Becoming a physician is a lifelong dream for many. Having the opportunity to train in the United States is also a deeply held ambition for countless aspiring doctors around the globe.

We are living out that dream. We came to the U.S. from Syria, a war-torn country in the Middle East, with the same goal: to attain highly specialized training at the best U.S. institutions. We had the idea that the U.S. had the best medical and research universities and hospitals in the world. Later, when we all made it here and started our journeys, our experiences came to confirm our initial impressions. Many great countries are on the frontiers of science, technology, and medical practice. However, the United States stands out from the crowd in that it attracts individuals with great passion for and high skills in what they do. Indeed, being a hub for the brightest and most talented minds has contributed immensely to U.S. strength in so many domains and for more than two centuries.

Some of us came into the U.S. more than a decade ago while others only a few years ago. All of us, however, share the profession of medical practice and research. We have studied and worked at some of the nations most reputable institutions across the U.S. We all have a strong passion and drive in different fields of biomedical, translational, and clinical research. Many of us also provide medical care for many patients across clinical disciplines. Some of us also provide that patient care in underserved areas.

Syria was one of the countries specified in President Trumps January 27 executive order (EO) on immigration. This EO was issued to protect the U.S. and Americans from potential terrorists. It detailed a ban on legal immigrants as well as non-immigrant visas from seven countries for 90 days, a 120-day ban on admitting refugees, and an indefinite ban on admitting refugees from Syria. For days after the order was announced, any individual with a legal visa from these countries was prevented from entering the United States regardless of their qualifications, skills, or expertise.

The executive order drew rapid litigation and on February 3, a federal judge temporarily prohibited the government from enforcing the order on equal protection grounds and due process guarantees. The Trump administration, however, has signaled it intends to rewrite the order, and on February 21 it issued new directives to the Department of Homeland Security to deport unauthorized immigrants. This will likely not be the final say on the matter, however, and the potential for blocking immigrants and refugees from Syria and other Middle Eastern countries from coming to the U.S. is still very real.

This EO had grave ramifications for thousands of people holding legal status and visas all across the U.S., those flying in, and those who were outside. It also had great personal impact on many of us, our families, friends, and colleagues. From our experience, we believe that the orders impact would be deeply felt across the medical professions. Any ban citing a persons national origin, religion, race, or ethnicity is very counterproductive to keeping and attracting international expertise into the U.S. health care system.

Even before the EO, Syrian medical students and graduates who wanted to continue their training in the US faced significant obstacles. For example, International Medical Graduates must first receive a visa to come to the US in order to be present for the USMLE Step2 CS exam as well as for interviews, both of which are necessary to be matched with a residency program. In September 2016, we conducted a brief survey of 106 Syrian medical students and graduates currently applying to be matched with a US residency program. Of our survey participants, more than 50 percent had to apply twice or more to be approved for a visa to the US and some even had to apply five times or more. What is more, all of them also had to visit a US embassy outside of Syria in order to apply for that visa that is because the U.S. embassy in Syria closed in February 2012. More than a quarter (28 percent) of those surveyed said they had to travel to two or more countries to apply for a visa. It is no wonder that many respondents reported declining interest among their peers in pursuing medical training in the U.S. That has not always been the case: As recently as 2014 University of Damascus, Syria, was among the top ten medical schools from which international medical graduates currently licensed in the US, had graduated. We fear that is likely to change.

After arriving in the U.S. and joining clinical training, research, or graduate degree programs, we found the U.S. system to be just and merit-based. When we came in, most of us had either a student or a work visa. What we found was that the educational opportunities spurred and surrounded those who worked hard, regardless of their background. A clich, but it has never been truer for us. This system, although not perfect, is one of Americas greatest points of strength.

When we look back at the diverse backgrounds of the many wonderful mentors and educators we had in the U.S., we cannot help but think how deficient our training would have been without them. We grew personally and professionally. And as our expertise expanded, our contributions to the U.S. communities that welcomed us expanded as well. Collectively, we have written hundreds of peer-reviewed publications, advanced medical science, and educated myriad of clinical and research personnel. Most importantly, since anti-immigrant rhetoric started to appear in the political arena during and after the election, we were told many heartwarming and empathic words of support from our patients and colleagues. We draw much strength and resolve from their support as we struggle to continue our lives and careers here in the U.S.

The views expressed in this article are of the authors only and do not represent the views of their employers.

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Syrian Doctors And The American Dream: Practicing Medicine In A New Immigration Landscape - Health Affairs (blog)