On Friday evening, President Donald Trump signed an executive order halting immigration from Syria, Iran, Iraq, Libya, Somalia, Sudan, and Yemen. It’s a reckless order that has sweeping implications for the medical community and its future generations. In March, medical students and graduates of foreign medical schools will learn if they matched with a residency program and can pursue their medical careers. With Trump’s executive order come concerns that applicants from those seven countries will be disregarded because of questions over whether they’ll be able to enter and stay in the United States. The order could easily end medical careers in America before they begin. I’m a first-year resident at Cambridge Health Alliance, so I remember distinctly the difficulties and anxieties of applying for a residency. For a woman I know here in the Boston area, the executive order has added an extra layer of stress to an already stressful situation. She is a young doctor from Iran who has had several interviews all over the US. She is worried that her application will be disregarded if a program director thinks that she won’t be able to get back into the US if she goes home. She’s just applied for a visa renewal and worries that a hospital won’t take a chance on her, even though she is well-qualified. A program in Ohio has already made such decisions. “It’s very unfair,” she said. The woman asked not to be named out of fear for her placement. “We may not have a chance to get into residency because of this law.” After finishing medical school in Iran, she moved to the United States in 2014 to train in neurology. She landed eight interviews this season, which is a testament to how well her skills are regarded. Because of the order, it’s unclear which programs are still considering her and which have decided not to. This makes my heart sink. I come from a family of immigrant doctors, and I’m intimately familiar with the extra hoops foreign medical graduates need to jump through in order to train and practice in the United States. From securing research opportunities to doing additional rotations and observerships, international medical graduates often need to do more than the average American medical student just to get a foot in the door for a residency spot. We need doctors — there are shortages in nearly every specialty. For decades, the US has relied on foreign medical graduates to fill unmet need. Trump’s “extreme vetting” of Muslim immigrants may turn her dream into a nightmare. She’s convinced her nationality will affect decision-making. “It feels like you are suffocating because you cannot do anything ” she said. Another doctor I spoke to from Sudan has been preparing for three years to apply for a competitive spot in vascular surgery. He also asked for anonymity for fear of visa problems. Between taking his medical licensing exams and securing rotations with different surgeons, he has been forced to travel back and forth between the US and Sudan because his visas have allowed him to be here only three months at a time. Despite these obstacles, he was also able to secure eight residency interviews. “What I’m worried about is how this can affect the rank order lists, because this news, when it came, it came at a critical time for us,” he said. “It’s really a big blow for doctors who want to do residency in the US. We spend a lot of money and we spend a lot of physical time since our graduation to come here.” He could have gone to the UK or Saudi Arabia, but he told me that he came to the US because there is no limit to achievement here. He plans to call program directors to plead his case. “I’m shocked … I’m really overwhelmed about what is going on,” the man said. For residents already in training here, the ban has implications too. Last week, hours before Trump signed the order, I received a letter from the Committee of Interns and Residents, warning our members not to travel outside of the US. “If you are from a Muslim majority country, we recommend seeking legal advice from an immigration attorney before exiting the U.S,” the advisory warned. The CIR’s website even advises all foreign nationals legally working in this country to take precautions. “At this juncture, nationals of all countries may want to consider postponing all non-essential travel until the implications of this order become more apparent.” With all that has happened since Friday afternoon, I have realized that the executive order applies to me in a way that could affect my family — and my career. I’m married to a green card holder, and that means for the time being, we can’t travel together to visit family abroad any time soon. It’s a decision we made out of fear and uncertainty. Nothing seems more un-American than that. Source
