Health educators in Pacific Islands affiliated to the United States fear the loss of US funds to train up their own nurses.
Washington's budget crisis means the Area Health Education Centre programme could be cut back or axed altogether.
US federal funds go towards training health professionals in local colleges from Guam to American Samoa.
Our correspondent in the Marshall Islands, Giff Johnson, says the programme has been described as transformative for the region, which suffers from a lack of healthcare professionals.
"It's training certified licensed health people who are trained to address emerging public health problems in the region. A critical need out here is to have local institutions training their own people to address largely preventable health problems."
Giff Johnson says lobbying is underway in Washington to prevent the programme's demise but Pacific Island health educators aren't optimistic.