Future of ‘dreamer’ doctors in jeopardy as Trump rescinds DACA status; medical community ‘dismayed’ by the decision

Jeff Sessions
Attorney General Jeff Sessions announced Tuesday that the Trump administration will end DACA. Image: Gage Skidmore / CC BY-SA 2.0

President Donald Trump’s decision Tuesday to rescind the immigration protection program for younger undocumented immigrants drew harsh reaction from the medical community.

Advocates from the Association of American Medical Colleges said they were “extremely dismayed” by the decision, which Stanford University described as “shameful,” and a representative from Loyola University’s Stritch School of Medicine said was a “sad day” for the country, the healthcare workforce and patients.

Attorney General Jeff Sessions made the announcement that the administration has decided to end the Deferred Action for Childhood Arrivals or DACA, a program enacted by the Obama administration to protect young immigrants from deportation and provide them with work permits so they can find legal employment. In a written statement issued after the televised briefing, Trump said that the administration had to make a decision about the legality of DACA because officials from 10 states are suing over the program.

“The unwinding process will be gradual,” Trump said. “New applications for work permits will not be accepted, but the government will honor existing work permits until their date of expiration up to two full years from now. This will provide a window of opportunity for Congress to act on the matter.”

Mark G. Kuczewski
But the move means that fourth-year medical students with DACA status now may not have a work permit a year from now and won’t be able to go on to a residency or work with underserved populations, Mark G. Kuczewski, Ph.D., chair, department of medical education and director, Neiswanger Institute for Bioethics at Loyola University Chicago Stritch School of Medicine, told FierceHealthcare this morning. “They are bilingual, bicultural and ready to serve and they are one answer to the diversity problem,” he said.

Loyola’s medical school, the first medical school to put a policy in place for those with DACA status to apply for admissions, currently has 32 students with DACA status, according to Kuczewski. Those students felt like they took a gut punch when they heard the announcement, he said. “Most of their lives they lived in the shadows but felt that if they worked hard and did well they could eventually use their talents as a physician. DACA made them believe that more strongly. Yesterday they were told to go back to the shadows,” he said.

However, Kuczewski said they are resilient and Loyola is determined to find a way that the students can continue their studies. He called on all healthcare leaders from the American Medical Association to the Catholic Health Association to individual physicians with practices and corporate executives to call their state representatives and urge passage of the Dream Act.

The Association of American Medical Colleges also calls for similar action. In an interview with FierceHealthcare, Matthew Shick, director, government relations and regulatory affairs for the AAMC, said the organization sent a letter to Trump after the November election urging him to retain the DACA as a program until there was a permanent pathway in a place. In essence, no repeal without a replacement, he said.

In the 2016-2017 academic year, 113 students with DACA status applied to U.S. medical schools, according to the AAMC and 65 DACA students were enrolled. Although the organization doesn’t have numbers for the new year, the numbers will likely be higher because most of the 800,000 individuals with DACA status haven’t completed college.

These future doctors not only could add diversity to the student body and healthcare workforce as Kuczewski mentioned, they could also help address the projected physician shortage of between 40,800 and 104,900 doctors by 2030, Shick said.

The timing of the announcement also is unnerving because many medical students are just starting classes or clinical rotations, Karen Fisher, chief public policy officer for AAMC, told FierceHealthcare. “Medical school is already a stressful experience,” she said, noting that the timing of the announcement is “disheartening during a period when they should be studying and learning how to treat patients and instead their attention is diverted to concern about their DACA status.”

Stanford University said in a statement that it “vigorously and adamantly opposes the shameful decision,” which it says will bring “further profound disruption and uncertainty” to those with DACA status.

“At Stanford, we stand in firm support of everyone in our immigrant community,” the statement said “ Stanford will continue to advocate tirelessly for immigration reform efforts that allow us to continue to welcome students, employees and scholars who contribute to our mission of education and discovery. In that context, we urge Congress to expeditiously pass legislation to provide permanent legal residence and a path to citizenship for our country's DREAMers.”

The American Medical Association also called on Congress to ensure the dreamer doctors can remain in the country. The decision, said AMA CEO and Executive Vice President James L. Madara, M.D., “fails to recognize the enormous contributions of hundreds of thousands of individuals who are living, working, and providing vital services in the United States, including healthcare services.”

Furthermore, Madara said the AMA is especially concerned that the policy reversal could have “severe consequences for many in the healthcare workforce, impacting patients and our nation’s healthcare system.”