How Foreign-Born Doctors Help Refugees, Other Immigrants

Deepa Halaharvi is a morning person.

"Eat, read, pray, and get ready to go to work," she says, laughing. "And usually I’m out the door around 6:15 or 6:30."

Waking up early was a habit she started in medical school – she was a wife, a mother of two young kids, and the caretaker for her sick father. Just about the only time she had to study was 3 a.m. 

"You have to work harder, you have to get straight A’s, you have to be the best at what you do to be noticed," she says. "Those are the things that are in your control that you can do. And so I think in order to be successful, those are your weapons." 

Halaharvi attributes that mentality to growing up as an immigrant in the United States. Her family left India when she was 17 so she and her siblings could get ahead in life. 

"One of the teachings that was instilled by my dad was whatever you do, be good at it, be great at it. It didn’t matter if I was a waitress, he’d say be the best waitress you can be," she says. "So when I finished my breast surgery training, my prayer was, 'How can I be the best breast surgeon possible? And really the answer came in the form of my own diagnosis." 

Eight months into starting her dream job as a breast cancer surgeon at Ohio Health, Halaharvi herself was diagnosed with the exact ailment she helped others overcome. Halaharvi is one of many immigrants in the state behind a somewhat surprising statistic: over 28 percent of surgeons and doctors in Ohio are foreign-born.

"The overall population that is foreign born in Ohio is just 5 percent, so you can see that immigrants are really over-represented in that occupation," says Dan Wallace of the New American Economy. The non-profit research group examines the role immigrants – documented or not – have on the economy.

Wallace analyzed Census data and found that immigrants also make up make up a substantial percentage of software developers, as well as nail salon and beauty workers. In Ohio, 14 percent of STEM workers are immigrants, according to Census data. Wallace says that information isn’t surprising, considering the rates of educational attainment in some immigrant communities. 

"Immigrants are a little bit more likely than U.S.-born in Ohio to have less than a high school degree, but they’re also more than twice as likely to have a graduate degree," he says.

Wallace says having a high percentage of foreign-born doctors and surgeons in a state with many rural areas could help increase access to healthcare. The Association of American Medical Colleges estimates the U.S. is short tens of thousands of physicians, especially in rural areas. 

"There’s a huge need for folks in those occupations and so we should be thinking about immigrants as a potential piece of the solution to health care shortages overall," Wallace says. 

But the political climate could mean fewer foreign-born doctors in the U.S., says William Pinsky, head of the Educational Commission for Foreign Medical Graduates. The organization helps them get certified to practice here.

"We’ve seen a small decline over the last two years in terms of overall applications of international medical graduates, including decline from muslim majority countries," he says.

Pinsky says President Trump’s stance on immigration has affected how foreign doctors view this country. And it’s made U.S. medical schools worry about accepting foreign-born physicians into their programs.

"It’s the perception of it and the stress that that causes, and in some cases it’s actual denial of a visa, either denial or postponement of re-entry into the country," Pinsky says.

Halaharvi says her personal experiences as an immigrant and a breast cancer survivor helps her empathize with patients, many of whom are immigrants themselves. Still, she sometimes faces questions about her background and abilities.

"I think when people come in they do have a little bit of reservation as to how I would treat them, 'Do I speak English, am I going to give them the same care or not?'" she says. "I’ve even had a patient’s husband ask me the country I came from, if I was allowed to talk. And I’m like, just from our interaction you should be able to tell I talk a lot!" 

Despite the challenges she faced to get where she is today, Halaharvi is quick to say that she is lucky. The number of immigrant doctors is high, but doesn’t include the thousands of foreign-trained doctors who live in the U.S. but haven’t been able to obtain a license to practice medicine here.

This story was produced by  Side Effects Public Media , a news collaborative covering public health.

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