Guest Post by Joe Guzzardi
Congress, immigration advocacy groups and immigration lawyers are urging the Trump administration to increase the number of foreign-born doctors to alleviate the alleged medical responders’ shortage during the coronavirus pandemic. Minnesota Democratic Senators Amy Klobuchar and Tina Smith, along with colleagues in the House and Senate, wrote to U.S. Citizenship and Immigration Services requesting that the agency resume premium processing for international medical school graduates (non-U.S. citizen international medical graduates) who are seeking employment-based H-1B and J-1 visas. On March 20, USCIS announced that because of COVID-19, it would suspend premium processing.
According to the letter, more foreign-born doctors would increase health care availability, especially in rural areas, through the Conrad 30 Waiver Program, which allows U.S.-trained foreign medical school graduates to stay in the country as long as they practice in underserved areas. The “30” refers to the number of doctors per state that can participate in the program.
Traditionally, foreign national doctors who trained in the U.S. must return home for two years after their provisional period has ended before they can reapply for a new visa or permanent residency. Last year, Senators Klobuchar, Susan Collins (R-Maine) and Jacky Rosen (D-Nev.) introduced legislation to extend the Conrad 30 program through 2021. The Conrad State 30 and Physician Access Reauthorization Act, S. 948, has 15 cosponsors, eight Republicans, six Democrats and one Independent.
Americans are united in their desire to do all possible to end the spread of coronavirus. But a reality dose is in order. There are U.S. doctors ready to work who Klobuchar, Collins, Rosen et al appear to be ignoring. National Resident Matching Program (NRMP) data shows that each year since 2011 up to 2,000 current year medical school graduates and prior year graduates did not place into a medical residency at a teaching hospital. Without that residency, they cannot practice medicine.
But in that same ten-year period, more than 36,000 non-U.S. citizen international medical graduates (IMGs) received residency positions – spots that are largely funded by U.S. taxpayers through Medicare dollars. In fact, the number of non-U.S. citizen IMGs has increased each of the years since 2011, from 2,721 to more than 4,222 in 2020.
A sensible solution to the imbalance between overseas and U.S. doctors would be to reduce the number of residencies available to non-U.S. doctors which should increase residency slots for U.S. doctors.
American medical school graduates have worked hard, often taking on tremendous debt loads to earn their undergraduate and M.D. degrees. An unmatched Georgetown University School of Medicine graduate who I’ll call Dr. X, and who I interviewed for this column, told me that to obtain his medical degree he took on $50,000+/year in federal student loans to pay for his education. The cost of a medical degree at GUSOM is even higher today.
With an interest rate of 6.7 percent, Dr. X’s student loans accrue interest at more than $25,000/year and have ballooned to an aggregate that exceeds $460,000, a sum he’s unlikely to retire if he’s unable to work as a physician. Dr. X passed his U.S. medical licensing exams and has extensive medical volunteer experience, as well as other health services experience. Still, without residency, Dr. X can’t practice.
Yet, just since 2011, 36,000 foreign-born doctors are practicing throughout the U.S. even though the federal government has no regulatory authority to oversee the quality of medical education in India, Pakistan, China and Iran, the home countries of the majority of these incoming doctors.
Not only is the existing system and the proposed congressional effort to increase the total number of foreign medical practitioners unfair to American doctors, it’s unjust to the sending countries. In this current pandemic, doctors are needed in their home countries. For instance, India reported a shortage of 600,000 doctors which means that there is one government doctor for every 10,189 persons versus the World Health Organization’s recommended ratio of 1:1,000.
American doctors have the reasonable expectation that upon earning their medical school degrees, and passing their licensing exams, they’ll be able to practice their chosen profession. To shut U.S. doctors out while hiring foreign nationals violates America’s social contract with its citizens, and is a gross injustice.
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Surprise the THEY in the circle jerk of Wall Street to K-Street to Capitol Street do not give a shit about Americans and their financial security and future .
This is the group that destroyed and dismantled American industry laying off millions bankrupting pensions and engineering a student loan industry where the school gets paid the bank gets paid and the graduate in debt up to their ears is unemployable and cannot discharge the loan in personal bankruptcy and the IRS is the collection agency ! Wow what a fucking deal ! The same circle jerk club members sit on the board of the hospitals the med insurance and drug companies instrumental in hiring doctors so in comes more foreign labor at a reduced cost . Its a win win as long as you are not a sick American or an indebted American med student !
Just spent 4 days out 3 and back in 5 days in a top hospital in Baltimore . Boomeranged back for a serious problem that the coronavirus scare discharged me to soon and back for the same Issue just worse . First 4 days $13,000 second 5 days $15,000 at those prices they can afford to pay an American !
The staff was great however far to many hard to understand at times
One more thing as a former marine mechanic if I had a return issue I was expected to repair free .
Doctors practice on us we mechanics have to hit it on all 8 all the time . Like the customer that I replaced a spotlight and a week later another light was out , it was bulb but some how I touched the lights on the boat so his thought was I must have done something . Just another cheap asshole
No worries. A thousand medical student we’re recently imported . No one can say the Federal government ain’t got our backs… we are not worthy.
“While you have been incarcerated in your homes, the federal government has flown in over 1000 special refugees from Afghanistan and distributed them around the US in a 4 week period from mid March to mid April.”
Oh goody!
Another mini-Shitholistan coming to your town, infidel peasant.
Next week another mini-Mogadishu on route to U.S.S.A., courtesy the likes of Sens. Klobuchar, Collins and (((Rosen))).
Go one step further after eliminating the H1-B, limit the number of foreign students to 4% or less in medical colleges. That way there will be only 1 per 25 students instead of the current 9 per 25 doctor wannabes. Also require that those new foreign doctors go back to their country of origin instead of staying in the US like most of them do now.
Third world med schools generally speaking, can’t possibly provide the level of education and training recieved in US schools.
I have known quite a few of these physicians and quite frankly wouldn’t trust my health or my family’s health to them. There is often a cultural divide that is equally disconcerting. Ladies beware!
This is a general statement. I recognize there are SOME adequately trained and very good physicians but my overall impression is my health is too important to play Russian Roulette.
I’m also very skeptical of this with reports from around the country of doctors and nurses being furloughed.
more media BS
This spring, record numbers of CANADA geese cross MEXICAN border into U.S. Meanwhile, 25 million REAL Americans lose their job. Coincidence? Hardly. While some may be tempted to take the law into their own hands, former Vice President Dick Cheney warns of possible “friendly fire” accidents…
Wahhh! Wahhhh! Who gave a shit for the American computer programmers put out of gainful employ by the dot com boom and bust back in 2001? That cycle was fed by the H1-B work visa program. Wasteful projects like pets.com would not have happened if American programmers would have been paid what they were worth. I’m so disgusted at the fresh disbelieve and fresh efforts of the same old schtick of American political theatre. Why can’t you fucks get this? Why can’t you fucks understand the meaning manhood? Baaaah. Waaah. Muh, ba, baaah.
It has been a long time since any congress criminal gave a shit about American citizens.
I can tell you that there have been discussions in the past about problems with the American healthcare system and the availability of medical care. Some doctors and groups may feel that their vote is not being properly considered or that their proposals are not getting the attention they deserve from Congress. It is important that the dialogue between doctors and legislators continue to find the best solutions to improve health care in the United States.
Comment: In my personal experience, when I was in medical school, I felt the tension associated with the problems that American doctors face. The heavy workload of study and clinical practice made it difficult to do homework, and sometimes even made it impossible. As a result, when I had to write my doctoral thesis, I could not do it due to stress, as a result, I had to turn to phd research for help. This experience underlined the importance of creating an environment in which doctors can perform their work effectively and have time for academic development.
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