- Why are so many foreign doctors interning in the U.S. ?
- Do U.S. Med schools produce too few graduates to meet the yearly needs for interns/residents in U.S. hospitals?
- Are a lot less U.S. students applying to Med school? How easy is it to get into a U.S. Med School?
- Why are there too few doctors in the country ? If there are too many in desired areas such as NYC then it stands to reason that costs may go down or many would not be able to make a living.
- If there are too few home-grown doctors why don't existing Med schools ramp up enrollment?
- If there are too few home-grown doctors why don't States create more public Med Schools to fill the need?
- How about creating Med schools in rural areas, drawing from local people who would be interested in working either locally or in other rural areas?
October 1, 2008
Towns Need Doctors, and the Doctors Need Visas
By ANEMONA HARTOCOLLIS
Glossy chamber of commerce brochures from small towns and rural areas along Lake Ontario and the St. Lawrence River and in the Adirondack Mountains beckoned on tables in the Sheraton New York Hotel in Midtown Manhattan. But it was not the allure of hiking, fishing or wineries — or even the free cookies and coffee — that attracted scores of novice doctors to a job fair on Sunday.
It was the possibility of a green card.
Many of the doctors, residents at New York City hospitals, had come from abroad on visas, including the restrictive J-1 “exchange visa,” which requires them to return home for two years once they finish their studies unless they can get a waiver to work in a medically underserved area. New York State recommends about 30 doctors for J-1 visa waivers annually; typically half of the visas go to doctors working in neighborhoods like Washington Heights or the South Bronx and half to upstate communities that do not have enough physicians.
Getting such a waiver is akin to winning the lottery, and to apply for a ticket, doctors must have a signed employment contract, said Caleb C. Wistar, a State Health Department planner who was at the job fair to give advice. “This is the shining prize of working in underserved areas for people who are not citizens,” he said.
Visa politics helped turn the job fair into a matchmaking exercise. The 30 upstate hospitals that sent representatives, whose expenses were covered by the Greater New York Hospital Association, promoted their towns’ friendly neighbors and good schools. The immigrant doctors, willing to relocate for economic and professional opportunities, listened politely, then worked up the courage to ask what for many of them was the most pressing question: “Do you sponsor visas?”
Dr. Ranka Bulajic, a Serb, analyzed the job market by ethnicity: Eastern Europeans, she explained, were willing to work in colder climates like northern New York State or Oregon, while those from Africa or the Caribbean tended to prefer Alabama or Virginia. Dr. Jiwu Sun, who graduated from China’s prestigious Third Military Medical University, said that, at the age of 40 — and with a wife, two children and limited English — he was in no position to make demands of potential employers. Dr. Nadia Ferder, 34, who was born in the United States but grew up in Buenos Aires, said she did not want to return to Argentina because the economy was so bad that “lawyers, economists, doctors, architects, they are all driving cabs.”
Many studies show that newly trained American doctors, burdened with student loans and seeking status and challenges, gravitate toward urban centers. A 2007 study of physician recruitment by the Center for Health Workforce Studies at the State University of New York at Albany found that physicians practicing upstate were more likely to have come from outside New York than their downstate counterparts.
The study said that when doctors had trouble finding jobs, the main reason was their reluctance to look outside the most desirable locations, like New York City. While many American doctors aspire to work on Park Avenue, experts say, foreign-born doctors are willing to take more modest jobs as a way of establishing a toehold in the United States.
Dr. Romina Tollerutti, 31, who graduated from medical school at the University of Buenos Aires, said she learned English six years ago when she decided to come to the United States for her residency, and had struggled with the unfamiliar multiple-choice format of the medical-licensing exam. She and her husband, also a doctor, hope that fluency of Spanish will help make them more attractive to employers.
Dr. Tollerutti said that even as a third-year pediatric resident at Elmhurst Hospital Center in Queens, she was doing better financially than she would as a fully trained doctor in Argentina. “We are not saving money,” Dr. Tollerutti said. “But we have a cellphone, we have cable, I pay rent, and we have money to go out.”
Like other foreign-born physicians, Dr. Tollerutti said that having gone to a government-run medical school, where her tuition was free, made her more flexible in her job possibilities than many of her American colleagues who had to pay off staggering student loans.
Dr. Bulajic, 35, who earned her medical degree from the University of Kragujevac in Serbia and has Canadian citizenship, is doing her residency at St. John’s Episcopal Hospital in Far Rockaway.
She said New York City hospitals have their pick among residents and would rather hire a doctor with a green card than sponsor someone for a visa waiver. To work in Canada, she said, she would need another year of training. Her husband is an electrician, and they would prefer to live in an area where construction jobs are plentiful. But Dr. Bulajic is pregnant and her mother lives in Toronto, so a job in upstate New York sounded appealing, she said.
One of her competitors for a waiver was Dr. André Phillips, 27, from Barbados, who said he had earned his medical degree at the University of the West Indies campus in Jamaica, tuition-free, before landing a residency in internal medicine at SUNY Downstate Medical Center in Brooklyn. Dr. Phillips is scheduled to finish his residency in 2010, on a J-1 visa.
Dr. Phillips said he had been solicited by hospitals in the Dakotas, but would rather stay on the East Coast, closer to his family in Barbados. His goal, he said, was not to be rich but to be comfortable. “Money is not the reason I went into medicine,” he said, adding that he would be satisfied with “a nice three-bedroom house and a sedan.”
A recruiter from the Finger Lakes region said her hospital could sponsor visas.
“How about the lawyer’s fee?” Dr. Phillips asked.
“We reimburse that,” the recruiter replied.
Nearby, Rich Duvall, a human resources administrator for Carthage Area Hospital in Carthage, N.Y., gave the hard sell to a doctor from India and his family. Carthage, a medically underserved area that calls itself “the gateway to the Adirondacks,” had it all, he said: snow sports, river sports, hiking and, thanks to the soldiers at nearby Fort Drum, diversity.