Upcoming Match spotlights visa woes facing residency programs

Late arrivals and no-shows bring fresh anxiety to this year's Match.

By Myrle Croasdale, AMNews staff. March 8, 2004.

As a first-year psychiatry resident, Aftab Khan, MD, should be busy learning psychotherapy and psychopharmacology. Instead, he's making repeated visits to the U.S. consulate in Hyderabad, India, pleading to be allowed to return to the United States.

He left West Virginia University in Charleston in early February to get married in India. He was supposed to be gone two weeks. He has a valid visa, but he's caught in a bureaucratic snafu that is threatening his visa status.

"He's pretty sad," said Thomas Dickey III, MD, Dr. Kahn's program director. "He said in an e-mail, 'One day I'm a resident about to get married; the next I feel like a nobody.' "

This is the latest in a year of visa woes for Dr. Dickey. Only two out of his five first-year residents started July 1. Of the three with visa issues, one was delayed until Aug. 1, the second until the third week of September and the third denied a visa altogether. Dr. Dickey waited until October, then started looking for someone else. The replacement started Jan. 1, but Dr. Khan's problem has thrown the program right back into the cycle of uncertainty.

"You can imagine how disruptive this is," Dr. Dickey said.

International medical graduates make up one-quarter of the resident work force, and problems such as Dr. Dickey's have plagued residencies across the country following implementation of heightened security measures by the Dept. of Homeland Security.

Now, with the National Resident Matching Program's Match day looming, residency directors are edgy. Many can't fill their programs without IMGs, yet hiring physicians who need visas has become risky business.