President Trump’s immigration ban is not just keeping out “potential” terrorists, it will also impede the intellectual and cultural exchange in medicine. Limiting travel will halt immigration pathways to medicine and threaten access to high-quality healthcare for some of our country’s most underserved populations.
Border walls, travel bans and other social fences such as racial anxiety will completely disrupt the social mandate to diversify medicine, as we block opportunities to cultivate global and national medical education. Darrell G. Kirch, M.D., President of the Association of American Medical Colleges (AAMC), said this executive order directly impacts thousands of medical students, residents, fellows, faculty members, physicians, and scientists. It affects students like Mustafa.
Mustafa was born in Kenya and lived through a civil war that forced his family to flee for their safety. He spent 17 years in a refugee camp where food, water, and healthcare were scarce. He had no formal education and English was his third language. Living in Dadaab Refugee Camp―-one of the world’s largest and most notorious open air camps―-Mustafa used his experiences to fuel his fierce commitment to his studies and to improve his life circumstances and those of his family.
In the refugee camp, he worked for Doctors Without Borders as a medical interpreter. He closely watched them work to save the lives of his friends and relatives. He was inspired by a physician who donated his own blood to a patient because there were no blood banks in the refugee camp. It was in that moment that he saw the healing power of healthcare.
Because of the United Nations Higher Commission for Refugees (UNHCR) and the United States’ State Department, his family was able to resettle in Tucson. Since then, Mustafa has finished his master’s degree in Cellular and Molecular Medicine and is in his first year of medical school. He plans to serve in Kenya while also caring for his Kenyan patients in the United States. Mustafa’s story is why it’s important to put diverse physicians into communities, locally and internationally, that need care.
Currently, the composition of underrepresented minorities in medicine is only 8.9% of the physician workforce. International graduates comprise 25% of the physician workforce. They are critical to addressing the needs of the current physician shortage. Research shows that diverse physicians contribute to culturally competent care, improve access to healthcare delivery in underserved populations, and provide an increase in patient care satisfaction overall. In contrast, the percentage of active URM physicians declined between 2010 and 2013 and, despite a national demographic shift to more racial and ethnic diversity, the physician workforce has not kept pace.
Consider these statistics from the U.S. Census Bureau:
· In 2043, minority populations will become the majority in the United States. The non-Hispanic white population will remain the largest single group. By 2060, the minority population is projected to comprise 57 percent of the population, an increase from 37 percent today.
· By 2060, nearly one in three Americans will be Hispanic (the term used by the U.S. Census), up from one in six today. The Hispanic population will more than double to 12.8 million.
· The percentage of African Americans will increase to 14.7 percent or 61.8 million in 2060.
· The number of international migrants is expected to grow by 41.2 million.
So, why is there is a need for a physician workforce to come from across the world? Without them, medical research will be drastically affected as medical schools and hospitals rely upon leaders and researchers from every continent. Research also states that underrepresented minorities are more likely to return to serve their home communities. Additionally, patient affinity increases healthy practices. If patients feel some type of connection with their doctor, they will be more apt to ask questions, follow their doctor’s treatment plan, and live a better life. Cultural understanding in healthcare promotes connection and enhances the field of medicine in general. The United States’ patient population is diverse; being culturally competent cannot simply be a course you take in medical school.
Medical students must be a reflection of this country’s population―this is where the higher learning of diversity takes place. Think about Oscar’s story. His parents came to the U.S. from Mexico and their first American home was a homeless shelter. His parents worked hard to purchase their first home―a dilapidated trailer surrounded by colorful broken glass. Oscar’s mother helped him learn English and he learned from his parents to be positive, no matter the challenges of life. He is now a first-year medical student who plans to work to eliminate the health disparities prevalent in Native American communities. Keeping Trump’s immigration ban or building a wall would undeniably limit our access to physicians like Oscar who truly care about their patients, their outcomes, and the impact on diverse communities. Keeping this ban cuts through the core of our nation’s character.
The Statue of Liberty has long symbolized freedom and democracy. While the benefits of educational diversity in medicine has hit certain structural milestones, the invisible wall still exists. If upheld, this executive order will disrupt the diverse workforce in medicine. Yes, some people believe the ban is necessary considering the very real problem of terrorist activities. But, there are more informed ways to fight terrorism. Eliminating opportunities to be educated and freely serve others is not a good idea. If we want to keep our country healthy, educational leaders must carefully consider how this political decision adversely impacts diversity in higher education. Disease, patient care, and medical research have no boundaries nor should the education of our future physicians and scholars.
Dr. Tanisha Price-Johnson is Medical School Admissions Director at the University of Arizona and a Tucson Public Voices Fellow with the OpEd Project. Email her at email@example.com.