Match Day reminds us that thousands of doctors are sidelined in our fight against COVID-19
Medical schools across the country recently announced who “matched” to residency and fellowship programs, a final step in becoming a licensed, practicing physician in the U.S. Thousands of qualified, experienced immigrant and refugee physicians were in the running for these slots, though they have already completed residency in their home countries. Many have practiced medicine for years — if not decades — abroad.
Yet this year, just 55 percent of these non-native international medical graduate applicants matched for residency, down six percentage points from 2020 match rates. By comparison, 93 percent of U.S graduates got spots. Scoring a scarce residency slot is among the myriad barriers that keep an estimated 165,000 immigrant and refugee healthcare professionals from contributing their training and skills to the U.S. health sector.
Sura, a participant in my organization’s job coaching program, is among the thousands of immigrant and refugee doctors currently sitting on the sidelines of our healthcare system. She is originally from Iraq, but lived as a refugee in Syria, where she studied medicine, completed residency, and practiced medicine as a licensed physician. When she resettled to Chicago as a refugee in 2014, she brought 20 years of experience, a valid medical degree, and valuable multilingual skills with her. Her years of experience in conflict and crisis situations have prepared her well to serve on the frontlines of the pandemic response. But instead of treating patients during this time of need, she’s earning minimum wage in an administrative role.
That talented doctors like Sura languish in low-wage jobs as our healthcare system has struggled to manage COVID-19 is disappointing at best. When considered in the context of intensely overworked medical personnel who have treated millions of COVID patients, including the 530,000 who have perished to date in this pandemic, this waste of healthcare talent is indefensible.
In 2020, Sura passed the last of three steps of the U.S. Medical Licensing Exam (USMLE), the U.S. equivalent of a test she’d aced in Iraq two decades earlier. But since then, she’s struggled to match for residency.
The barriers that have stymied Sura’s career are similar to the hurdles we see in other hiring systems: immigrants and refugees have limited professional networks in this country, unfamiliar degrees and experience on their resumes, and limited experience with U.S.-style interviews. Many programs automatically filter out international graduates, meaning their applicants aren’t even considered. And at age 48, Sura’s years of experience actually work against her: Residency programs tend to prefer more recent graduates.
We need Sura’s skills, arguably now more than ever. Multilingual abilities and cross-cultural competencies are consistently linked to improved patient outcomes, particularly in the immigrant and communities of color that have been hit hard by the pandemic. Many immigrant and refugee healthcare professionals are veterans of efforts to fight SARS, Ebola, Swine Flu in their home countries and now offer invaluable experience to the U.S. COVID-19 response.
Opening opportunity for this community of talented healthcare professionals requires our residency, licensing, and hiring systems to begin to recognize international credentials as assets, not liabilities.
There is precedent for these much-needed reforms. Pre-COVID, states like Minnesota, Missouri, New York and Virginia had begun to address the accessibility of their licensing processes so that more foreign-trained healthcare professionals can put their skills to work. In recent weeks, Washington State’s House passed a bill that would allow internationally-trained physicians to practice in some state-run health facilities under the supervision of a licensed doctor. The White House has also encouraged states to create temporary licenses for foreign-educated healthcare professionals, part of an effort to ‘surge’ our nation’s vaccination workforce.
The pandemic has stretched and strained our system in heartbreaking ways. But the need for a resilient healthcare workforce won’t end when COVID-19 is under control. Analysts project a shortage of 122,000 physicians by 2032. Now is the time to build systems that recognize and utilize the skills of everyone in this country.
If a silver lining exists, it is that we now have the opportunity to apply and scale the lessons learned during this time of crisis to improve our quality of life in times of bounty — and utilize a readymade workforce to do the work that must be done.
Jina Krause-Vilmar is CEO of Upwardly Global, an organization that removes employment barriers for immigrant professionals.