CLEVELAND, Ohio — President Donald Trump’s controversial executive order on immigration couldn’t have hit at a worse time for international medical students and U.S. hospital residency programs — right in the middle of the competitive process leading up to March’s Match Day.
In Northeast Ohio, between 15 and 25 percent of residency programs are filled by international students. Trump’s executive order temporarily barring immigration from seven majority-Muslim countries has thrown a wrench into an already complex match process, causing uncertainty for medical students and concerns about fairness among those who are ranking them.
“It seems likely that residency program directors will be reluctant to rank J-1 visa applicants because they may not be able to enter the country to begin training,” said Mona Signer, president and CEO of the National Resident Matching Program in a statement.
In a statement earlier this week, St. Vincent Charity Medical Center said “we may be forced to turn away our best candidates for fear that their citizenship will be an obstacle. This is detrimental to both the advancement of medicine and the care of our patients. And it is an affront to our faith.”
The executive order has already interrupted medical training for one Cleveland Clinic doctor, internal medicine resident and Sudanese citizen Suha Abushamma, who was detained and unable to return to the U.S. after traveling to Saudi Arabia last week.
The Clinic, which receives more than 5,000 applicants each year for its 650 residency slots, said international medical graduates fill about a quarter of those slots.
Clinic spokeswoman Eileen Sheil said the hospital system’s plan this year is still to “rank to match the best and the brightest applicants from around the country and around the world.”
UH spokeswoman Alicia Reale echoed the Clinic’s statement, saying UH will continue to analyze the order’s impact on recruitment. “University Hospitals remains committed to recruiting the most promising rising physicians from all nations and backgrounds to train at UH,” she said.
In an email sent last week, MetroHealth Director of Graduate Medical Education Marcie Becker told staff compiling their match lists to be aware of the travel restrictions.
“Please check your match lists and check citizenship of your applicants who are requesting a visa,” the email read. “I will be happy to review any applicant file prior to submitting your rank list.”
Becker was not available to comment on the email.
“We try to match with the best possible candidates, and that includes physicians from outside the United States,” MetroHealth spokeswoman Tina Arundel said. “MetroHealth does not discriminate based on national origin.”
Last year, there were 10,170 non-U.S. citizen international medical graduates who registered for the main residency match, 7,460 who submitted rank order lists, and 3,769 who matched, according to the resident matching program.
NRMP does not keep track of international medical graduates by citizenship, so it’s hard to know exactly how many students could be impacted by the executive order, which targets Syria, Iraq, Iran, Yemen, Sudan, Somalia and Libya.
There are about 1800 doctors enrolled in residency and fellowship programs who graduated from medical school in the seven countries, according to a letter sent to members of the graduate medical education community Thursday that was written by Dr. Thomas Nasca, CEO of the Accreditation Council for Graduate Medical Education (ACGME).
“These physicians are providing much-needed medical care to a conservatively estimated 900,000 patients in urban, suburban, and rural communities across the country annually. They too are a valued and welcomed group of colleagues,” Nasca said.
Noting this fact, the American Medical Association on Wednesday asked the Trump administration to clarify the executive order to avoid affecting patient care and the training of international medical graduates, or IMGs.
“The executive order places into question those IMGs who have applied for or who have been granted visas to come to the United States to train and provide care in underserved communities,” wrote AMA CEO Dr. James Madara to Secretary of Homeland Security John Kelly. “Guidance is urgently needed from the Administration to ensure the upcoming residency matching program in March 2017 does not leave training slots vacant and that all qualified IMG applicants can participate.”
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