What should be the threshold for allowing doctors to work in the US?

The United States of America is an immigrant country. It is a melting pot of many peoples and has basically been so since before the Mayflower passengers laid foot on New England soil. Promise of equality, success, quality of life and freedom have drawn multitudes of professionals from all over the world to try to make it in the US.  Some of these professionals are doctors.

A doctor that wants to work in the US has to pass many hurdles. Some of these hurdles are immigration-bureau related, some are professional and many are actually cultural. The questions I wish to pose are: Are all these hurdles necessary? Can exceptions be made?

In order to address these questions one must first understand why these barriers have been put up in the first place. There are actually many great reasons to set restrictions for the entry of foreign doctors. First, not all that claim they are doctors in their homeland have actually graduated or been practicing physicians. In some Eastern-European countries, for example, purchasing fake documentation is not difficult. Even those who are really physicians and have actually been engaging in medical practice do not necessarily practice the same type or quality of medicine that the US government would like to see here, in the States. No doubt these two reasons are more than enough for any sound minded leader to put up barricades.

But, as is often true in life, there is a flip side to this story as well. There are many under-privileged populations in the US that are being treated much below par. There is also a real shortage of doctors in many communities. Obviously, these communities are not large cities on the East or the West Coast. But these are not necessarily communities that should be abandoned.  These two points are actually well known. I would like to surface a third point, that is often not being discussed, in my experience.

The US is not only a focal point for immigrants. It is also a Mecca for trainees. Doctors from all over the world flock to major medical centers in the States to be exposed to large patient populations and to earn skills that can later serve their own communities back home. But does this make sense? Does it make sense for American centers of excellence to practically give away knowledge and expertise, when these could potentially benefit the American people? Some of the doctors that come over to the US for training or for research are very well appreciated in their field and have promising careers in front of them.  Most of these doctors finish their training and go back to their countries of origin. Some make it there and some don’t. It is a matter of personality, opportunities and luck. No doubt, not all of them will succeed. But some will. And those with the most potential can often be marked when they are just starting off. Should they have to pass the same hurdles that all the others have to pass? Should they be discouraged by mounds of bureaucracy and testing? These are not physicians that the US wants to deter or test. These people can be vouched for by the best of the medical leaders in the country.

I claim that even though a government that has to lead over 300 million people needs a strong system in place, exceptions should be made according to local leaders’ opinions. This will not open a loop hole for less professional  doctors to infiltrate the system. It will serve as an open invitation for excellent young professionals to benefit American communities.

Ido Weinberg is founder of Angiologist.com.

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  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    I think it should go farther than this. I don’t see any reason why physicians that complete programs in countries with medical education as good as what is commonly available in the US, should not be allowed to practice in the US. It shouldn’t be too difficult to identify the foreign institutions and programs that can make this possible.

    • http://www.facebook.com/people/Steven-Reznick/100000549195050 Steven Reznick

      Agree with Margalit. Quality is quality

    • Sunjay Devarajan

      I agree with this too.  As a US native who just went through the residency interview process, it is really sad to find out that the perception of residency programs who accept foreign medical graduates is significantly worse as a result.  We forget that in order for foreign graduates to get to the US in the first place (from India, let’s say) via the officially sanctioned channels, you have to be the creme of the crop from your native country.  We don’t do a good job of acknowledging this fact.

    • http://twitter.com/Angiologist Vascular Medicine


      Thank you for this response. You can imagine that I agree with the essence of your point. Trying to think from the perspective of the immigration authority in the states, I am not sure how they can identify who is who…

      • http://onhealthtech.blogspot.com Margalit Gur-Arie

         I remember a couple of years ago requesting visas for foreign employees (can’t recall the type of visa) and there was a section where you could specify that the particular skills cannot be located in the US. There was a requirement to place an ad on a job board for a certain amount of time as well. Another section required that the foreign individuals submit their education credentials to substantiate the application.

        I think something like this could work, particularly for primary care in more rural and underserved settings. Surely, a list of credible international medical schools and residency programs could be compiled for immigration folks to use. The catch would be that a prospective employer would need to initiate the request.

        I am aware of the ill effects this would cause to other nations, but ill effects did not stop anybody in the US from off shoring American jobs, so maybe this is the price of globalization….

  • http://pulse.yahoo.com/_2LRZNHDZS6DU45WQ567LPQ7CMI ninguem

    “……Doctors from all over the world flock to major medical centers in the
    States to be exposed to large patient populations and to earn skills
    that can later serve their own communities back home…..”

    Do we actually have statistics on this?

    How many doctors come to the USA to train, and then return to their native country?

    I can count on one hand, the number of docs I know or met, who came here to train then returned to their homeland. This is after decades of medical practice, many years in residency and fellowship, and several years in academic medicine.

    Surely someone’s counted this sort of thing. Doctors who are foreign nationals, trained outside the USA, who come here for postgraduate training. How many actually return to their homeland to practice?

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