Dream of being a doctor might not become reality
Medical careers hinge on continued protection of child immigrants
Last month, Juan Vasquez was in class at UCSF’s medical school when he heard President Trump’s announcement to rescind the program known as DACA, which grants Vasquez — who came to the U.S. illegally when he was 9 — the ability to study and work in the United States.
The pronouncement injected a familiar sense of uncertainty into Vasquez’s future, one that the El Salvador native has lived with most of his life, since moving to Southern California in 2001. The uncertainty had been cast aside temporarily after Vasquez, 25, was accepted into the DACA program in 2013 — after which he was able to work as a medical scribe at a San Bernardino hospital and a lab research assistant at his alma mater UC Berkeley, and apply for college grants that were previously unavailable to him as an unauthorized immigrant.
Now, Vasquez’s ability to practice medicine in the United States, the country where he grew up, depends on congressional action to renew or amend the Deferred Action for Childhood Arrivals program. The program was enacted in 2012 and grants work permits and protection from deportation for young unauthorized immigrants who meet certain requirements. Trump has set a six-month deadline for Congress to come up with a solution, though recent congressional hearings have reaped little progress on replacement legislation.
“It’s hard to predict what’s going to happen,” Vasquez said. “What happens if Congress fails to act in the next six months? A routine traffic stop could be a potential risk for deportation.”
Vasquez, a first-year medical student,
Dreamers “want to contribute to solving problems in the nation. We want the opportunity to do so. Rescinding DACA deprives us of that opportunity.” Juan Vasquez, UCSF medical student
expects to finish school in 2021, after which he would start residency training. But his DACA work permit is set to expire in 2019, and it is unclear whether he will be able to renew it.
Vasquez is one of about 100 DACA recipients, often called “Dreamers,” who are enrolled in U.S. medical schools — up from 65 last year, according to estimates from the American Association of Medical Colleges. While that represents a sliver of the roughly 700,000 DACA recipients across the country, health industry experts say ending the program without a comparable alternative could exacerbate a long-standing imbalance between California’s health care workforce and the patients it serves.
Vasquez is precisely the kind of physician-intraining that medical industry leaders say is critical to the profession’s ability to treat patients in the future: bilingual, and statistically more likely to work in poor, underserved communities, where the need for health care professionals is more pronounced. He is among a handful of DACA students at UCSF’s medical school.
“In California, we have a mismatch, we don’t have a health care workforce that reflects the demographic diversity of the state,” said Sandra Hernandez, president and CEO of the California Health Care Foundation, the Oakland nonprofit that researches health policy. “Immigrants and Dreamers represent an asset to us in thinking about how we leverage the workforce to meet those population needs going forward.”
Primary care physicians are in short supply in underserved regions like Central California, and there is a projected shortage of other workers in health sector jobs that are heavily staffed by foreign-born trained professionals like nurses and medical technicians.
Ending DACA would lead to a “measurable reduction in the availability of health care workers,” said Eloy Ortiz Oakley, chancellor of California Community Colleges, which includes 114 community colleges across the state.
More than 60,000 Dreamers — out of roughly 100,000 undocumented students — attend California community colleges, Oakley said. The community college system does not track how many Dreamers are in the pipeline to work in health care jobs, but Oakley said the health fields are popular with DACA students because they often lead to well-paid jobs.
Attorney General Jeff Sessions has said that DACA, which was enacted during the Obama administration by executive action, lacks legal standing and has resulted in immigrants taking jobs from Americans citizens. Trump, however, has indicated he wants to make DACA part of a comprehensive immigration reform plan that includes building a border wall between the United States and Mexico.
Vasquez said being accepted in the DACA program allowed him to seek work experiences that shaped his interest in pursuing a career in medicine, and helped him get into medical school. He said he has friends who are also Dreamers working toward degrees in public health, nursing and business administration.
“The cause of the Dreamers is not a problem facing the nation,” he said. “Most are educated and going into careers that I think are going to benefit the economy . ... We want to contribute to solving problems in the nation. We want the opportunity to do so. Rescinding DACA deprives us of that opportunity.”
“It’s hard to predict what’s going to happen. What happens if Congress fails to act in the next six months? A routine traffic stop could be a potential risk for deportation.” Juan Vasquez, UCSF medical student