Colorado groups want to make it easier for international medical graduates to work here

Three years ago, after multiple visits to the emergency room and her OBGYN practice, a patient with severe pain and no diagnosis turned to Wafa Elejmi for advice.

Elejmi, who worked as a clinical researcher in Denver, was not a practicing physician in Colorado but had residency experience in OBGYN after graduating from medical school in Libya. Someone the patient knew recommended that she contact Elejmi when she was at the end of her tether.

After 10 minutes of listening to the patient talk about her symptoms – vaginal bleeding and hemorrhagic cysts in her pelvis, pain and sleeplessness – Elejmi gave her opinion: the patient had an incomplete bilateral oophorectomy. Basically, she still had ovarian tissue in her body, despite having her ovaries removed at least a year earlier, and that was causing issues with the hormone replacement therapy she was taking. It took the patient’s and three other doctors’ advocacy to examine her ultrasound before confirming what Elejmi had told her.

“We are trained to use our knowledge and skills rather than relying on machines,” Elejmi said. “It’s a strength that we can add to this healthcare system: accurate diagnosis. Then the machines can confirm our diagnosis and not the other way around.

Although Elejmi was born in Greeley, she spent most of her life in Libya, minus a few years in the UK, so this is where she studied medicine, before returning to Colorado. in November 2007. She was not prepared for obstacles. she would face as an international medical graduate trying to practice medicine in the state – the process is not only long and expensive, but it requires these graduates (from approved schools) to complete three years of postgraduate clinical training in the state to get licensed to practice, competing for limited residency places. American graduates only have one year to complete.

Earlier this year, Colorado Democratic lawmakers asked the Colorado Nurses and Physicians for Healthcare Advisory Working Group within the Colorado Department of Regulatory Agencies to make recommendations on how to facilitate the process for the approximately 2,000 Coloradans who have graduated in medicine and obtained a license. in other countries so they can join the Colorado physician workforce. The group released a list of three main recommendations, including six proposals that would require legislative action or approval from the Colorado Medical Board.

These recommendations include allowing physicians who had an active medical license in another country to qualify for a Colorado license by passing a competency assessment; international medical graduates who have not qualified for an active license in another country can apply for internships to practice in a clinical setting and match residency; and increase residency slots and reserve places for qualified international medical graduates.

“NPATCH’s recommendations regarding the licensing pathways available to International Medical Graduates (IMGs) could allow Colorado to benefit from underutilized medical expertise in our communities,” said Lee Rasizer, spokesperson. from the Colorado Department of Regulatory Agencies, in an email. “In the longer term, a successful implementation could attract medical expertise from a wider range and potentially help alleviate health care shortages. “

In April last year, Governor Jared Polis signed an executive order temporarily modifying certain licensing requirements for medical professionals, including international medical graduates who could become eligible for temporary licenses under certain conditions. until May 31, 2022. This was independent of the NPATCH recommendations and was intended to meet the high demand from healthcare professionals with an increasing number of COVID cases.

But only two international medical graduates were able to obtain their temporary licenses and only one is currently practicing with, according to Carrie Miller, head of the Colorado Welcome Back program at the Spring Institute. The organization helps internationally educated healthcare professionals build careers in Colorado healthcare.

Problems arose with malpractice insurance, but it also became evident that too many barriers to entry still existed for those who had obtained a medical degree outside of the United States.

These barriers often include time and cost – many professionals end up having to take on other jobs to support their families more quickly, and state residency programs don’t accept anyone who has graduated more. three years ago, said Victoria Francis, state defense official. for the International Rescue Committee.

“Even if you were a surgeon and ran a hospital in another country, you come to Colorado and you don’t have the option of going back to a medical residency unless you move out of state, so there is just has a whole host of reasons why it’s really hard for these people to put their skills to work in Colorado, ”Francis said.

Lawahiz Abbas, an international medical graduate from Sudan who moved to Colorado in 2012 to join her family after applying for asylum, knew she would have to start early to pursue a medical career. But first, she needed time to adjust to her new country – to learn the language, the culture and its systems.

When she was ready to join the ranks of doctors, she continued to face obstacles. She decided to pursue other paths, while continuing to work towards her license. She has worked as a medical interpreter and with refugee programs in health care centers. She is preparing a master’s degree in public health.

“I’m not going to stop trying,” Abbas said. “I hope they can do something to make it easier because there are so many international medical graduates in Colorado. They are really qualified and really trained.

Miller was on the advisory group helping provide information for NPATCH recommendations, and she said during her research she found that over the past decade in Colorado, only 2.5% of all Residency slots have been awarded to international medical graduates.

Elejmi is one of these graduates. After returning to the United States, she again studied, passed the required first exam, and completed medical internships with doctors. She said she was treated like a colleague because of the amount of experience and knowledge she brought with her.

Yet despite the recommendations she received and the number of applications she submitted, she could not be matched for a residency program.

Now Elejmi works as a clinical researcher for the Rocky Mountain Cancer Centers in Aurora and also serves as a consultant for the Colorado Welcome Back program to share her experiences.

“I didn’t have a plan B,” she says. “I needed to realize this passion.”

Representative Naquetta Ricks, a Democrat from Aurora, plans to introduce legislation next year that would implement some of NPATCH’s recommendations, including finding a way to help international medical graduates access residency programs in the state. She also wants to explore some type of reciprocity for people who have practiced medicine in other countries to find pathways to exercise in Colorado, potentially modeling a program after what other states like Minnesota are doing. . Part of the bill that is still being drafted may also include requirements for these graduates to work in areas of the state that are underserved.

“Considering the current shortage of the medical workforce, including doctors, nurses and CNA, we need to make sure that people who come here with medical degrees have the opportunity to work in our society to do so. what they were trained to do. Ricks said.

Elejmi advocates for these changes as she continues to apply and track her medical skills, undeterred.

“I do what I do because I am passionate about helping people and what better way than to help people stay healthy to continue their journey in life to reach their goal,” he said. she declared. “I have so much to give.”

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