Foreign-trained doctors can wind up facing an uphill climb when they look for opportunities to practice in the United States.
With consistent reminders about the ongoing physician shortage in the news, turning to foreign-born doctors might seem like a natural solution. The foreign-trained doctors who spoke with CommonHealth, however, found the barriers to getting licensed much higher than expected. Afsaneh Moradi, who trained in Iran, studied for five years to complete the myriad certifications and examinations required for her to practice in the U.S., but has been unable to score a residency match. While the match rate for physicians from American medical schools sits at nearly 95 percent, the match rate for foreign-born graduates is much lower.
David Scales, M.D., of Cambridge, says the majority of the problem lies with “prestige bias” among residency program directors, who prefer applicants from better-respected medical schools. Vice President of the American Association of Medical Colleges Atul Grover, M.D., points to a freeze on federal funding for residency positions depressing the number of slots available, but Fitzhugh Mullan, M.D., of the George Washington University Health Workforce Institute, disagrees with this assessment. Mullan not only believes residency slots are sufficient to meet the demands from U.S. medical schools, but that offering more slots to foreign-born doctors simply because they want them makes little sense. He sees the movement of doctors from poorer countries to wealthier ones as a bigger issue, arguing that the poorer countries are more likely to require their services.
Meanwhile, Elise Tristan-Cheever, who practiced pediatric surgery in Brazil, wound up taking a job as an administrator with Cambridge Health Alliance after working low-wage jobs while she tried to go through the licensing process. The Massachusetts Immigrants and Refugee Advocacy Coalition estimates there could be more than 60,000 unlicensed foreign-trained doctors in the U.S.
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