Visa crackdown puts these rural doctors at risk

How Trump's Travel Ban Affects This South Dakota Doctor

At her pediatric clinic in Sioux Falls, South Dakota, Dr. Alaa Al Nofal sees 10 patients a day. He has known some of them since they were born. Others, he still treats them after they graduate from high school.

“I treat these kids for Type 1 diabetes, thyroid problems, thyroid cancer, pubertal disorders and adrenal diseases,” he said.

Al Nofal’s expertise is crucial. He’s one of five full-time pediatric endocrinologists in a 150,000-square-mile area that includes both South and North Dakota.

Like most of rural America, this is an area plagued by a shortage of doctors.

“We are very fortunate to have Dr. Al Nofal here,” said Cindy Morrison, marketing director of Sanford Health, a non-profit healthcare system based in Sioux Falls. to lose someone with his expertise” runs 300 hospitals and clinics in predominantly rural communities.

Related: Visa ban could make rural US doctor shortage even worse

However, Sanford Health could lose Al Nofal and several other doctors who are crucial to its healthcare network.

patient dr nofal
Dr. Alaa Al Nofal [here with a patient] is one of only five pediatric endocrinologists in South and North Dakota combined.

A Syrian citizen, Al Nofal is in Sioux Falls through a special workforce development program known as the Conrad 30 visa waiver – essentially waiving the requirement that doctors complete residency on a visa J-1 exchange visitors must have returned to their country of origin for two years before applying for another US visa. The Conrad 30 waiver allows him to stay in the US for a maximum of three years as long as he commits to practicing in an area that is experiencing a shortage of doctors.

After President Donald Trump issued a temporary immigration ban that restricted people from seven Muslim-majority countries – including Syria – from entering the US, Al Nofal was uncertain about his future in the US. .

Al Nofal said: “We agree that something more needs to be done to protect the country, but this executive order will have a negative impact on doctors from these countries who desperately need it. throughout the United States. “They may no longer want to practice in the United States.” The action is currently in legal limbo after a federal appeals court temporarily halted the ban.

Related: Trump angry after court upholds travel ban

For the past 15 years, the Conrad visa exemption 30 attracted 15,000 foreign doctors into underserved communities.

Sanford Health has a total of 75 doctors in these visa waivers and seven from the countries listed in the executive order. “If we lose Dr Al Nofal and our other J-1 doctors, we will not be able to fill the critical gaps in healthcare access,” said Morrison of Sanford Health. for rural families.

And the ban could also hurt the training of new doctors. The Conrad 30 Visa Waiver Program is supported by medical school graduates with J-1 nonimmigrant visas who have completed residency in the United States.

rural south dakota
Crawling in the fields just outside Sioux Falls.

More than 6,000 medical interns from abroad enroll each year in U.S. residency programs through J-1 visas. According to the Association of American Medical Colleges, about 1,000 interns come from countries affected by the ban. J-1 visa holders who were out of the country when the ban went into effect are barred from entering the United States and cannot start or end school as long as the ban is in effect.

The State Department told CNNMoney that the government could issue J-1 visas to people coming from one of the blocked countries if it is in the “national interest,” but would not confirm whether the shortage of doctors. happens or not. eligible for such consideration.

“The stress and anxiety created by the short-term executive order could have long-term effects, with fewer doctors choosing to train in the states and then work,” said Dr. increasing the extent of the deficit in willing suppliers in rural and deprived areas”. Dial, associate dean of the clinical department at the Marshall University School of Medicine in Huntington, West Virginia.

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Al Nofal attended medical school in Damascus, the capital of Syria, and completed a residency at the University of Texas on a J-1 visa. He went on to do a PhD at the Mayo Clinic and later applied for a J-1 waiver, which landed him in Sioux Falls.

Nineteen months after his three-year commitment, Al Nofal either directly treats or serves as a On average, doctors consult more than 400 pediatric patients each month.

He sees most of his patients at the Sanford Children’s Specialist Clinic in Sioux Falls, where families often drive hours to get to appointments. Once a month, he flies on a small plane to see patients at a clinic in Aberdeen, about 200 miles away.

sanford children
Al Nofal’s patients drove for hours to see him at the Sanford Children’s Clinic in Sioux Falls.
aberdeen hospital
Once a month, Dr. Nofal flies to Aberdeen, SD to see patients at an outreach clinic.

“It’s not easy to be a doctor in this setting,” said Al Nofal, citing South Dakota’s long hours and notoriously cold winters. “But as a doctor, I’m trained to help people under any circumstances and I’m proud of that.”

That’s one of the reasons why Al Nofal and his American wife Alyssa have struggled to come to terms with the visa ban..

“I have a 10-month-old baby and I can’t go to Syria now. My family in Syria can’t come here,” he said. “Now my family can’t see their first grandson.”

“I knew if we left, I might never come back,” he said. He also doesn’t want to travel anywhere in the country right now. “I was afraid of how I would be treated,” he said. He’s also afraid he’ll be stopped at the airport – even if he’s traveling to another state.

Related: Trump’s travel ban and what you need to know

Almatmed Abdelsalam, from Benghazi, Libya, had planned to start practicing as a family doctor in Macon, Georgia, through a visa waiver program after he completed his residency at the University College of Medicine. school in Central Florida in July.

Everything went smoothly. Abdelsalam, who treats patients and veterans in the hospital, applied for a visa waiver and was accepted. He contracted to work with Magna Care, which supplies doctors to three hospitals in the Macon area, and he began looking for a home to relocate for himself, his wife, and their two young children over the summer.

almatmed Abdelsalam
Dr. Almatmed Adbelsalam with his family.

But there is one final step. In order for his J-1 waiver application to be fully completed, it needs final approval from the Department of State and U.S. Citizenship and Immigration Services.

“The executive order came right in the middle of that process, stalling my filing at the State Department,” he said.

Because he is a Libyan citizen (Libya is also barred from visas), Abdelsalam fears the outcome.

“The hospital in Macon urgently needs doctors. Although they have hired me, I’m not sure how long they can wait for me,” he said.

“No one can argue that it is necessary to keep the country safe, but we should also keep the country healthy,” he said. “Doctors like me, trained in the US at some of the best schools, are an asset not a liability.”

CNNMoney (New York) Originally published February 10, 2017: 7:47 PM ET

https://money.cnn.com/2017/02/10/news/economy/visa-ban-rural-doctor-shortage/index.html?section=money_news_international Visa crackdown puts these rural doctors at risk

Edmund DeMarche

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