Written by Jennifer Poo and Edited by Myra Ali
The immigration debate has been growing more heated and divided in the capitol. A great portion of this debate has centered around immigrants who perform low-wage and physically intensive labor. However, there is one portion of the immigrant workforce that has largely been looked over: doctors. The immigration policies that are currently being discussed in the capitol affect everyone who is coming into the U.S. searching for work, even medical graduates who are seeking to provide healthcare to those who need it.
After graduating medical school, graduates must train as residents before becoming practicing physicians. Despite the “resident” title, these graduates still do jobs that are as important as the jobs that doctors do themselves. However, not enough U.S. natives are attending and graduating medical school to fill residency positions available in America. As a result, our system is reliant on foreign medical graduates immigrating into the U.S. to bridge this gap. According to a study conducted in 2015, a quarter of all U.S. residents are foreign medical graduates, and they constitute over a third of residents in subspecialist programs [1].
Not only that, but almost a quarter of all active physicians in the U.S. were educated abroad [2]. Much like in other professions and fields of work, immigrants are more likely to work in positions that others find less appealing. For example, one of the least popular medical fields chosen by U.S. medical graduates is geriatrics: healthcare for the elderly. Fields like geriatrics are unpopular for a number of reasons, including lack of financial incentives, exposure, status, and the nature of the specialized work. With the increasing number of the elderly and the decreasing interest surrounding the field, less and less of the residency slots are getting filled [3]. To account for the deficit of graduates, currently foreign medical graduates constitute 50.7% of doctors specializing in geriatric medicine [4].
Foreign medical graduates can be subject to discrimination by patients who believe that their “foreign-ness” indicates a lower quality of patient-care as a physician [5]. An observational study from 2010 disproved such beliefs by finding that there were fewer observed in-hospital deaths for patients that were cared for by foreign medical graduates in comparison to the in-hospital death counts of patients cared for by U.S. medical graduates [6].
As of 2015, the U.S. ranks dead last in the amount of medical graduates per population when compared to twenty-seven other major countries [7]. Some argue that the small amount of U.S. medical graduates is greatly contributing to the doctor shortage we face now in the U.S. [8]. If the U.S. isn’t training enough doctors natively, then out of necessity the healthcare system must rely on a supply of foreign medical graduates. Cracking down on immigration would only make it more difficult for foreign-trained medical professionals to help boost our already “unpopular” and “problematic” healthcare system, as described by a Gallup poll [9].
While there are many other issues in the crisis that is the doctor shortage [8], barring foreigners from practicing medicine in the US is hardly beneficial to our current healthcare system. Foreign doctors are doing work that domestic doctors would prefer not to do. Instead of tightening a system that already makes it hard enough for foreign doctors to practice in the US [10], we should be considering working together with those who care for our country’s neediest.
References:
1. Ranasinghe, P. D. 2015. International medical graduates in the US physician workforce. The Journal of the American Osteopathic Association, 115: 236-241.
2. Center for Workforce Studies. 2015. 2015 state physician workforce data book. Association of American Medical Colleges.
3. Meiboom, A. A., de Vries, H., Hertogh, C. M., Scheele, F. 2015, June 5. Why medical students do not choose a career in geriatrics: A systematic review. Retrieved from Pubmed database.
4. Belluz, J., & Frostenson, S. 2017, February 3. How Trump’s immigration ban threatens health care, in 3 charts. Vox, Politics & Policy.
5. Whitgob, E. E., Blankenburg, R. L., & Bogetz, A. L. (2016). The discriminatory patient and family: Strategies to address discrimination towards trainees. Academic Medicine, 91(11), S64-S69.
6. Norcini, J. J., Boulet, J. R., Dauphinee, W. D., Opalek, A., Krantz, I. D., Anderson, S. T.2010. Evaluating the quality of care provided by graduates of international medical schools. Health Affairs, 29: 1461-1468. https://doi.org/10.1377/hlthaff.2009.0222
7. [Amount of medical graduates per population in 28 major countries]. (n.d.). Retrieved from Organization for Economic Co-operation and Development database.
8. Carroll, A. E. 2016, November 7. A doctor shortage? Let’s take a closer look. The New York Times, The Upshot.
9. Healthcare system (Gallup, Comp.). (n.d.). Retrieved from http://news.gallup.com/poll/4708/healthcare-system.aspx
10. Sopher, P. 2014, November 18. Doctors with borders: How the U.S. shuts out foreign physicians. The Atlantic, Health.