Navigating US immigration in the time of the coronavirus

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Future entry into country for graduate medical students, research fellows at risk

Navigating US immigration in time of coronavirus

This article was reviewed by Fasika Woreta, MD, and Sidra Zafar, MD

President Donald Trump recently signed an executive order temporarily suspending immigration into the United States in response to the coronavirus pandemic and the need to protect domestic jobs.

The executive order initially was supposed to be in effect for 60 days. However, shortly thereafter the suspension was redefined as indefinite.

This ban raised a question about the ability of foreign medical graduates to enter the country in the next wave of openings for residencies and research positions. Will the new students and fellows be able to come in ,and will the ones who are already here be allowed to stay?

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According to Fasika Woreta, MD, currently a post-doctoral research fellow at Johns Hopkins University School of Medicine, Baltimore, this is a stressful situation because it is unknown if visas will arrive in a timely fashion.

“There are numerous international graduate students working in many hospitals in the United States, and a travel ban is really going to affect delivery of health care and residency programs throughout the country,” Woreta said. “In addition to affecting clinical care, this ban also affects the ability of research fellows to enter the country. Innovation and research are also important in our mission.”

What to expect
The Wilmer Eye Institute accepts 5 residents per year. One such student is Dr. Woreta’s incoming resident, Sidra Zafar, MD, who is here on a J1 research visa, but hopes to change to clinical status for a residency slot at St. Agnes Hospital, Baltimore, beginning this month.

This change requires processing of a new visa application in order to begin clinical care. This visa will likely be processed in time, but Woreta foresees a problem securing a visa by students who are currently outside the United States. This ban will change the future of medical education, Woreta pointed out.

“Previously, we were able to rank applicants based on merit and not worry about their visa status,” she said. “If they were exceptionally talented, we would take them at Wilmer. Foreign medical graduates have contributed a lot to the health care system in this country, bringing incredible experience to the table. With suspension of immigration, we will have no choice but to stop accepting these talented students.”

This suspension will have a negative effect onpeople who live in areas that lack sufficient medical services.

“International medical graduates often practice in underserved areas and provide care in places there are shortages of primary-care physicians and psychiatrists. These underserved areas will be affected disproportionately by this suspension,” Woreta explained

Physicians from all specialties are being deployed to work in intensive care settings. The suspension of immigration will further exacerbate the shortage of qualified internal medicine doctors which will bedisastrous during this pandemic, she explained further.

“A temporary or permanent ban on immigration will have dire consequences in hospitals throughout the U.S.,” Dr. Woreta stated.

Timing is everything
Zafar has been a research fellow for 2 years and matched at the Wilmer Institute for ophthalmology residency, which she will begin in 2021.

She currently is on a J1 research visa and is uncertain about the next visa. Her current work visa will expire at the end of June and she started her required 1-year preliminary internship at St. Agnes Hospital on July 1.

Zafar said she is hopeful about obtaining her visa, despite the entire application process being slowed down.

“I have heard however that other individuals at different hospitals are beginning to be approved,” she said. “The current situation seems to be better than it was 1 month ago.”

For Zafar, one option is to extend her current work permit at Johns Hopkins, but she was uncertain if this would result in other problems in the processing of her visa. Returning to her home country of Pakistan is not possible because all airports are closed and she would not be able to return to the United States anytime soon.

The medical students coming from Pakistan, who would be entering the United States on a J1 visa are at the mercy of the COVID-19 virus because all flights have been suspended.

In addition, all of the graduate medical students require a Statement of Need from the Minister of Health in Pakistan issued to the U.S. Educational Commission for Foreign Medical Graduates. Because of the pandemic, obtaining these statements has become increasingly difficult.

“I am in a state of apprehension because there is such great uncertainty about what is going to happen,” Zafar concluded. “However, I am hoping for the best and that I willbe able to start my residency training on time. At the end of the day, the international medical graduates contribute greatly to health care in the United States.”

Read more by Lynda Charters

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Fasika Woreta, MD
e: fworeta1@jhmi.edu
Dr. Woreta is assistant professor of ophthalmology and residency program director at the
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore.

Sidra Zafar, MD
e: sidrazafariqbal@gmail.com
Dr. Zafar is currently a post-doctoral research fellow at Johns Hopkins University School of Medicine, Baltimore.