Foreign-trained medical professionals waiting to help
Baker urged to grant provisional licenses to them
By 
LAITH ALMATWARI has medical experience with respiratory and cardiovascular diseases that he thinks would be valuable in the fight against COVID-19, but bureaucratic red tape is preventing him from jumping into the fray.
The 34-year-old Almatwari trained and worked as a doctor in Iraq and Egypt, completed two residencies, and served as a medic for the US Army in Iraq. He now lives in Revere and is studying for his medical license after working with Mt. Auburn Hospital in Cambridge as a researcher in the radiology department. He feels like he could be doing a lot more.
“Doctors feel like we have a responsibility to help wherever we are. I’d be happy to help patients and support staffing in hospitals,” he said. “I feel like I have to do something.”
Like Almatwari, a number of qualified foreign-trained health care professionals, including physicians, nurses, and respiratory specialists, are ready and waiting to help during the coronavirus crisis. But they’re unable to jump in as providers because they are not licensed to practice in Massachusetts.
Almatwari as a resident in Ainshams University Hospital, Cairo Egypt. (Photo from Laith Almatwari)
Gov. Charlie Baker has acknowledged the need for reinforcements for frontline medical workers. In March, he asked medical schools to graduate their students early and approved 90-day provisional licenses for them.
But similar measures have not been taken yet for foreign-trained medical professionals, who often already have years of experience. At the end of March, New York Gov. Andrew Cuomo adjusted rules, specifically for graduates of foreign medical schools who are not licensed in New York but have completed at least a year of US-based medical graduate education. In New Jersey, Gov. Phil Murphy similarly ordered his Division of Consumer Affairs to issue temporary licenses to doctors certified and in good standing in other countries. California, Nevada, and Michigan may follow suit.
Across the US, there are an estimated 65,000 physicians who have not done any residency training in the US and therefore cannot be licensed to practice, but have extensive medical schooling and post-graduate training.
At Cambridge Health Alliance, Dr. Richard Pels has been speaking with immigration advocacy groups about the potential need that foreign-trained health professionals can fill. “There’s absolutely a need there. No question about it,” he said. “Because it’s an infectious disease, providers are falling ill themselves.”
Many international graduates have been “knocking on my door,” Pels said, eager to volunteer their services. “If it makes sense for early graduates in schools to get licensure, and we already have international graduates in our residency programs, why can’t we extend licensure to the foreign-trained as well?” he asked.
Pels said a proposal in front of the Board of Registration in Medicine would allow internationally trained graduates with a year of previous post graduate experience to get temporary licensure. Officials at the board replied after publishing, saying that on March 17, the Board of Registration in Medicine put in place a temporary, emergency license for physicians who have already completed postgraduate training, and that it includes graduates from the US and international medical students. But the move falls short of the emergency orders put in place by other Eastern US governors.
This is the first advocates and medical professionals who spoke with Commonwealth had heard of this. After reading through the Board’s statement, Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said that it shows that the bar being set for internationally trained medical professionals is high—“Three times as high as in New York, where internationally trained doctors who’ve completed one year of residency can get emergency licenses,” she said. “We don’t know any in our network who would meet the Board’s standard. Given the enormous need right now, and the large pool of highly skilled, experienced and multilingual doctors who are eager to help, we believe that Massachusetts would be better served by an emergency licensing standard like New Jersey’s, which we know many in our network can meet.”
The Baker administration hasn’t yet replied to their letter, and did not respond to requests for comment. “He doesn’t have to respond,” said Domb on Sunday. “He can create an executive order. We don’t want to exhaust the workforce. This seems like an easy fix to address this, and as an emergency, temporary option.”
The two legislators worked on a law that created a commission to study the issue last year. The commission has not completed its work yet, but Millona, who is also a member of the commission, said a pool of foreign-trained doctors is out there.
In a public survey for foreign-trained health professionals, the MIRA Coalition is seeing what interest looks like in emergency licensure. The form asks if the person is willing to volunteer, if they would want to be paid, what their length of training is, their specialty, and if they would be interested in assisting in the medical response for COVID-19.
Robert Marlin is a primary care physician in Lowell who helps facilitate a group of hundreds of foreign trained health professionals in the state. “We have many foreign-trained health professionals not working in their specialty,” he said. “They’re cleaning houses, or driving for Uber now,” he said.
Some, he said, work as nurse assistants or interpreters in safety net hospitals. Since the beginning of coronavirus, he’s heard from physicians. surgeons, internists, and specialty doctors asking if they can help, and if there have been changes on the licensure front. Places like the Boston Welcome Back Center at Bunker Hill Community College, which works with nurses with licensure in other counties, could help fast track documentation. “We already have resources poised to help,” Marlin said.
“Our response to this pandemic will demand the mobilization of as many qualified caregivers as possible. State leaders have been helpful in creating much-needed flexibility for the healthcare workforce during this state of emergency and MHA is working with them as the demand on our front-line workers intensifies,” said a spokeswoman in a statement.