The effect of high-skill immigration remains central to many US industries and policy debates. Beginning in 2009, the federal government heightened enforcement of existing laws and increased employer fees for the cost of obtaining certain common immigration visas. The change can be viewed as a de facto tax on immigrant labor. I estimate the extent to which high-skill non-citizen workers, in the form of international medical school graduates seeking residency training in US teaching hospitals, are displaced by US citizens who received their medical school training abroad. Changes in immigration policy can have important effects in this labor market with implications for the larger health care system. I find that demand for medical residents among teaching hospitals based on immigration status is highly responsive to increased regulatory cost.

高技能移民的影响仍然是美国许多行业和政策辩论的核心。从 2009 年开始，联邦政府加强了现有法律的执行并增加了雇主为获得某些常见移民签证的费用而收取的费用。这一变化可以被视为对移民劳动力征收的事实上的税。我估计高技能的非公民工人，以寻求在美国教学医院接受住院医师培训的国际医学院毕业生的形式，被在国外接受医学院培训的美国公民所取代的程度。移民政策的变化可能对这个劳动力市场产生重要影响，并对更大的医疗保健系统产生影响。我发现，基于移民身份的教学医院对住院医师的需求对增加的监管成本高度敏感。