reconsideration of NRPF and charging policies.

Based on qualitative data of 34 highly-educated migrant entrepreneurs this paper examines the paradoxical implications of pandemic-induced immobilities in Singapore, interrogating how the same pandemic-related situations – in terms of stringent border restrictions, immigration and workforce policy transformations, or shifting landscapes of population flows – could simultaneously entail both immobility and mobility along different dimensions. The paper contrasts the way newly-arrived (South)East Asian entrepreneurs interpret startup opportunities post-migration as moving towards a positive direction within their lives with the existential immobility that long-term non-Asian entrepreneurs, some of them previous corporate expatriates in Singapore, perceive as stuckedness. Using the notion of existential (im)mobility the paper conceptualizes how spatial, legal, and socio-economic (im)mobility are intertwined and made explicit and reveals the precarious conditions even highly-educated economic migrants face in Asian restrictive migration regimes like Singapore. However, the contrasting cases also foreground the significance of life stage and the time of arrival at different times of geopolitical power constellations and highlight that (im)mobility is never ‘fully achieved’. Rather, existential (im)mobility manifests through subjective interpretations of moving in relation to one’s own and others’ previous experiences and changing expectations over time.

The Canadian college sector is facing a systemic crisis driven by the perfect storm of chronic provincial underfunding and abrupt federal immigration policy shifts. This moderated discussion explores how reforms to Canada’s immigration laws with respect to international students have triggered a crisis for Canadian postsecondary institutions, including substantial budget losses, program cancellations, and significant human costs for international students and college and university employees. Through professional perspectives from advising, department leadership, faculty, and executive, the authors detail institutional responses to fiscal constraints and operational uncertainty. Using case studies from Seneca Polytechnic, Durham College, and Conestoga College in Ontario, and Kwantlen Polytechnic University in British Columbia, the moderated discussion highlights the precarious reliance on international tuition and the resulting erosion of campus community. Ultimately, the authors argue that this crisis necessitates a new social contract for Canadian higher education, urging a fundamental transformation of funding models and a renewed focus on institutional integrity and public purpose.

Health and socio-political crises combined during the Covid-19 pandemic and Brexit (the UK’s exit from the European Union) impacting the housing experiences of migrant essential workers. Major new research funded by the UK Economic and Social Council generated three datasets: an online survey (n = 1,105) and interviews with 40 UK-based Polish essential workers and 10 stakeholders. The sequential exploratory mixed-methods analysis reveals housing precarity as the missing link in understanding systemic resilience during times of ongoing polycrisis. We find housing precarity is not only intersectionally differentiated and compounded for individual migrants but also creates society-wide vulnerabilities that undermine the labour market, economy and society. Essential workers whose financial situation worsened, job changed and/or employment was part-time were disproportionately affected. Youth, especially men with lower education, limited access to social security and insecure immigration status were particularly associated with moving home. Overcrowding was problematic because of housemates and landlords, with shared private rental accommodation exposing essential workers to health risks. Lack of access to green space was the element of housing precarity most clearly connected with worsening mental health. Better housing outcomes in Scotland imply that localised approaches in other countries might support essential work even within broader hostile immigration policy contexts.

Post-WWII migration from the Global South to the United Kingdom mostly comprised immigrants who were simultaneously (post-)imperial citizens. Among major attempts to remake South–North migration dynamics in the 1960s–1970s were Britain’s efforts to distinguish overlapping citizen–immigrant categorisations, recasting ‘Commonwealth citizens’ as lacking rights and subject to control. Yet this dichotomisation remained incomplete: ex-subjects whom Britain ceased to consider citizens still present claims which complicate Britain’s immigration control intentions. What explains this contradiction? This article employs a concept of ‘entangled imperial citizenship’ to trace how imperial and post-imperial ideas of citizenship interpenetrated in key periods of UK policy development, producing residual rights. Examining the policy cycles surrounding successive immigration acts in 1962, 1968 and 1971 underlines two overarching reasons why post-imperial citizens’ rights claims were not fully extinguished. First, the overlap of imperial and post-imperial citizenship concepts in shaping earlier policies generated legacies that frustrated escalating intentions to degrade Commonwealth citizenship. Second, emerging complexity in the immigration policy field, where conflicted understandings of social membership increasingly highlighted state interests in social cohesion and domestic legitimacy, interfered with reform attempts. Entangled imperial citizenship in Britain exemplifies Global North states’ difficulties in conforming migration control to their post-decolonisation intentions for South–North dynamics.

The enforcement of national identity sovereignty through selective immigration policy currently confronts systemic vulnerabilities arising from regulatory disharmony. The phenomenon of foreign nationals exploiting the self-registration system at the Class III Non-TPI Immigration Office of Tanjung Redeb demonstrates that public service applications lack robust validation capabilities due to the absence of real-time interconnection obligations with a population database. This study aims to analyze material legal defects in the population documents of foreign nationals and to evaluate the inter-agency dysfunction in data integration for passport issuance, while simultaneously highlighting the urgency of transforming biometric verification. This normative-empirical legal research employs the statute and case approaches, collecting data through in-depth interviews with two immigration officials, which were then analyzed using doctrinal instruments for State Administrative Law. The research results indicate that the paper-based population documents hold a void ab initio status due to their violation of sovereignty prerequisites. The sectoral synchronization failure forces immigration authorities to execute the law enforcement identification instrument of the Biometric Management System as the primary supervision mechanism. The synergy between the deterrence database and the apparatus’s capacity in formulating the Minutes of Examination successfully thwarted this administrative legal smuggling. Nevertheless, this jurisdictional isolation generates further implications for state administrative authority disputes. This study recommends regulatory harmonization mandating cross-ministerial Application Programming Interface interconnection, in which immigration electronic notifications must be recognized as preliminary evidence for regional population agencies to initiate revocation proceedings for materially defective documents.

Liminal forms of immigration relief have proliferated within U.S. immigration policy, providing noncitizens with temporary reprieve from deportation while leaving their long-term status fundamentally uncertain. Other forms of liminality have emerged from the erosion of more permanent forms of status, resulting from policies that terminate status, strip benefits associated with status or leave noncitizens in limbo through bureaucratic delays. While many of these forms of temporary status are associated with humanitarian immigration protection in the United States, they also serve a clear economic function: fulfilling a demand for flexible and undercompensated labour. The volatile landscape of immigration enforcement – epitomised by the aggressive deportation practices of the Trump administration – throws the precarious position of these noncitizen workers into sharp relief. This project explores liminality as an instrument of racial capitalism, identifying how the extended ‘grace’ of temporary status cannot be separated from wider policies of exclusion, enforcement and surveillance, which serve as an embodied form of bordering that furthers worker subordination.

This article historicises restrictive migration governance by tracing the narrative strategies that enabled immigration restriction in Britain and France from the 1960s to the mid-1980s. Drawing on parliamentary debates, media coverage and public statements, it identifies five key narratives – ‘invasion’, ‘difference’, ‘humanitarian’, ‘oil-shock’ and ‘crisis’ – and analyses how they operated at distinct stages of policymaking: agenda-setting, policy formulation, decision-making, implementation and evaluation. The article demonstrates that these immigration narratives were not spontaneous reflections of public opinion but strategically crafted tools of governance, adapted to institutional contexts in Britain and France. It shows that emotive threat frames initiated restrictions, humanitarian narratives legitimised them as moral protection and economic crisis narratives entrenched them as a technical necessity. This sequencing enabled cross-party convergence and the institutionalisation of restrictive immigration policies. A key finding is that the economic crises of the 1970s, including the Nixon shock and oil shocks, did not originate restrictive narratives but reinforced a path-dependent trajectory already under way. The article reveals how elite actors transformed complex post-colonial migration questions into politically actionable frames, contributing to understanding contemporary restrictions in the Global North.

An ecological model was developed to examine the pathways linking immigration state policies to physically safe work conditions and work volition, interpersonal discrimination, and mental health distress. The ecological framework was tested among two subsamples totaling 529 Latinx immigrant participants: (1) immigrants who resided in states with anti-immigrant policies, and (2) immigrants who lived in states with greater health equity policies for immigrants. We used path analysis to assess the model's goodness of fit and the strength and significance of the paths. The model fit well with both subsamples. For the anti-immigrant state subsample, greater health equity in state policies was associated with greater physically safe work and discrimination, but not work volition. For the pro-immigrant state policies subsample, more equitable policies were not linked to safer work conditions, work volition, or lower discrimination. Across both subsamples, safer work conditions were linked to lower discrimination, and higher discrimination was associated with mental health distress. We discuss implications for community research, interventions, employers, and policymakers in promoting migrant justice and responding to racist and xenophobic immigration policy climates.

ABSTRACT The Maltese government often touts its successful containment of so-called ‘irregular’ (that is, forced, racialised) migration, obscuring the fact that most migrants do not settle in Malta permanently, but either leave through EU resettlement schemes or, more commonly, unauthorised routes. Through narrative biographical interviews, this paper traces how individuals who have migrated to/through Malta navigate Malta’s (in)formal immigration policies and practices. The paper highlights the untransparent, arbitrary and punitive nature of Maltese migration governance, arguing that these features ultimately ‘nudge’ migrants out. The variegated experiences of ‘being nudged’ are further explored: how do migrants understand and exert their mobility and agency despite the impositions made by Maltese/European migration governance and the protracted uncertainty they experience in Malta? The paper argues that the notion of ‘nudging’ helps us better understand the interaction between government policy and migrant agency, and prompts us to question the established dichotomies of ‘forced’/‘voluntary’ and ‘regular’/‘irregular’ migration.