Our world-class economy in the United States is a result of four centuries of immigrant contributions and their integration into our communities and workforce. The past two decades of wars in Afghanistan, Iraq and Syria have brought a new wave of immigrants and refugees and California is seeing a significant increase in foreign-educated adults making a life for themselves and their families as new Americans. These individuals bring diverse and impressive educational backgrounds capable of enriching the American economy: engineers, scientists, doctors, teachers and social workers. Yet many find themselves underutilizing their advanced degrees, including MD degrees, instead working in low-wage jobs to make ends meet. This issue of foreign-educated immigrants unable to utilize their skills and education is called “brain waste.”
In the U.S., international medical graduates make up 25 percent of the U.S. physician workforce and 4 percent of the overall nurse workforce, according to the American Public Health Association. Little data, however, is available on the number of unlicensed IMGs who are refugees or Special Immigrant Visa holders. In addition to pre-migration war traumas, IMGs are confronted with post-resettlement severe everyday life difficulties. California is home to the city of their maximum concentration: Sacramento.
What are the obstacles? 95 percent of seniors in U.S. medical schools get into medical residency whereas most immigrant physicians do not. Due to “residency bottleneck,” increasing numbers of medical graduates compete for a capped number of residency slots. The 5-year post-graduation policy in U.S. medical residency programs also bars many Education Commission for Foreign Medical Graduate certificate holders from admission to training. In addition, American residency programs prefer applicants with clinical experience acquired in the U.S. Many Arab immigrants’ foreign work is thus not recognized. And it is difficult to get such experience outside of medical school or residency. Foreign-trained physicians often need assistance in English proficiency and exam preparation in navigating the path to licensure. To address this issue, UC Davis will head a cross-sectional descriptive study directed by Dr. Patrick Marius Koga, the director of Ulysses Project at the UCD School of Medicine, and Dr. Abdul Bashir Noori, the Ibn-Sina director. Along with Master of Public Health students and research assistants, barriers to a successful professional reentry of refugee and SIV IMGs — whether in practicing medicine or in alternative health, research or academic careers — will be researched to inform policy recommendations.
Our current workforce and employment systems erect barriers that prevent the minds and skills of new Americans from contributing to our economy in a more meaningful way by reaching their full potential. As Americans, our strength and future as a nation depends on our ability to embrace and integrate our immigrants fully and welcome and utilize their expertise. Policy changes must be made or programs implemented so that IMGs overcome these obstacles. With refugee IMG integration into the medical workforce, we may see a positive effect on the health of their own local refugee communities.
Nathanael Rodriguez is a fifth-year psychology major and public health minor at UC Davis. He is also a participant in the Stanford Medicine Center of Excellence in Diversity in Medical Education’s Leadership Education for Aspiring Physicians (LEAP) program to improve the health of Northern California communities, in which he is one of the research assistants.
Written by: Nathanael Rodriguez
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