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Out of status, employment gap and status revalidation Gap in employment(paystubs) and the resulting problems during status transfer and green card filing.

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  #1  
Old 11-17-2008, 09:54 PM
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Default Conspiracy against foreign medical graduates

To push them to primary care which nobody wants to go they are now lobbying ( i am deleting signature information)

Dear Fellow Program Directors,
>
>
>
> This morning National Public Radio reported that Homeland Security, in
> cooperation with the incoming Obama administration, is about to
> recraft rules governing H1b VISAs. As a group, we might consider
> whether to engage DHS in this process. Since more than 40% of
> trainees in Medicine are now international graduates it is possible
> that immigration policies could be crafted to assist our country's
> healthcare needs. To the extent that citizenship is a great
> privilege, why shouldn't the medical gateway to citizenship encourage
> career paths that will best serve our population? Our need for
> more primary care physicians and geriatricians will soon become a
> "crisis." Consider the following (or some facsimile):
>
>
>
> 1. DHS will begin to earmark a certain number of H1b VISAs (which are
> often a path to Green Cards) for IMG's who will commit to Primary Care
> as a career and offer a certain number of "paths to Green Card" for
> those who subsequently elect Primary Care careers. In many
> countries, Internal Medicine is not a recognized discipline and many
> extremely talented IMGs come to the States with the explicit goal of
> subspecialty training. As part of an overall healthcare reform that
> is now inevitable, what if Program Directors were asked to recommend
> to DHS the best 2-3 IMGs who were willing to pursue a career in
> Primary Care (or other underserved specialties). If DHS limits
> (i.e. reduces) the number of Green Cards issued for subspecialties
> while ensuring a large number of paths to citizenship for the best
> IMGs (possibly vetted by programs) to serve Primary Care needs,
> everyone wins. The current system favors conversion of H1b VISAs for
> subspecialists with "extraordinary contributions," usually of the
> scientific variety. Primary Care should become the ascendant
> "extraordinary contribution."
>
>
>
> 2. DHS allows J1 waivers to be performed in Primary Care (in addition
> to service in economically disadvantaged areas). To continue
> incentives for service in economically distressed areas, the waiver
> could remain 2 years in such areas. Primary Care in underserved but
> economically OK communities might engender a 5-year pay-back waiver on
> the way to citizenship.
>
>
>
> Obviously the specifics could be tweaked. But the idea is to leverage
> the immigration process to favor specialties we need; and we can
> potentially cherry pick the best and brightest from the rest of the
> world if the policy is crafted properly.
>
>
>
> Such would require aggressive and immediate politicking (and I don't
> know APDIM well enough to know whether it is possible if members like
> the idea).
>
>
>
> Respectfully,
>
>
>
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  #2  
Old 11-17-2008, 10:28 PM
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Default details?

Are you a physician? If so why are you EB3?

Either way, I would appreciate more details on this. IV-Physicians has been following the IMG issues very closely. Please send me a private message with more information. Thanks!
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  #3  
Old 11-17-2008, 11:19 PM
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Default

What happens once the person becomes a green card holder or a citizen with equal legal rights. These are the sort of short sighted policies that will eventually backfire. I do see them eventually declining H1b visas for residents however in favor of the J1 visa, that is within the gov'ts choice, as it largely funds GME training.

I am interested in hearing the details, since there are serious counter points to this which can be presented. A profession should be made attractive or not on its own merits to prospective candidates. Primary care medicine is not attracting people today because of its relative unattractiveness in terms of hours/responsibility level/pay/respect etc. If changes proposed don't fix that then no amount of tinkering with immigration law will address that root cause. BTW many FMGs already serve in underserved areas in the J1 waiver program. Furthermore specialty slots were recently added/expanded to this program. This is not new. However the terms in which the letter is phrased borders on discriminatory, the bottom line is that no doctor will commit to a 30 yr rural career unless he/she wants to do so. A J1 waiver is an opportunity for that community/area to welcome them, that is the way it should be framed. Those considering taking a waiver job should look at turnover. If you see little of it, it is probably an endearing place, I've known friends who went to places they promised themselves they would leave in 3 yrs and ended up there for 30, and I've known places that can't keep a single doctor more than 3 yrs. Surely something is particularly unattractive there.
Employers/Hospitals/Communities that want to take advantage of your situation will not retain their doctors.

Let us know the details so we can present the strong counterpoints. Besides, program directors are not stupid either, they are only too aware of the current trends. Hence the impetus for change in the current care delivery model.

Last edited by alterego; 11-17-2008 at 11:41 PM.
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  #4  
Old 11-18-2008, 06:34 AM
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Default It sounds more positive than the other way ......

Over the years I have noticed FMG's could only get into primary care residencies. The selection/match process makes sure you never get interview in the higher/better specialties. At least now they would get a H-1 than the regular J-1 where they rot in some under served area for years to see the daylight. And once you get your gc there is no way they stop you going for a Cardio fellowship that is faster on the H-1 route. Again we need exact details from this bill/plan as well you can always get a h-1 now also as long you have passed the step 3 before joining the residency need to talk to the program who selected you to coordinate this change from j-1.
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  #5  
Old 11-18-2008, 12:22 PM
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Post News on shortage of Primary Care physicians

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Old 11-18-2008, 12:52 PM
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Originally Posted by imneedy View Post
Yes I watched it on CNN morning where John Roberts and Sanjay Gupta were discussing this. Not sure how it would benefit us
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