CHICAGO — The American Medical Association (AMA) sent the following letter today to the U.S. Department of Homeland Security regarding the Administration’s executive order issued last week, “Protecting the Nation from Foreign Terrorist Entry into the United States:”

The Honorable John F. Kelly
U.S. Department of Homeland Security
Washington, DC 20528

Dear Mr. Secretary:

On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to urge that the Administration clarify the executive order titled, “Protecting the Nation from Foreign Terrorist Entry into the United States,” which was issued on January 27, 2017. While we understand the importance of a reliable system for vetting people from other nations entering the United States, it is vitally important that this process not impact patient access to timely medical treatment or restrict physicians and international medical graduates (IMGs) who have been granted visas to train, practice, or attend medical conferences in the United States. The AMA is concerned that this executive order is negatively impacting patient access to care and creating unintended consequences for our nation’s health care system. Specifically, there are reports indicating that this executive order is affecting both current and future physicians as well as medical students and residents who are providing much needed care to some of our most vulnerable patients.

Many communities, including rural and low-income areas, often have problems attracting physicians to meet their health care needs. To address these gaps in care, IMGs often fill these openings. To date, one out of every four physicians practicing in the United States is an IMG. These physicians are licensed by the same stringent requirements applied to U.S. medical school graduates. They are more likely to practice in underserved and poor communities, and to fill training positions in primary care and other specialties that face significant workforce shortages. 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. 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. We urge the Administration to provide details and mitigate any negative impact on our nation’s health care system.

On a related issue, the AMA urges the Administration to carefully consider any future action related to individuals with Deferred Action for Childhood Arrivals (DACA) status. We were pleased to see President Trump’s recent comments about working to ensure that individuals with DACA status are able to remain in the United States. According to the Association of American Medical Colleges, 61 U.S. allopathic medical schools reported that they considered applications from students with DACA status for the 2016/2017 academic year. In 2016, 108 students with DACA status applied to U.S. allopathic medical schools, and 34 of those individuals matriculated, bringing total allopathic medical school enrollment of DACA-eligible individuals to approximately 70 students. One study has predicted that the DACA initiative could introduce 5,400 previously ineligible physicians into the U.S. health care system in the coming decades.

The AMA strongly supports medical students and physicians with DACA status. These individuals help contribute to a diverse and culturally responsive physician workforce, which in turn helps benefit all patients. We urge the Administration to retain the current DACA initiative until a permanent solution on lawful immigration status for DACA participants is implemented.

Thank you for considering our concerns.

James L. Madara, MD

Editor’s Note: The AMA has noted the following news reports indicating that the executive order is affecting patients, as well as physicians and medical students who are providing much needed care to some of our most vulnerable patients:

Ban sparks panic among refugees awaiting urgent medical care in U.S.Reuters
Trump’s Executive Order Strands Brooklyn Doctor in SudanProPublica
Meet the scientists affected by Trump’s immigration banNature

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About the American Medical Association

The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.