A new Trump administration plan that could lead to the deportation of hundreds of international medical students enrolled at institutions that are temporarily moving to online-only learning is unfair to the students and an ill-advised action for a nation in the middle of a pandemic and facing a looming physician shortage.
The AMA is urging the administration to withdraw its modifications to the Student and Exchange Visitor Program (SEVP) for foreign students with nonimmigrant visas so medical students can remain in the country while enrolled in fall classes that have been moved online as a result of the COVID-19 public health emergency.
“If an academic institution determines that it is in the best interest of the safety of its faculty and students to offer online-only courses in the fall of 2020 as a result of the COVID-19 pandemic, then students on F-1 visas should not be penalized and subsequently deported based on a health and safety decision that a university makes,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to acting Homeland Security Sec. Chad Wolf and Deputy Director of U.S. Immigration and Customs Enforcement (ICE) Matthew Albence.
The SEVP was established as part of the Homeland Security Investigations National Security Investigations Division within ICE.
The letter cites reports that about 9% of U.S. colleges and universities are planning online-only classes for the fall and another 2% are still deciding what to do.
Dr. Madara noted that 48 U.S. undergraduate medical institutions accepted 325 foreign applicants in 2019.
“To ask these students to transfer to a new school or program weeks before the beginning of the term is not a viable solution and is completely unfair to students that have worked for years to be able to go to medical school,” Dr. Madara’s letter says.
The letter adds that the modifications do not make it clear if students will be allowed back in the U.S. to work or resume their studies once the public health emergency is over.
Unwise to deter entry
The modifications may also reduce the nation’s current and future work force by discouraging immigration and possibly causing additional financial problems for medical schools.
“At a time when physicians are needed in the U.S. more than ever, it is unwise to deter medical professionals from coming to the U.S. now and potentially in the future,” Dr. Madara wrote.
“Moreover, this modification will likely cause medical students to attend school in other countries leading to less revenue for colleges and universities … and leading to a brain drain as other countries obtain and likely retain the brightest young medical minds from across the world,” the letter adds. “We implore the administration to withdraw the modifications to its temporary exemptions for nonimmigrant students taking online classes due to the pandemic for the Fall 2020 semester.”
Should the U.S. Department of Homeland Security (DHS) choose to move ahead with its plan, Dr. Madara urges the agency to strongly consider an exemption during the 2020-2021 academic year for F-1 visa students seeking to attend, or currently attending, medical school in the U.S.
The DHS announced that it intends to publish procedures and responsibilities regarding the program modification in the Federal Register as a temporary final rule.
Keeping IMG families together
In the meantime, the AMA continues to advocate on behalf of international medical graduates (IMGs) on several fronts and recently spearheaded a letter, with 36 other medical organization, urging the administration to allow H-1B visa-holding physicians and their dependent family members to enter the U.S. in a timely manner so they can begin providing valuable medical services.
The administration’s “Proclamation Suspending Entry of Aliens Who Present a Risk to the U.S. Labor Market Following the Coronavirus Outbreak” contains a carve out for “any alien whose entry would be in the national interest” of the U.S. and exceptions for “certain medical professionals.”
“Every physician is mission critical,” the AMA and the other organizations said in the letter to Wolf and Sec. of State Mike Pompeo.
“We urge you to clarify that all health care professionals, such as medical residents and fellows, biomedical researchers, and those working in non-clinical settings—not only those who are involved in COVID-19 research and practice—are critical to our national interest, and therefore exempt from the proclamation,” the letter states.
To maintain a robust health care workforce, the letter adds, the U.S. is “heavily reliant” on IMGs who are citizens of other countries.
The organizations also call for exempting from the ban the H-4 visa-holding spouses and dependent children of H-1B physicians who are providing critical care to some of the sickest U.S. patients in some of the most under-served areas of the country.
“It is critical not to endanger patient care and our research enterprise by closing our borders to skilled health and science professionals during this pandemic and beyond,” the letter states.
A COVID-19 FAQ page offers guidance to IMG physicians and details AMA advocacy efforts on behalf of these professionals who are either currently licensed to practice in the U.S. or are seeking such licensure, and to help ensure that visa-related issues do not stop IMG physicians’ ability to continue to care for patients during this challenging time.