No Jobs For American Doctors?

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July unemployment came in at 10.2 percent last month, still above the 10 percent high in the 2007-2009 recession. Now more than ever, every effort should be made to create and keep jobs for Americans across all professions to ensure that our country rights itself. That includes those professions that are, mistakenly, perceived to be recession-proof.

Media coverage in recent few months has bemoaned that some doctors on visas might have to leave the U.S., or not be allowed to enter the country with pandemic travel restrictions. But there’s been scant attention paid to the thousands of recent American graduates of medical schools who remain unlicensed, and thus unable to practice medicine.

Why? One factor is that U.S. taxpayer-funded medical residencies have gone to doctors from other countries – more than 4,200 just this year – those that media is so concerned about.

As doctors and nurses work 12-hour shifts, nearly dropping from exhaustion and with no pandemic end in sight, there is another long-ignored conversation – the prolonged U.S. doctor “shortage.” That we would have a doctor shortage when we have thousands of newly minted doctors not working is certainly confusing.

An obvious solution to what’s being consistently reported as too few doctors is to put our own talented, dedicated doctors to work and to eagerly recruit and encourage others to enter medicine, rather than pilfer, hijack and steal the physicians from other nations.

We as a nation hold the embarrassing 52nd spot in the world in our doctor-to-patient ratio, far behind dozens of other nations, including some developing countries. Armenia, Azerbaijan and Andorra outrank America. Cuba, with 8.19 doctors per 1,000 patients, has the highest doctor/patient ratio and contrasts to our 2.59 doctors per 1,000 patients.

We cannot continue to invest taxpayer and other dollars in training doctors only to then push them aside, effectively saying, “Although you thought you had reasonable, fair and equitable expectations when you graduated from medical school, you were wrong. Fooled you!” It’s completely unsustainable, as has been our approach in other areas, including technology.

In the last decade, more than 36,000 non-U.S. citizen students and graduates of international medical schools have been granted U.S. residencies (remember, they’re taxpayer-funded), and in each of the last ten years, the number has gone up, from 2,721 to 4,222 this year. All this is happening as our U.S. citizen doctors may be left driving Uber, with eight years of education that doesn’t easily transfer to another profession, and perhaps as much as half a million dollars in student loan debt.

By every ethical and moral standard, we are violating our social contract with our own citizens. It is nothing less than immoral and unethical to have medical students – students accepted into highly competitive schools – rise to meet brutal academic requirements and, in most cases, take on a huge debt load for their educations, all in the hopes of serving others, only to be shut out of the whole system. “Sorry! We’ve decided to hire the doctors from other countries instead.”

This is a most brutal and unacknowledged form of discrimination.

The powerful American Medical Association, which has lobbied for more H-1B and J-1 visas to bring in foreign doctors, has a lot of explaining to do, as does the Association of American Medical Colleges. Ditto our elected officials in the House and Senate.

Our doctors are waiting to go to work.

Kevin Lynn is the founder of Doctors without Jobs and U.S. Tech Workers. Contact him at [email protected]

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We Should Prioritize Hiring American Doctors

Outsourcing U.S. jobs to foreign markets followed by replacing local workers with foreign laborers has been the reality of our labor market for almost two decades.,

Manufacturing was the start of outsourcing, and then employers moved on to back-room corporate operations like credit card processing and call centers for customer service. This was followed by importation of workers from around the world for jobs in accounting, tech – and all the STEM fields – and health care. Still, some will be surprised to learn that even physicians have been negatively impacted by the importation of foreign labor.,

Each year, hundreds of American graduates of medical schools do not match to hospital residencies. Under the current medical system, doctors who do not complete a residency cannot practice as doctors. While these doctors can reapply in successive years for resident positions, the chances of matching to a residency diminish as more years pass.,

After a tremendous commitment to education of at least 20 years – that’s 12 years of public school followed by eight years of higher education – that doctors are shut out of their profession is mind-boggling. These are doctors who are likely to have incurred hundreds of thousands of dollars of debt to obtain their medical degree. After completing a residency, an average doctor’s salary (primary care physician – family medicine, internal medicine, pediatrics and psychiatry) is approximately $10,000 a month (higher for specialty fields), but without this salary, it’s impossible to service the huge debt load.,

Even though they are highly educated, doctors cannot just readily choose another professional field. They have very specific training that doesn’t lend itself to other careers, and they may be seen as overqualified for many positions. As well, alternate careers may require more education, which a doctor already carrying perhaps half a million dollars in debt might be reluctant to grow further. Even if one were to go this route, for instance, to obtain teaching credentials, the typical teacher’s pay would be insufficient to cover the debt load – and live.

It’s a baffling situation, considering the attention that has been given to a reported doctor shortage in the United States that’s expected to get worse, according to the Association of American Medical Colleges, which estimates a physician shortfall of between 35,000 to 88,000 by 2025. If there’s such a shortage, it’s difficult to understand how this year 1,927 U.S. medical school seniors and previous U.S. medical school graduates did not matriculate into residency training, according to the National Resident Matching Program, a nonprofit organization which matches the preferences of medical students to U.S. residency positions.

Further perplexing in the face of doctors going unemployed is that at the same time, for years, non-U.S. citizen international medical graduates have filled U.S. residencies. Roughly 12 percent of the 30,000 residency positions in a year are given to foreign doctors.,

For 2014 to 2018, non-U.S. citizen students/graduates of international medical schools who were given residency averaged 3,763 each year. For the same period, the number of U.S. medical school seniors and previous U.S. medical school graduates who did not obtain a residency averaged 1,894 each year.,

Based on the math above, simply prioritizing American citizens who’ve graduated from medical school would ensure they all are placed into residencies, while still leaving slots for foreign doctors.,

Many American citizens committed to a grueling, competitive education, expending significant resources of time and money, in order to become physicians. The country too made an investment in these future doctors through years of public education and the extension of loans. To not prioritize U.S. citizen medical school graduates over foreign doctors is a huge malinvestment that makes no sense.

Kevin Lynn is the Executive Director of Progressives for Immigration Reform. Contact him at [email protected]

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