This week saw the signing of the second version of the executive order banning nationals from Muslim-majority countries from traveling to the U.S. - this time permitting current visa holders and citizens of Iraq.
The initial travel ban signed on January 27th and its revision come at the same time as the new administration has cracked down on illegal immigration with new deportation policies and stricter border controls. In addition, this year has seen an uptick of acts of intimidation against minorities with acts of violence specifically against Indian Americans, including two engineers, occurring in recent weeks.
It's in this atmosphere that it is necessary to point out the valuable, arguably essential, part that foreign-educated graduates play in our medical system. Just as in other technology heavy fields, foreign graduates work at every level of health care system - in clinical medicine as nurses, pharmacists and physicians and as graduate students and researchers in academia and private industry working to further the basic science and clinical research that is at the heart of medical innovation.
A recent analysis done by Harvard Medical School faculty found foreign trained doctors make up 21% of those working in the U.S. - a total of over 164,000 physicians. Of this group, over 8,000 physicians are from the seven nations targeted in the first travel ban.
Immigrant doctors are especially essential to the rural healthcare system. Foreign nationals, seeking visa guarantees from employers, will often choose to work in rural areas that highly-trained U.S. citizens are leaving behind. The Immigrant Doctors Project, an analysis performed by MIT and Harvard graduate students, found that physicians from the banned nations are most heavily concentrated in the rust-belt states of Michigan and Ohio. At a time where there is a profound physician shortage in rural counties it makes no sense to restrict the entrance of professionals who are willing and able to work in these areas.
In addition to those directly targeted by the ban it appears recent events have the potential to produce a chilling effect on highly-skilled immigration from other nations as well. According to Science Magazine, engineering programs in the U.S. have seen a drop in the number of applications from international students. This is a trend that could foreshadow next year’s residency match in the US.
As the response to first iteration of the Trump travel ban showed, many Americans are not on board with the inward-looking and short-sighted policy positions of the current administration. As the social and legal response to the new ban begins we need to remember that protecting and improving U.S. healthcare remains another important reason to oppose these orders.
Osmaan A. Minhas, DO
2nd Year Family Medicine Resident
Orange Regional Medicine Center, Middletown NY
Trump’s New Travel Ban Could Affect Doctors, Especially In The Rust Belt And Appalachia. https://fivethirtyeight.com/features/trumps-new-travel-ban-could-affect-doctors-especially-in-the-rust-belt-and-appalachia/#fn-2 Published March 6, 2017.
The Immigrant Doctors Project. https://immigrantdoctors.org/ Published January 2017.
Drop in foreign applicants worries U.S. engineering schools. http://www.sciencemag.org/news/2017/02/drop-foreign-applicants-worries-us-engineering-schools Published Feburary 14, 2010.
The Immigration Ban And The Physician Workforce. http://healthaffairs.org/blog/2017/03/06/the-immigration-ban-and-the-physician-workforce/ Published March 6, 2017.
Denying Visas to Doctors in the United States. N Engl J Med. 2017; DOI: 10.1056/NEJMc1616421