Scores of doctors serving patients across Kentucky are from the six Muslim-majority countries under President Trump’s revised temporary travel ban. Those doctors, many of them in underserved rural areas, provide over 100,000 appointments in a year. Across the U.S. there are about 7,000 practicing doctors from those six countries.
These statistics come from a recent study by Harvard and MIT research economists. Their work also found that a large proportion of these doctors are cardiologists and neurologists, specialists much in demand because of the immediate attention required to treat people with heart attacks and brain injuries.
An estimated 25 percent of all physicians working in the U.S. are foreign born, according to the American Medical Association. Some are immigrants, and some are non-immigrants who received their medical training in the U.S. and are here temporarily with special visas. Many of these doctors are working in underserved communities providing treatments for patients’ needs that would otherwise go unmet – unmet because of an ongoing shortage of doctors.
The Association of American Medical Colleges in March released its updated study projecting a shortage of doctors in the U.S. that could reach as high as 104,900 by the year 2030. That breaks down into shortfalls of up to 43,100 primary care physicians and up to 61,800 specialty physicians.
The shortage of doctors is a longstanding one. In 1994 Senator Kent Conrad of North Dakota introduced a bill that has evolved into the Conrad 30 Program, which allows foreign-born doctors who received their medical training in the U.S. to apply for temporary visas to practice here in exchange for a commitment to work full-time for three years at a medical facility in a designated underserved area.
In early March, the White House rolled out a revised anti-Muslim travel ban which was immediately blocked on constitutional grounds by federal courts, the same fate of its predecessor. But the administration’s intent has been made clear, prompting The American Medical Association to write to the U.S. Department of Homeland Security: “The AMA is concerned,” stated the letter, “that this executive order is negatively impacting patient access to care and creating unintended consequences for our nation’s health care system. Specifically, there are reports indicating that this executive order is affecting both current and future physicians as well as medical students and residents who are providing much needed care to some of our most vulnerable patients.”
Further complicating the situation, as reported in the New York Times, the government has altered processing rules for H-1B Visas. The temporary H-1B Visa allows highly skilled foreign workers to join the U.S. workforce. The majority of these visas have been used for high-technology and engineering enterprises, and that use has been mired in controversy with claims that qualified U.S. workers in some cases have been displaced by cheaper foreign workers. Doctors from foreign countries who have received their medical training in the U.S. also require the H-1B Visa to work here. Starting on April 3rd, the U.S. Citizenship and Immigration Services is suspending for up to six months the expedited processing for the H-1B Visas, which, for a fee, could have the visa approved usually within a couple of weeks, otherwise the process can take months. Medical facilities that rely on expedited visas to fill doctor vacancies will be left without critical services for an uncertain period of time.
The atmosphere encouraged by the anti-immigrant rhetoric and actions of the Trump administration certainly is having negative impacts. Consider that there are near 50,000 Indian physicians practicing medicine in the U.S. providing hundreds of thousands of medical appointments and treatments for patients. On February 22nd, Srinivas Kuchibhotla, an Indian engineer, was shot and killed and his fellow Indian friend wounded at a bar in Kansas. The shooter, it’s reported, mistook them for Iranians. He shouted at them to get out of his country and fired on them. This incident shocked U.S. Indian communities and reverberated in the media of India. It’s impossible to discern how far reaching the negative impacts will be in the future. Is enrollment of foreign students at medical schools dropping and will less foreign doctors trained in the U.S. opt to practice medicine in the U.S. for underserved communities?
There are no medical school enrollment figures available for this piece. A spokesperson for the University of Kentucky Medical School wrote that it’s “too early to tell about any impact on College of Medicine recruitment. While we have a few international students enrolled in medical school, the majority are Kentucky residents.” What is known at this time is that some engineering schools are experiencing sharp declines in international applications, this according to the publication Science. The University of Massachusetts in Amherst has seen a 30 percent decline from the 2016 level of international applications for electrical and computer engineering programs. Vanderbuilt University in Nashville reports an 18percent decline in its international applications for the graduate level engineering department.
“University administrators worry,” reports Science, “that the declines…reflect heightened fears among foreign-born students that the United States is tightening its borders. A continued downturn, officials say, could threaten U.S. Global leadership in science and engineering by shrinking the pool of talent available to carry out academic research. It could also hinder innovation in industry, given that most foreign-born engineering students take jobs with U.S. companies after graduation.”
Such reports from other sectors may reflect as yet undiscerned trends in the medical world. There’s great risk here given our dependence on foreign doctors to help provide medical services to vulnerable and underserved populations in the U.S.