Striving for Health Equity
IMG Assistance Program Offers Hope for Many IMGs Seeking to Re-enter the Health Workforce
M
arch 13, 2017 (“Match Day�), the day that aspiring physicians learned whether they were accepted into medical residency programs, served as yet another reminder to Tedla Kefene that he was no closer to realizing his dream of serving his community, in Minnesota, as a physician than he had been since 2008. His journey to practicing medicine had come to a screeching halt at the door of entry into medical residency. This journey began in the late 1990s when he immigrated to the United States from Ethiopia. Prior to coming to the U.S., he had a decade of medical experience serving as a general practitioner, medical director, and medical faculty in Ethiopia and Saudi Arabia. Upon arriving in Minnesota, he quickly learned about the steps necessary to practice medicine in this state. As an International Medical Graduate (IMG) he needed to have his educational credentials certified; pass the United States Medical Licensure Exam (USMLE), Step 1 and Step 2 within three attempts; become ECFMG certified; secure medical residency and complete at least two years in an accredited program; pass the USMLE Step 3 exam; and apply for a Minnesota Medical License. He enthusiastically began this journey not knowing that it would be a long and arduous journey, not understanding that it would take more than just hard work and determination and not appreciating that the cost would be more than just monetary.
By Edwin N. Bogonko, MD, MBA and Yende Anderson, JD
16
September/October 2017
Edwin N Bogonko, MD, MBA
Yende Anderson, JD
As required, his educational credentials were certified and he passed the USMLE, Steps 1 and 2 on his first attempt with high marks. He became ECFMG certified and applied to residency programs. Despite his experience and efforts he was denied. Understanding that there is intense competition for limited residency spots, he took the denial in stride and reapplied the following year. He was denied. He reapplied again. He was denied. He sought help from a non-profit organization, New American Alliance for Development, which provided support and guidance for international medical graduates to recertify as physicians in Minnesota. He even took USMLE, Step 3, an exam taken post residency, to demonstrate that he would be successful in a residency program. Yet every application to a residency program was denied. Kefene was facing two impenetrable barriers. First, the recency of his graduation from medical school. Most residency programs prefer and/or require that
applicants be recent graduates of medical school — those graduating from medical school within five years of applying to residency. Kefene graduated from medical school over a decade prior to his application to U.S. residency programs. Second, U.S. clinical experience. Residency programs require at least one year of U.S. clinical experience. Most U.S. medical graduates obtain this during the 4th year of medical school. It is extremely difficult to obtain hands-on U.S. clinical experience outside of medical school. In the interim, he worked as an interpreter, laboratory assistant, adult rehabilitator for mental health services, and a health screening provider. He also volunteered in his community providing health education at his church and participating in efforts of non-profit to advocate for the integration of IMGs. After applying to residency programs for over a decade, he was stuck and could get no further despite all his efforts. For the first time in his life, failure to achieve
MetroDoctors
The Journal of the Twin Cities Medical Society