Foreign-born doctors worried about their jobs

|     Michael Ollove     |

WASHINGTON (The Washington Post) – Just a few months ago, the future appeared promising and certain for Sunil Sreekumar Nair. A British citizen, he was completing a residency in internal medicine at a Brooklyn hospital and had accepted a job in a hospital near Fort Smith, Arkansas, a rural area with a severe shortage of doctors.

Then the Trump administration announced that it was suspending the 15-day expedited process to obtain an H-1B visa, a programme that allows US employers to temporarily employ foreign-born workers in specialty fields such as medicine and information technology. Now Nair may not receive his visa for at least eight months, long after he is supposed to show up for his new job in Arkansas.

The Arkansas hospital has offered to keep the job open for him, but Nair isn’t even sure he’ll be able to stay in the country after his original visa expires with the end of his medical residency in June.

“To say I am frustrated would be an extreme understatement,” Nair said.

In addition to suspending the expedited application process, President Donald Trump in April ordered a review of the entire H-1B programme.

The uncertainty swirling around the H-1B programme is creating problems for parts of the country that have difficulty attracting American physicians.

“For us, this has been a very positive programme that has brought health care to areas of Wisconsin that would otherwise go without,” said Lisa Boero, legal counsel for the immigration programme at the Marshfield Clinic Health System. Marshfield Clinic operates more than 50 facilities in central and northern Wisconsin.

Hospitals in distressed urban neighbourhoods also rely on foreign-born graduates of medical schools to fill residencies that might otherwise go vacant.

Fadel Nammour obtained an H-1B visa in 2002 and moved to Fargo, North Dakota, to practice gastroenterology. He is now a US citizen. - THE WASHINGTON POST
Fadel Nammour obtained an H-1B visa in 2002 and moved to Fargo, North Dakota, to practice gastroenterology. He is now a US citizen. – THE WASHINGTON POST

“Who else is going to do the work if we lost them?” asked Conrad Fischer, director of the medical residency programme at Brookdale University Hospital and Medical Center in Brooklyn, where Nair is chief medical resident. “We would have to close down.”

This year, for the first time in five years, the number of applicants for H-1B visas dipped below 200,000. However, immigration experts say it’s too soon to attribute that drop to Trump’s policies or anti-immigrant and anti-refugee rhetoric in the United States.

The Migration Policy Institute, a Washington think tank, says US patients are being treated by about 230,000 foreign-born doctors. That amounts to about a quarter of the country’s physician workforce.

A study published in April found that federal officials granted permission for nearly 10,500 physician jobs to be filled by foreign-born doctors with H-1B visas in 2016.

According to that study, New York state had the highest number of H-1B physician slots approved in 2016, with 1,467. If those slots were all filled by H-1B visa holders, they would represent about 2.5 per cent of the total number of doctors doing clinical work in the state.

In North Dakota, the approved H-1B slots represent a greater percentage of the total number of practitioners, nearly 4.7 per cent. “They are vitally important to our state,” said Courtney Koebele, executive director of the North Dakota Medical Association.

The current vice president of the association is a former H-1B visa holder. Born in Lebanon, Fadel Nammour completed a medical residency in gastroenterology in New Jersey under a short-term visa called a J-1. He was supposed to return home after his studies. But he wanted to stay.

In 2002, Nammour was offered a job with a health plan in Fargo and received an H-1B visa, which cleared him to stay in the United States for up to six years. In Fargo, he married a local woman, had three children, obtained a green card, bought a home, became a naturalised US citizen in 2010 and opened his own practice in 2013.

If the H-1B programme ever launched an advertising campaign, Nammour could be its face.

“We aren’t taking jobs from Americans,” Nammour said. “We are filling jobs that Americans weren’t taking and providing a service that North Dakota needs.”

Pope Moseley, dean of the medical college at the University of Arkansas for Medical Sciences, said that the university, which had 86 slots for H-1B visa holders in 2016, used the visa programme to recruit pioneering researchers from around the world.