Feb 6, 2026
Hello,
My name is Sam Hsieh. I am a general surgeon and have served as a Chief Medical Officer in Eastern Washington for the past 13 years. I am also an International Medical Graduate, and I have been an active advocate for IMGs throughout my career.
I want to start by saying this clearly. IMGs do not fail to enter residency because they are less competent than US graduates. The reality is that this is a system issue. The number of residency positions has not meaningfully increased in over 30 years, despite growing population needs. As a result, the United States is projected to face a shortage of nearly 100,000 physicians in the next decade. IMGs are a critical part of the solution.
Over the years, I have worked closely with TIMGA and the Washington Medical Commission to help pave the way for IMGs without US residency to gain supervised clinical experience through alternate pathway licensure. That work has led to meaningful progress, including the development of a pathway toward full licensure in Washington State. This model is now informing similar efforts in other states.
Physician Pathway Solutions was created to responsibly scale this work. PPS partners with healthcare organizations to educate them on alternate licensure pathways, supervision models, and regulatory requirements, while helping match qualified IMGs into appropriate clinical roles. To date, we have successfully supported the placement of over 50 IMG physicians, with many more opportunities in development.
We have also recently launched We Are Docs, a private Facebook community created for IMGs to connect, share experiences, exchange accurate information, and learn from one another as these pathways continue to evolve. This platform is meant to foster community, transparency, and collective growth.
Our mission is to work alongside IMGs and partner healthcare organizations to open enough pathways, place enough physicians, and build a critical mass that demonstrates IMGs are just as capable and, in many cases, exceptionally well prepared to serve patients through these models. The goal is not one state or one program, but a unified solution that can be brought to every state.
We are actively collaborating with TIMGA, IMG Helping Hands, and other IMG organizations to build alignment and unity rather than fragmentation. Many of you I have already spoken with, and I want you to know how encouraged I am by your energy, professionalism, and resilience.
I will be sending a follow up email soon to coordinate scheduling calls. I would truly value the opportunity to speak with you individually, learn more about your goals, and discuss some exciting positions that may be suitable for you.
Thank you for your grit, your patience, and your commitment to medicine. Please keep up the good work. Together, we can make a real difference for our patients, our communities, and for IMGs everywhere.
Sincerely,
Sam Hsieh, MD FACS FACHE
Chief Medical Officer | Co-Founder
Physician Pathway Solutions | We Are Docs