I

t’s debatable whether the U.S. Supreme Court’s 5-4 decision to uphold President Trump’s policy to prevent people from five Muslim-majority countries from entering the United States will protect national security. But it is certain to be a setback for the health of Americans.

The travel ban now restricts certain visa classifications for citizens of Iran, Libya, Somalia, Syria, and Yemen, as well as those from North Korea and Venezuelan government officials. While it applies broadly to individuals in all fields of study and professional practice, it has a disproportionate impact on the field of medicine. Millions of Americans, particularly those in underserved communities, depend on foreign doctors, thousands of whom hail from countries affected by the restrictions.

Today, roughly 1 in 4 physicians practicing in the United States is an international medical graduate. Such physicians, who get their medical education in countries outside the U.S., make up an even greater share of the primary-care physician workforce — about 40 percent.

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International medical graduates also tend to practice in poor and underserved communities in the United States, where the physician shortage is most acute. In places where fewer than 10 percent of residents have college degrees, approximately 30 percent of doctors are international medical graduates. In regions with per-capita income below $15,000 a year, internationally educated doctors account for more than 42 percent of physicians.

Many parts of the United States are already experiencing a shortage of physicians, and that’s expected to get worse. By 2030, our nation could be short 121,000 physicians. The shortage in primary care, the front line of our nation’s health care system, could reach 49,000 by the end of the next decade. With a catastrophic doctor shortage on the horizon, the United States can’t afford to turn away qualified physicians.

Consider a few accounts from people in underserved communities who know firsthand how essential international medical graduates are.

About 1,500 international medical graduates currently practice medicine in Iowa. Dr. Steve Craig, executive director of the Des Moines Area Medical Education Consortium and an assistant dean at the University of Iowa Carver College of Medicine, told me: “We recruit international medical graduates to our training programs because it’s hard to attract other physicians to train in such small communities and because they often stay in these communities and practice after their training.”

Dr. Archana Chatterjee, chair of the department of pediatrics at the University of South Dakota Sanford School of Medicine, is one of only two pediatric infectious disease specialists in the entire state. Both are international medical graduates. “There is a large volume of work here that is being done by these doctors,” she said.

In Georgia, Dr. Michelle Nuss, who serves as campus dean for the Augusta University/University of Georgia Medical Partnership, said that “international medical graduates are a lifeline for our programs. Not only do they bring diversity, but they deliver high-quality patient care and are some of the best residents I’ve worked with.”

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Simply put, foreign-born physicians help keep native-born Americans healthy. Yet the Trump administration, in its attempt to enhance national security, has unknowingly implemented policies that may prevent much-needed doctors from training and practicing in communities across the United States.

The Immigrant Doctors Project estimates that approximately 7,000 physicians from Syria, Iran, Somalia, Sudan, Libya, and Yemen now live and work in the U.S. They staff 14 million doctor appointments for Americans each year. About 2.3 million of those occur in areas currently experiencing a doctor shortage.

The visa restrictions may be stopping talented foreign physicians from even applying for residencies in the United States. In 2017, the number of Iranian, Libyan, Somali, Sudanese, and Syrian applicants who applied for certification from the Educational Commission for Foreign Medical Graduates, which is required for international medical graduates who want to train and practice in the U.S., declined nearly 18 percent. This year, the number of residency applications from these five countries plus Yemen dropped 27 percent.

Doctors from Muslim-majority countries aren’t the only ones affected by the travel restrictions. These and other recent changes in U.S. immigration policy have created an environment of uncertainty and anxiety for residency applicants from all countries. The number of non-U.S.-citizen international medical graduates who have applied for residencies in U.S. hospitals has declined in the past two years, in part because they perceive our country to be an unwelcoming environment.

Dr. Majid Aized, an international medical graduate from Pakistan who completed surgical residency and fellowship programs in the United States, knows this all too well. “I know more than a few medical graduates from my country who spent months waiting for a visa. Some were late to their U.S. training programs,” he said.

We cannot afford to deter talented foreign-born doctors from caring for American patients. Our nation already has too few doctors to meet our population’s needs. So the travel restrictions aren’t protecting our nation — they’re putting American lives at risk.

William W. Pinsky, M.D., is the president and CEO of the Educational Commission for Foreign Medical Graduates and board chair of the Foundation for Advancement of International Medical Education and Research.

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  • THIS SHOULD OPEN THE DOOR FOR FOREIGN PHYSICIANS, MOST OF THEM AMERICAN CITIZENS, WHO ARE STILL NOT ABLE TO SECURE A RESIDENCY PROGRAM SO THEY CAN COMPLETE THEIR DESIRE TO SERVE THE NEEDY AMERICANS PEOPLE. I AM ONE OF THEM. PLEASE ANSWER ME.

  • Estoy de acuerdo con Trump porque eso permite oportunidades a los nacionales US para entrar a programas de residencia en USA Porque no dicen el número de nacionales médicos que quedaron sin poder entrar en un programa de residencia este año y sin embargo la cantidad de Médicos de la India que si entraron a programas de residencia creo que la falta de médicos es debido a la falta de oportunidades a los nacionales y ustedes bien lo saben además saben porque prefieren en un programa de residencia a uno de la Indyque a un nacional n

  • Dr. William W. Pinksy is neither a foreigner nor a foreign medical graduate. He’s an Obama liberal out spreading lies under the auspice of his job title. Pinsky was never elected by the members of the ECFMG organization to be President. Trump has made it perfectly clear that he wants to prioritize merit based immigration. Importing doctors are at the top of the list.

  • iam dr. mohammed from iraq.iam orthopaedic surgeon and i completed step1 and 2 (ck) usmle and iwant to take cs but i had no visa in 3 times from usa embassy in baghdad.
    i want to take orthopaedic fellowship from usa and return to my home because i have sponsorship for my fellowship and i dont want to stay in usa .
    i think , not all IMG want to stay in USA .
    USA health education consider the best in world , so when you restrict it , many people in the world will be effected .
    regards

  • Mr Pinsky I’m a US citizen FMG and I can say that all this outcry that you exhibit in your editorial is sad and damaging and I will tell you why. I never see the same type of support from you for people like me that owe thousands of dollars in student loans and then is so hard to get into a residency position. These people from the middle east/Africa don’t have any loans to pay, need a work visa, and take the few residency slots available away from us. In other words, you should instead aggressively support US FMG because we are from here and we gonna practice here. Who is to blame if like you say there is not enough physicians to attend the american population and hence people are gonna suffer? The medical establishment is responsible for not creating more MS/residency slots for everybody that wants and is able to study medicine. It is a shame that we have to go to another country to fulfill our dream and when we come back, we find that there is not enough residency positions for everybody. We are probably the only country who needs PA/NPs because there is not enough doctors. You should learn from other developed countries which don’t have this kind of problems. Please, think twice before you write your next article about this issue.

  • I am 100% supporting Trump’s policy. As there are many US citizens who are foreign medical graduates
    And they are staying home, because the residency programs prefer to accept foreign physicians based on their scores, and adjust their Visa status and spend more money for that, rather than offering US citizens their chance to work in the country they are already living in.
    So that I think this policy will give US citizens their fair chance to work and serve their country.

    • It’s funny,
      You give your self the rights to graduate from foreign medical school and get your degree!
      But don’t give the same rights for ather foreign graduates to apply for us residency program?????!!!!!!!
      If you feel you’re qualify get good score at the TEST and get the position.

  • While this might be an issue, it is an even bigger issue is how the American licensure system is scaled to lower the scores of foreign medical graduates, even those American born so that they students of American Medical school can pass their exams and get residency preferentially. As an American foreign graduate, I have first hand experience with this.

  • I am a USA born FMG; so I have some idea of what it takes to get into a residency program in the US. I don’t doubt Mr. Pinsky’s assertions regarding physician shortages and the positive effects FMGs have for the people in our country, and how they disproportionately serve the underserved, lower economic groups. The travel ban is not all bad however. These countries harbor terrorists. That is true. Whether they support them or not is not the question. You might ask , how many MDs are terrorists ? Well, I think the de facto leader of Al Queda who became that after Osama Bin Laden was snuffed out is an Egyptian physician; so all MDs are not good people. That being said. While the ban is on, applicants should continue to apply, and the government should put together a tight vetting process for all people from those countries, and should put out a statement telling the American people what they are attempting to accomplish, i.e. protect Americans in terms of safety and health. Both achievable !!

  • I came to this country in 70s, and have seen sea change in the overall attitude of americans over the years. Luckily physicians have recognized and accepted talent and contribution made by foreign born and trained physicians! However, political climate is anything but conducive to recognizing the real talent. Unfortunately they will roll the carpet only when the country suffers from shortage.

  • This is just intellectually dishonest and you know it statnews.com. An extremely significant majority of the International physicians that come here to practice medicine and be students or residents in hospitals, are from India, China, South Korea etc. Not saying that there aren’t a number that may be attempting to come to America from the countries included in the travel ban, but to dedicate an entire article with the headline of making “Americans sicker” is just absurd. Wake up and realize that this is why people do not trust media outlets as much anymore. It is not the President’s words or rhetoric, it is your piss poor writing, reporting and unfiltered bias while claiming bi-partisanship.

    • Jamie — I just wanted to make sure that you saw that this article, a First Opinion article, is opinion, not reporting.

      Pat Skerrett
      STAT

    • Still, they are foreigners coming from “sh@th@le” countries according to your beloved president. That means they are despised and unwelcome.
      On the other hand, as those areas are traditionally voting conservative, and now Trump. It would be in everybody interest to support the government agenda. If people voting for them love to shoot themselves in the foot, we should support their stupidity and let them rotten, as I am pretty sure they will not have health coverage, among other things.

    • Jamie-you are absolutely right about India/China having the largest percentage of IMG/FMG physicians, residents and students in American hospitals (especially underserved areas). But the travel ban and overall policy towards immigration spills far beyond the countries listed. How many Indian/Chinese/Korean/Canadian medical graduates will be able to serve the US population when medical residency programs stop sponsoring visas? There has already been a huge reduction as a direct result of the uncertainty that has been caused. With an aging population (including physicians close to retirement), increased prevalence of chronic diseases and decreased spots in residency for ALL foreign trained medical graduates the population will absolutely become “sicker” and the healthcare system will be worst than it already is. Short-term thinking tends to produce negative results.

    • Jamie,
      You are talking like politicians?
      You close your eyes on the values of the founders of this great country !!
      Unfortunately under the neam of security we are loosening our freedom, and American values ????
      Please be aware to distinguishing rights of free opinion and free speech.

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