Reader Response: Immigrant Neurologists in the United States: The Path of Most Resistance
AfsanehShirani, Assistant Professor of Neurology, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska
RanaZabad, Professor of Neurology, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska
Submitted April 01, 2021
We commend Mahajan et al for their article regarding the problems faced by immigrant neurologists in the US.1 Our commentary focuses on the unique challenge imposed by the J-1 visa on the future academic path of immigrant physician-scientist neurologists. The primary method for neurologists with a J-1 visa to waive the two-year home residency requirement and develop their careers in the United States is to work in medically underserved areas of the country for 40 hours per week for three years in a clinical care setting. The rationale behind this directive, which was established in 1994, was to address the physician shortages in rural and urban areas.2 However, this requirement has failed to adapt alongside the evolution in the healthcare system towards integration of research and clinical care, patient-centered research, and pragmatic clinical trials.3,4 It adds a challenge for immigrant neurologists with proven research records who are striving to build a physician-scientist career. As a result, these individuals are deemed ineligible for federally funded career development awards for the first three years of their academic career. With an increasing shortage of physician-scientists in the US,5 it is time for policymakers to consider a paradigm shift to facilitate integration of immigrant neurologists into the physician-scientist pool.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Mahajan A, London Z, Southerland AM, Khan J, Schuyler E; Graduate Education Subcommittee and Education Committee of the American Academy of Neurology. Immigrant Neurologists in the United States: The Path of Most Resistance [published online ahead of print, 2020 Nov 16]. Neurology. 2020;10.1212/WNL.0000000000011196.
Writer SN. Conrad 30 reauthorization bill earns bipartisan support. American Medical Association. https://www.ama-assn.org/delivering-care/health-equity/conrad-30-reauthorization-bill-earns-bipartisan-support. Published May 18, 2017. Accessed March 27, 2021.
Simon GE, Platt R, Hernandez AF. Evidence from Pragmatic Trials during Routine Care - Slouching toward a Learning Health System. N Engl J Med. 2020;382(16):1488-1491. doi:10.1056/NEJMp1915448
Sacristán JA. Clinical research and medical care: towards effective and complete integration. BMC Med Res Methodol 2015; 15:4.
Vidyasagar D. Integrating international medical graduates into the physician-scientist pool: solution to the problem of decreasing physician-scientists in the United States. J Investig Med 2007; 55:406-409.
We commend Mahajan et al for their article regarding the problems faced by immigrant neurologists in the US.1 Our commentary focuses on the unique challenge imposed by the J-1 visa on the future academic path of immigrant physician-scientist neurologists. The primary method for neurologists with a J-1 visa to waive the two-year home residency requirement and develop their careers in the United States is to work in medically underserved areas of the country for 40 hours per week for three years in a clinical care setting. The rationale behind this directive, which was established in 1994, was to address the physician shortages in rural and urban areas.2 However, this requirement has failed to adapt alongside the evolution in the healthcare system towards integration of research and clinical care, patient-centered research, and pragmatic clinical trials.3,4 It adds a challenge for immigrant neurologists with proven research records who are striving to build a physician-scientist career. As a result, these individuals are deemed ineligible for federally funded career development awards for the first three years of their academic career. With an increasing shortage of physician-scientists in the US,5 it is time for policymakers to consider a paradigm shift to facilitate integration of immigrant neurologists into the physician-scientist pool.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References