When people ask if they should call me “doctor,” I’ve always answered, “Please, call me Lubab.”
Titles don’t matter to me. But what does matter to me is for America to acknowledge my medical training and the skills I honed as a physician in Iraq and to let me work here as a doctor, especially after having toiled on the frontlines of Covid-19 care alongside thousands of other foreign-trained health professionals: physicians, nurses, medical assistants, and others.
We helped saved countless lives.
After graduating ninth in my class of 300 at Baghdad College of Medicine, I worked as a licensed pathologist for a decade in Iraq’s capital city. My family and I had to flee when death squads tried to kill us. At the time, I didn’t know where we would end up. When we arrived in the U.S. in 2014, I thought that it wouldn’t take long for me to qualify to work as a physician.
I was wrong. American laws make it difficult for foreign physicians to apply for licenses to practice medicine. The high cost makes it even harder.
So I ended up working the drive-thru at a Popeyes to make ends meet. We didn’t have thousands of dollars to spare for any reason, even to secure my future as a doctor. Eventually, I was lucky to find work as a pathologist’s assistant in New Jersey.
There’s a big difference between being a licensed pathologist and being a pathologist’s assistant. When a patient has surgery for cancer, the tissue the surgeon removes is sent to the pathology department. A pathologist’s assistant removes malignant tissue from the specimen and prepares it for the pathologist to analyze under the microscope and make a diagnosis about the specimen. In Baghdad, I was the one making the diagnosis. In New Jersey, I’m just the preparer.
I’m not alone living in this kind of professional limbo. A recent study from the Migration Policy Institute estimates that 263,000 immigrants and refugees have educations in health-related fields from abroad, but are either unemployed or underemployed in low-paying jobs here, an unfortunate waste of their brains. They aren’t able to work at the level of their training here because the U.S. does not make it easy for them to pass the licensing exams. I’ve come to realize that in America, medical licensing is a business. It’s all about money.
In April 2020, as Covid-19 was surging across the U.S., Phil Murphy, the governor of New Jersey, issued an executive order that gave some foreign-trained health care workers temporary licenses, which made it possible for them to help fight Covid-19. Through the executive order, I received a temporary license to work as a fully qualified physician, just as I had done in Iraq.
At the time, many clinicians were reluctant to go into the state’s nursing homes and test residents and staff members for Covid-19, worried about catching the virus themselves or bringing it home to their families. I don’t shy away from challenges, so I went into nursing homes in New Jersey to do nasal swabs on residents and staff. I was also able to work in Queens, Staten Island, and Brooklyn in New York where, thanks to the governor’s special dispensation, I supervised a team of unlicensed medical professionals — all of whom had trained abroad — to do this job across the region.
At the time, there was a growing realization of how deadly Covid-19 was in nursing homes. I and other foreign-trained health professionals helped prevent the number of such deaths from reaching even higher. I am proud of the work we did together.
The executive order expired in February 2021, and with it my ability to work as a fully qualified physician.
Letting me and other foreign-trained health professionals work at close to the level of our foreign qualifications to help fight a pandemic that has so far killed more than 550,000 Americans and then taking away those licenses makes me feel like we are disposable, to be relied upon during the pandemic and then tossed aside like a used N-95 mask.
This morning, as I write this, I’ve already prepared 10 case reports for the attention of the senior pathologist in my department, who will arrive around 9:30 a.m. and sign off on my work. I often discuss cases with the pathologists on the team, and add information they had missed or insights they had not thought of. My colleagues recognize my expertise and trust my word.
I appreciate the opportunity they have given me, but I want to work in a way that puts my skills to their full use. I’ve written to President Biden and others seeking changes to the laws on foreign medical licensing, but I have yet to get responses. I have suggested that the U.S. model its approach to foreign-trained medics after the United Kingdom’s system, which allows people like me to work under the supervision of a U.K.-trained doctor for two years before taking a specialist examination. The cause has received some national attention from the New York Times, the New Yorker, NPR, and others. Still, I’m not holding my breath.
My family and I are saving money so I can take New Jersey’s exam, which will let me once again work as a licensed pathologist. But I can’t help feeling that it shouldn’t be this hard at a time when experts often sound the alert about the shortage of physicians in the U.S., especially in rural regions and poor parts of urban regions.
This country could benefit from treating foreign-trained professionals with the respect they deserve. The issue goes far beyond undervaluing health care workers. I have lost count of the foreign-trained engineers I have met working in Walmart or foreign-trained chemists driving taxis. A friend of mine is a brilliant math teacher from Turkey. But in the U.S., which has a shortage of math teachers, she isn’t able to serve her community with her teaching skills.
America can do better to value the talent and credentials of immigrants and refugees.
Lubab al-Quraishi is a licensed physician in Iraq who now works as a pathologist’s assistant in New Jersey.
Hear al-Quraishi talk more about American medicine on an episode of the “First Opinion Podcast.”