The Travel Ban: ASN Addresses Its Impact on Patients, Physicians and Scientists

By David White

Legal update: Yesterday, the United States Court of Appeals for the Ninth Circuit, in San Francisco, CA, held an hour-long oral argument for plaintiffs—represented by the State of Washington—defendants—represented by the U.S. Department of Justice.  A conference call is considered an unusual method for hearing oral arguments for Federal Appellate Courts.  The Ninth Circuit is considered very influential, covering 20% of the American population.  The ruling will almost certainly be followed by an appeal to the Supreme Court.

Since President Trump signed the January 27, 2017 executive order pertaining to immigration from seven Muslim majority countries, there has been no shortage of confusion.  Many American Society of Nephrology members have expressed their concerns about the executive order its implications for patients, doctors, and communities. 

ASN first expressed its concern about the executive order on Tuesday, January 31, 2017, in a statement by ASN President Eleanor D. Lederer, MD, FASN, in which she declared “Kidney diseases do not differentiate among race, religion, or geographic borders.” On February 7, ASN joined more than a dozen other societies in writing Department of Homeland Security Secretary John F. Kelly, expressing shared concern that the order will undermine medical education and result in patients losing access to their doctors.

ASN members have expressed their alarm in ASN Communities postings, emails, and other forms of communication saying that the current restrictions hinder the free exchange of information and travel among medical students, residents, and physicians around the world and will result in limiting Americans’ access to care.

In academic year 2016 alone, more than 65 percent of the 863 nephrology fellows-in-training graduated from international medical schools. More than half of internal medicine residency positions were filled by IMGs. Approximately 25% of the nation’s physicians are IMGs and these individuals provide a disproportionate share of the care to Americans in underserved communities that have a shortage of U.S. born and trained physicians.

Crystal A. Gadegbeku, MD, ASN Policy and Advocacy Committee (PAAC) Chair, stated “ASN feels strongly that this ban undermines the health care community’s commitment to the free flow of people, medical knowledge, and medical care across borders and will continue to voice those concerns independently and in partnership.”

Specifically, ASN urged the Department of Homeland Security to:

1. Reinstate the Visa Interview Waiver Program. Suspension of the program “risks creating substantial backlogs in the processing of new and renewal visas for trainees from any foreign country — delays that create substantial problems for residency programs with trainees on visas and that could interfere with the residency match process this year.” [http://www.nejm.org/doi/full/10.1056/nejmp1701339]

2. Remove restrictions on entering the U.S. for physicians from the 7 designated countries who have been approved for J-1 or H-1B visas and students from those countries with F-1 visas who have been accepted to U.S. medical schools.

3. Develop and implement a plan to allow physicians from the 7 designated countries to obtain travel visas to travel to the U.S. for medical conferences and other medical and research-related engagements.

4. Make it a priority to implement a process to admit refugees, without further delay, who had already been vetted and approved for entry prior to the executive order and who are are in need of urgent medical care.

ASN will continue to follow developments related to the executive order, take action where possible, and report on this issue to ASN members and Kidney News Online readers. Please feel free to share your feedback at info@kidneynews.org

 

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Legal update: Yesterday, the United States Court of Appeals for the Ninth Circuit, in San Francisco, CA, held an hour-long oral argument for plaintiffs—represented by the State of Washington—defendants—represented by the U.S. Department of Justice.  A conference call is considered an unusual method for hearing oral arguments for Federal Appellate Courts.  The Ninth Circuit is considered very influential, covering 20% of the American population.  The ruling will almost certainly be followed by an appeal to the Supreme Court.

Since President Trump signed the January 27, 2017 executive order pertaining to immigration from seven Muslim majority countries, there has been no shortage of confusion.  Many American Society of Nephrology members have expressed their concerns about the executive order its implications for patients, doctors, and communities. 

ASN first expressed its concern about the executive order on Tuesday, January 31, 2017, in a statement by ASN President Eleanor D. Lederer, MD, FASN, in which she declared “Kidney diseases do not differentiate among race, religion, or geographic borders.” On February 7, ASN joined more than a dozen other societies in writing Department of Homeland Security Secretary John F. Kelly, expressing shared concern that the order will undermine medical education and result in patients losing access to their doctors.

ASN members have expressed their alarm in ASN Communities postings, emails, and other forms of communication saying that the current restrictions hinder the free exchange of information and travel among medical students, residents, and physicians around the world and will result in limiting Americans’ access to care.

In academic year 2016 alone, more than 65 percent of the 863 nephrology fellows-in-training graduated from international medical schools. More than half of internal medicine residency positions were filled by IMGs. Approximately 25% of the nation’s physicians are IMGs and these individuals provide a disproportionate share of the care to Americans in underserved communities that have a shortage of U.S. born and trained physicians.

Crystal A. Gadegbeku, MD, ASN Policy and Advocacy Committee (PAAC) Chair, stated “ASN feels strongly that this ban undermines the health care community’s commitment to the free flow of people, medical knowledge, and medical care across borders and will continue to voice those concerns independently and in partnership.”

Specifically, ASN urged the Department of Homeland Security to:

1. Reinstate the Visa Interview Waiver Program. Suspension of the program “risks creating substantial backlogs in the processing of new and renewal visas for trainees from any foreign country — delays that create substantial problems for residency programs with trainees on visas and that could interfere with the residency match process this year.” [http://www.nejm.org/doi/full/10.1056/nejmp1701339]

2. Remove restrictions on entering the U.S. for physicians from the 7 designated countries who have been approved for J-1 or H-1B visas and students from those countries with F-1 visas who have been accepted to U.S. medical schools.

3. Develop and implement a plan to allow physicians from the 7 designated countries to obtain travel visas to travel to the U.S. for medical conferences and other medical and research-related engagements.

4. Make it a priority to implement a process to admit refugees, without further delay, who had already been vetted and approved for entry prior to the executive order and who are are in need of urgent medical care.

ASN will continue to follow developments related to the executive order, take action where possible, and report on this issue to ASN members and Kidney News Online readers. Please feel free to share your feedback at info@kidneynews.org

 

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