When José Alberto first arrived in Las Vegas from Cuba three years ago, he worked a number of odd jobs: he drove for Uber, worked in a warehouse, and fried chicken at a restaurant — a common path for many immigrants. But back in Havana, Alberto was an internal medicine doctor with a master’s degree in infectious disease.
“I consider myself a good doctor with a pretty good experience. I want to help others, like I did in Cuba. That’s my passion,” Alberto said.
State law requires doctors like Alberto to get a whole new license. That could mean doing a residency program again, which could take three to seven years.
“I came here looking for opportunities to grow as a professional, as a person. I came here also looking for freedom and for a better future, especially for my family,” Alberto said.
Nevada legislators are trying to streamline the process. Senate Bill 124 would allow health care workers who have completed postgraduate training and practiced in a foreign country to take the United States medical exams and skip the required residency program. They must work under the supervision of a licensed physician for two years and receive a job offer to apply for a license to work independently.
Twelve other states have enacted similar bills, including Colorado and Idaho in the Mountain West. Similar bills failed in Wyoming and New Mexico this year.
Nevada Democratic Sen. Fabian Doñate, a public health administrator, sponsored the bill for this simple reason:
“I started to ask many of my other staff members that are immigrants, and I learned that I have many medical assistants that work directly for me that were physicians in Cuba and Mexico,” Doñate said.
But the U.S. wouldn’t recognize their credentials.
There are an estimated two million college-educated immigrants and refugees in the U.S. who are underemployed or unemployed, according to the Migration Policy Institute. In Las Vegas alone, there are roughly 70 foreign medical professionals ready to work but can’t, according to Americans for Prosperity.
Natalie El-Deiry, the director of U.S. policy at World Education Services, said this legislation is one piece of the puzzle for filling health care provider gaps.
“We all have an aging population, not only of physicians who are moving out of practice into retirement, but also increased care that’s needed for an aging population,” El-Deiry said. “We just don’t have the doctors and the health care practitioners to serve the need within our states and Nevada is no different.”
In fact, all of Nevada’s 17 counties face some type of health care provider shortage. One issue that contributes to that is the lack of residency slots. There are only 400 slots, but the state needs an additional 2,500 physicians for its population, according to the National Library of Medicine. On top of that, the state doesn’t have residency or fellowship programs for dermatology, oncology, and neurosurgery. Research shows people tend to live and practice where they studied.
However, not everyone is on board. The State Medical Association and Dean of the College of Osteopathic Medicine at Touro University Nevada in Las Vegas opposed the legislation. They said the state should instead focus on increasing residencies, and that it undermines patient care and licensing standards.
But El-Deiry disagrees.
“There are a lot of safeguards in place to make sure that people are getting the same quality of care and that we’re not compromising the safety or care of individuals who receive medical treatment or care from internationally trained physicians,” El-Deiry said.
One of those aspects is the English proficiency requirement. Doñate went back and forth on this. There are language needs in Nevada: One-third of residents speak a language other than English at home, with the highest being Spanish.
“But I also hear the concern from the reverse that you should retain some level of knowledge of English, because your level of care is also dependent on you talking to other physicians and consulting with everyone else,” Doñate said.
So far this session, the bipartisan SB 124 has passed unanimously out of the Senate and needs to receive another vote in the Assembly Commerce and Labor committee before Friday’s deadline.
Doñate said this bill will also show how immigrants contribute to the community at a time when the president is spreading very divisive anti-immigration rhetoric.
“We can talk politics all we want, but either you have a doctor in one community or you don’t,” Doñate said.
For Alberto, who has wanted to be a doctor since he was a child, the bill’s passage would mean being able to go back to doing what he loves most — helping people.
