By Sreekanth Donepudi, MD, MPH
When we think about the medical workforce in the United States, often forgotten are the 1,2000 international medical graduates (IMGs) mostly practicing in rural and underserved areas on temporary visas, often for decades. Many of us are from India, and I am one of them. Having completed a master’s degree in public health at the University of Birmingham, a fellowship in geriatric medicine and hospice and palliative care at the University of Nevada Reno, and a medical oncology fellowship at University of Arizona, and working in rural community in Pierre, South Dakota since 2014, I am still on a temporary visa, with the expectation that I probably won't receive permanent legal status in my lifetime due to my country of birth. You heard it right. U.S. immigration has an arbitrary cap of 7% of “green cards" for any particular country, dating back to the 1990s. This country cap is especially frustrating for those of us from India and China, due to the large number of skilled professionals trying to immigrate from these countries. I am in a line, as I have always been.
The current pandemic has thrown a new wrench in my daily living. If something happens to the doctor on a temporary visa, their family has to self-deport. We don't really have any rights, as we are “foreigners,” and most IMGs know this. Every hospital administration is preparing for the surge of patients with COVID-19 and are asking specialist doctors if they are willing to work in the ICU, ER, etc. The doctor in me says that I should not hesitate to volunteer, but the father in me says that it is not worth risking my children’s future.
There are other challenges on being a temporary visa. I cannot work outside my designated workplace on my visa, meaning I cannot work in the emergency department of a different hospital, even in a pandemic when every medical professional may be needed. I have limited job opportunities due to visa restrictions. I cannot apply for most grants, as they require permanent legal status or citizenship. When I am denied equal opportunities, I sometimes wonder, why should I risk my life and put my family at risk by working in a high-risk COVID area like the ICU or ER? Even as some organization have requested that the Administration remove some of the visa restrictions, often they don't ask for any protections for visa holder’s family. IMGs are leaders in our local communities, but we are invisible to national organizations and to the rest of world.
Almost every organization is receiving some kind of relief during the pandemic. It is sad that no major organization has really stood up for the “little guys”—for IMGs working in small, rural, and underserved communities. Some of us have gathered and started Physicians for America Health Care Access (PAHA). We are advocating for the passage of House Bill HR2895 and Senate Bill S948. These bills are intended to streamline the pathway to permanent legal status for any IMG who has worked in a rural or underserved community for 5 years. This is only fair and reasonable.
Despite our individual member efforts, no major organization had lent us their support or held our hand. This has left an empty feeling among many IMGs, particularly those of us of Indian origin, that we are invisible and dispensable.
Dr. Donepudi is a medical oncologist at the Avera Cancer Institute in Pierre, South Dakota, and a clinical assistant professor at the University of South Dakota. Follow him on Twitter @sreekanthdonep4.