Coronavirus: 1,200 Young Doctors Sidelined by Lack of Training Residencies

Young Doctors Without Residencies
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Neil Munro

Just as the coronavirus epidemic went nationwide, 1,200 young American doctors have been put on the sidelines because they were denied a place in the limited number of medical residencies for 2020, said Kevin Lynn, founder of Doctors Without Jobs. 

“More than 6 percent of the graduates of U.S. medical colleges did not get ‘matched‘ into a residency this week in a hospital, which means they will never practice medicine,” said Lynn,

“That is a systemic problem,” he said, adding, “we have an ever-increasing need for effective healthcare delivery in this country, and yet we seem to have made it extremely difficult to become a doctor.”

Without a residency for specialized training on their resumé, the fully qualified doctors cannot get doctors’ jobs because they are excluded from employers’ insurance coverage, he said.

Congress should quickly get the doctors into work during the epidemic by extending employers’ insurance coverage to include the many doctors who pass their tests but who have not had a residency, Lynn said. 

The annual match process allocates graduates to the limited number of hospital residencies.  The graduates — including several thousand foreign graduates — have already passed the Medical Licensing Examination (MLE) but they cannot work as doctors until they serve a residency in a hospital, he said.

“Failing to Match can represent a critical junction for medical students,” according to a 2019 article in opmed.doximity.com. It continued:

Now is the time to decide if you want to move forward with your medical training. While this may seem like an obvious choice — after all, you’ve already put four years and tens of thousands of dollars into the process — that may not actually be the case for many.

So, take the time to take stock of your goals. Talk to your family, loved ones, or partner. Consider looking into other careers in health care, such as hospital operations or consulting. Ultimately, you should ask yourself – is being a doctor truly my dream?

“It took weeks, if not months, to recover from the emotional trauma of not matching,” according to a 2018 article at KevinMd, com. The female doctor continued, “The feeling of watching your friends and classmates see their dreams come to fruition while yours crumbled around you is earth-shattering for a medical student.”

The American doctors are not excluded because they are unqualified, said Lynn. They have passed their college courses and the national MLE test, but do not get picked for specialized training because Congress does not fund enough residencies at hospitals, he said. “Are they at the top of their class? No, but they’re not in the bottom,” said Lynn.

The 1,218 doctors excluded in 2020 is an increase from the 1,162 excluded doctors in 2019, the 1,078 excluded doctors in 2018, the 1,059 excluded doctors in 2017, and the excluded doctors 1,130 in 2016. These exclusion do not count the doctors who repeated their effort to get matched, he said.

The accumulated lists of excluded doctors have created an unrecognized national reserve of perhaps 5,000 fully qualified doctors who can be deployed during the coronavirus, Lynn said.

Last week, President Donald Trump and Congress changed insurance rules to allow people to use tens of millions of N95 face masks that were designed for non-medical purposes. McClatchy reported March 20:

The purpose of the new legislative provision is to protect manufacturers from liability if U.S. citizens use the masks outside of a hospital environment during a public health crisis, and contract disease.

Under current law, “someone could buy one from Home Depot and say they got coronavirus while walking on the street and wearing a respirator, and the manufacturer will be liable,” said one congressional aide involved in the deliberations.

In Italy, where the epidemic is further advanced, the government has mobilized roughly 10,000 student doctors to the front line.

The supply of hospital residencies is limited because they are funded by Congress — and Congress limits the funding each year.

The number of residencies puts a cap on the flow of new doctors into the sector — and so drives up salaries for current doctors.

The mismatch also encourages various employers to import doctors from the Middle East, India, and Africa under various visa-worker programs.

The visa programs, such as the H-1B and J-1 programs, extract the foreign doctors that people in the foreign countries need for their health and economic growth.

Africa’s doctors are being extracted by U.S, European, and Arab governments who refuse to fund training programs for their own would-be-doctors, according to an April 2019 report in Al Jazeera:

Abuja, Nigeria – In March, hundreds of Nigerian doctors gathered at a hotel in Abuja, the capital, and another in Lagos, the country’s commercial centre, to take a test conducted by the Saudi Arabian health ministry.

In a symbol of the Nigerian medical “brain drain”, those yet to migrate must complete foreign exams in order to get work placements abroad.

Weeks before the attempt by Saudi Arabia to lure Nigeria’s greatest medical talents, dozens had sat the regular Professional Linguistic Assessments Board (PLAB) exams at the British Council. Once they pass, it will enable them to work in the UK.

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“The trend of doctors emigrating to other countries is at an all-time high,” Chike Nwangwu, head of NOIPolls, told Al Jazeera in Abuja. “Our survey … showed that 88 percent of doctors are considering work opportunities abroad.”

In the United States, the imported doctors most slowly migrate through a complex immigration system, often leaving them with partial workplace rights for several years.

For example, roughly 5,000 Indian-born doctors are waiting in a multi-year waiting line for green cards. The line is long because it is choked by an army of roughly 600,000 Indian H-1B workers and family members who have been imported by U.S. technology companies, banks, and insurance firms and their Indian-run staffing companies.

Sen. Mike Lee (R-Utah) is pushing his S.386 bill to put the many Indian workers to the front of the green card line — regardless of the impact on non-Indian migrants, and without any exemption for doctors.

Sen. Robert Menendez (D-N.J.) is pushing a bill that would provide more funding for 15,000 extra residencies per year.

His S.348 bill is titled the “Resident Physician Shortage Reduction Act of 2019,” sand it ays:

the aggregate number of increases in the otherwise applicable resident limit under this subparagraph shall be equal to 3,000 in each of fiscal years 2021 through 2025, of which at least 1,500 in each such fiscal year shall be used for full-time equivalent residents training in a shortage specialty residency program.

Menendez’s bill has 17 co-sponsors, including Sen. Susan Collins, (R-ME)

“Not only do we need the additional residencies, but we also need the prioritization of American graduates to get those residencies,” said Lynn, who noted that U.S. hospitals awarded residencies to thousands of foreign doctors each year. 

“It gets down to OK, what’s the value of spending years at an Americans college, accumulating all that debt and cost? Why not go to India and go to medical school there?” he asked. “There has to be a value in going to an accredited U.S. medical college.”

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