Unmatched American Doctor’s letter to Sen. John Katko- The S348 Resident Physician Shortage Reduction Act of 2019

First, I would like to introduce myself and then provide you with some details on a group of American doctors that need your help. My name is Dr. C. A and I grew up in Jefferson County. My father worked in the Army on Fort Drum and my mother worked on the base as a civilian. I grew up middle class and was lucky to have supportive parents that incentivize me to pursue academics. Upon graduation from High school, I had already completed calculus 1 and 2 and Anatomy & Physiology Biology. I went to college at SUNY Plattsburgh where I played lacrosse and graduated with Honors with a major in Biology and a minor in Chemistry. I went to medical school at St. Georges University in Grenada, W.I. This makes me a U.S. citizen international medical graduate. I have passed my medical school exams and US medical licensing exams ( Step 1, 2, CS and Step 3) but have not been selected for a residency (the crucial last step of my training). Since graduation I have worked in Medical Research, taught A & P Biology and Chemistry at local colleges and have been working at a free clinic in Upstate NY in order to enhance my clinical skills while serving the people in my community. Recently I have been working in Missouri with an Assistant Physician license for unmatched doctors.

I know that the doctor shortage is really affecting the health of those in my area and I want to help. Would it be possible to talk with you about sponsoring S348 Resident Physician Shortage Reduction Act of 2019?

The group I represent is composed of 250 physicians who banned together out of a larger group of 6,570 unmatched doctors over this issue in April 2020 and have been tweeting videos of our stories. Our twitter videos have received over 80,000 combined views and we would like you and President Trump to see our stories to help us. You can see one of our doctors, on a recent @jobspax twitter post that has 35,200 views. We would like to help our country out of the healthcare crisis it is currently in and also aid in the current and future doctor shortages. Please see below more history on the issue. We are currently sponsored by Amworkco, NumbersUSA, White Collar Workers of America, and Doctors Without Jobs.

The primary qualifications for US residency are passing of USMLE (United States Medical Licensure Program) steps 1 and 2, and having graduated from a duly accredited medical school. The National Residency Matching Program (NRMP) was conceived not as a qualification measure or process but strictly as a matching process. Yet every year the NRMP, albeit inadvertently, essentially and inappropriately, with respect to it’s professed mandate, disqualifies and locks out many qualified medical graduates from residency training. US residency is a critical capstone phase in the training of American physicians and under current medical regulations must be completed in order for US citizen MD graduates to capitalize on their 8 years plus of education beyond high school i.e. be license- eligible to practice medicine.

[It must here be pointed out that no other profession in the USA is that way: not engineering, not law, not nursing, not physician assisting. In fact most state-proposed “assistant physician” legislation which recognizes this issue and would provide an avenue of practice for MD graduates without residency, is being largely rejected by medical leaders]

Without residency, it is as though those 8 plus years of study were for nothing. Contrary to popular intuition and perception medical graduates without residency training are not seen by employers as a good fit for other occupations and even more troubling, they are seen as “overqualified” by occupations with much overlap such as medical research. One cannot thoroughly examine this problem without emphasizing that medical training in the United States, unlike in almost every other developed society, follows an abridged model with pre-residency education and training on one hand, and licensing-independent-practice training on the other hand.

The NRMP process is the critical bridge. All pre-residency qualifications are rendered useless to the professional world without candidates crossing this bridge. The USA is the only nation where MD graduates risk being “stranded” on this bridge with no where to go after graduation if they don’t get a residency: it is like a bridge that ends in limbo and if you are not selected you do not have an avenue of escape from it. In every other country, MD graduates are license/practice-eligible, or at least professional-progression-eligible in their country of education. The match process by the NRMP without built-in protection for access to residency by qualified American graduates (we must reiterate all unmatched applicants are in fact residency-qualified as matter of course) has created a situation where unmatched American graduates are at a perilous disadvantage compared to applicants from other countries. Essentially if these foreign applicants don’t match in the USA they can still practice in their own country and earn a living. Not so with American graduates. The limbo of not matching is like being trapped: unqualified or overqualified for every other comparable job while being saddled with $200,000 to $400,000 dollars in federal student loan debt, not to mention the absolute waste of highly trained American minds and the massive loss to the American patient population in healthcare services that would otherwise be readily available.

Please help us by finding a way to carve out a place for us within the current healthcare system. We suggest that rather than giving our jobs to nearly 4,200 VISA Doctors per year, we give those jobs to U.S. citizen doctors. We are all happy to work rurally. Perhaps another solution would be to set aside rural primary care positions for U.S. Citizen Doctors since we identify so well with the communities that we were raised in. Thank you for your time and I look forward to meeting with you on behalf of,

The Unmatched and Unemployed Doctors of America.