WASHINGTON: Foreign educated doctors may soon not be welcome in the United States, if the Clinton Administration succeeds in getting legislation through the Congress in the next few months. And many of those ‘already here may be asked to leave.
The Department of Health and Human Services is seeking to curtail a visa programme that has allowed foreign doctors who have finished training to remain in the United States if they practice in poor areas, the New York Times said on Tuesday.
But if the Congress and the Department of Health and Human Services have their way, foreign born graduates of foreign medical schools will be largely barred from this country in the future.
While the Congress moves to shut the pipeline for residents, the Department of Health and Human Services under the leadership of Secretary Donna E. Shalala is moving to curtail physician immigration programmers.
This summer Ms. Shalala wrote to her counterparts at the Department of Agriculture and Housing and Urban Development to request that they no longer issue immigration waivers to foreign physicians, citing a national surplus of doctors. For the moment, the HUD program is on hold.
If the anti-doctors lobby has its way, foreign doctors, who work where many American doctors refuse to go may be an endangered species, the New York Times said.
Facing an oversupply of doctors, the Clinton Administration and Congress, in separate measures, are scaling back the government programs that have Tong allowed graduates of overseas medical schools to practice in the United States, providing crucial care in the sickest, poorest neighborhoods.
The Times said medical groups ‘which have long tolerated if not embraced foreign doctors, are turning Against them as competition for medial jobs increases in an industry that has been thrown into turmoil by budget cuts and the growth of managed care.
Public hospital administrators are in near panic at the prospect of losing a huge chunk of their work force.” There is this myth that if we cut off the supply of international graduates, somehow there are going to be American doctors who are going to want these jobs,” said Kalman Resnick, a Chicago lawyer who has helped Cook County Hospital find foreign trained doctors. “And that is just not the case.”
Of the 1,261 doctors in training who dispense care full time at New York’s public hospitals, nearly 70 percent are foreign-born graduates of overseas medical schools, and the percentage is even higher at some private hospitals in poor neighborhoods. At Bronx Lebanon it is 71 percent; at North General! Hospital in Harlem it is 91 Percent.
The international medical graduates, many of whom were recruited to this country by hospitals in need of their labor, feel betrayed.
“When this country needed a lot of physicians to help the health care system, international graduates was very welcome wined and dined,” said Dr. Busharat Ahmad, a Pakistani born ophthalmologist, who practices in Monroe, Michigan.
“And now when they don’t need so many they are thrown by the wayside and no one cares.”
The House Medicare bill that passed last month will cut federal subsidies for many if not most doctors in training who are international medical ‘graduates. Over SO percent of doctors in training fall into this category at many intercity hospitals, where such doctors dispense the bulk of frontline care.
Within the profession, graduates of foreign medical schools say they are facing new levels of bias, with groups like the American Association of Medical Colleges lobbying to restrict opportunities for foreign physicians.
This the latest phase in this country’s ambivalent relationship with foreign medical graduates, who are at once deemed inferior in training but critical to the delivery of health care to the poor. Central to the debate about the proper role of foreign trained doctors are a ‘couple of facts: First, that there are TOW too many doctors in the United States, particularly specialists, and health economists say this surplus breeds inefficiency and drives up ‘costs, And second, there are 149,000 international medical graduates now Practicing in the United States, which ‘mounts to 20 percent of the nation’s Physicians—a number that has been accelerating fast. Virtually all of these doctors enter the country for medical training but remain for years after world. To groups as diverse as the American Association of Medical Colleges.an industry group, and the Center for the Health Professions at the University of California at San Francisco, a research group, the proper course is a matter of simple match.
Officially, most foreign doctors who Obtain visas to train in this country do so with the explicit understanding that they will leave once that training is finished, But more than 75 percent and perhaps as many as 90 percent of these doctors end up practicing here, both because of poor job prospects in their native countries—most are from or nations—and because the technology based training they receive here is irrelevant at home. Although they come initially for primary care training, in the end most specialize. [P.L.11/17/95).
Article extracted from this publication >> December 1, 1995
