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Amewoke Adamaley graduated from medical school seven years ago and has been in the health care sector ever since.
But he isn’t working as the doctor he’s trained to be. Instead, he’s a nursing assistant at M Health Fairview University of Minnesota’s east bank hospital. That’s because Adamaley, who earned his medical degree from Southern Medical University in Guangzhou, China, has a tougher pathway to practicing medicine in the U.S. than doctors who were trained here.
Yet, with COVID-19 surging and likely to overwhelm the healthcare system in Minnesota and nationally, his medical expertise may be needed now more than ever.
Adamaley and the other estimated 250 to 400 foreign-trained doctors in Minnesota who can’t practice medicine could be screening patients with COVID-19 symptoms, triaging them by the severity of their infections, administering medicine, working with ventilators — “There’s just so much we could do,” said Adamaley, who is originally from Ghana but has lived most of the last two decades in Minnesota.
“What I see happening in New York, the doctors themselves are getting sick. They have to be quarantined, they can’t continue working,” he said. “If this crisis hits Minnesota and balloons out of control, we can step in and help out.”
Adamaley is one of nearly 30 foreign-trained doctors who last week registered on the state’s Minnesota Responds medical reserve corps list to offer their services to fight the COVID-19 pandemic if needed. He hasn’t matched into a residency program yet, but intends to specialize in geriatrics with a focus on physical medicine and rehabilitation.
Adamaley said he and others like him are in a unique position to help fight the pandemic. Many foreign-trained doctors, especially if they’ve practiced in developing countries, have experience working with a lack of resources and minimal staff — conditions similar to those faced currently by some parts of the U.S. healthcare system.
“The type of pressure with what I hope is not going to come, you just need people who’ve been there before,” he said.
Whether Adamaley and others will get the chance to pitch in is an open question.
States like New Jersey, where the pandemic has hit patients and medical resources particularly hard, are starting to take measures. There, Governor Phil Murphy last week signed an executive order granting temporary medical licenses to qualified foreign-trained doctors in response to the pandemic. Minnesota has yet to follow suit, as the state so far hasn’t been as overwhelmed by COVID-19 as other states.
Finding a path for foreign-trained doctors
Wilhelmina Holder, the executive director of St. Paul-based New Americans Alliance for Development (NAAD), is urging state leaders to take action.
“We need to plan before the crisis comes to be effective,” Holder said. “If people are ready and willing to work, then this is the best time to get them engaged, to get them excited.”
NAAD works to help foreign-trained doctors find pathways to practicing medicine in the U.S. It does this through financial assistance—the three board exams required to enter medical residency programs cost about $1,000 each—and career guidance.
The help is needed. Foreign-trained medical students are about half as likely to match into a medical residency program, which they’re required to complete in order to practice in the U.S., as those who attended medical school here, according to the Washington, D.C.-based National Resident Matching Program.
This means that tens of thousands of doctors, who are trained in various medical disciplines, can’t practice in the U.S. One study from the Massachusetts Immigrant and Refugee Advocacy Coalition estimated that there could be as many as 65,000 underutilized foreign-trained doctors in the country. And that comes at a time when doctor shortages are projected to get worse over the next decade, especially in rural areas.
Minnesota took a step toward alleviating the problem when it established the International Medical Graduate Program through the state Department of Health five years ago. One of the program’s chief components matches foreign-trained doctors with local residency programs provided they commit to working in an underserved rural area for their first five years of practice. But so far, the program has only had the resources and demand from hospitals to match a handful of doctors with residencies.
What these doctors bring to the table
Holder started NAAD in 2002 because of her own experience as a foreign-trained doctor. She received her medical degree from McGill University in Quebec in the 1970s and worked in her native Liberia afterward. The 1980 assassination and coup against her father, William Tolbert, who was Liberia’s president at the time, eventually brought her to the U.S. After her children grew up, Holder tried to get back into medicine here but couldn’t.
Now, Holder tries to help others in the same situation. She says foreign-trained doctors are especially needed as Minnesota’s population grows more diverse. They can bring various perspectives on how cultures relate to health, she said, and bond with patients originally from other countries.
“In a time like this, this is something that’s absolutely necessary,” she said, referring to the pandemic. “Because it’s the minority [population] that usually suffers worse.”
Nationwide, Chicago-based AMOpportunities, which works to connect medical students with clinical experience, launched a petition compelling state officials and medical boards to adopt policies allowing foreign-trained doctors to work during the pandemic. As of press time, the petition had more than 12,000 signatures.
Kyle Swinsky, CEO of AMOpportunities, said his organization has reached out to groups like the National Governors Association, which Swinsky said wanted to see more concrete examples, like the measure granting temporary medical licenses in New Jersey, before making policy recommendations on the issue.
“I think our next step is just to reach out to more local governments,” Swinsky said, mentioning New York and Pennsylvania as two potential targets. “Especially in areas where [international medical graduates] can really respond.”
Adamaley, for his part, said he doesn’t see Minnesota’s health care system overwhelmed yet by patients with COVID-19. But he said the state shouldn’t wait for the virus to get worse before tapping all of its resources to fight it. Particularly, Adamaley said he would like to see the state or other entities put together a two-to-three week course for foreign-trained doctors to get up to speed on helping during the pandemic.
“This is a health crisis,” Adamaley said. “It doesn’t make sense for us to just be sitting on the sidelines.”
