Visa crackdown puts these rural doctors at risk

At his pediatric practice in Sioux Falls, South Dakota, Dr. Alaa Al Nofal sees up to 10 patients a day. He has known some of them since they were born. Others he still treats after they graduate from high school.

“I treat these children for type 1 diabetes, thyroid problems, thyroid cancer, puberty disorders and adrenal gland diseases,” he said.

Al Nofal’s expertise is essential. He is one of five full-time pediatric endocrinologists in a 150,000 square mile area that covers both South Dakota and North Dakota.

Like most rural America, it is an area plagued by a shortage of doctors.

“We are very fortunate to have Dr. Al Nofal here. We cannot afford to lose someone with his specialization,” said Cindy Morrison, chief marketing officer of Sanford Health, a nonprofit health system based in Sioux Falls. operates 300 hospitals and clinics in primarily rural communities.

Related: Visa Ban Could Further Worsen Doctor Shortage in Rural America

Still, Sanford Health could lose Al Nofal and several other doctors critical to its health care network.

Dr. Alaa Al Nofal (here with a patient) is one of five combined pediatric endocrinologists in South and North Dakota.

A Syrian citizen, Al Nofal is in Sioux Falls through a special workforce development program called Conrad 30, which essentially waives the visa requirement for doctors who complete their residency on an exchange visitor visa D-1 to return to their country of origin. for two years before applying for another US visa. The Conrad 30 waiver allows him to stay in the United States for up to three years provided he agrees to practice in an area where there is a shortage of doctors.

After President Donald Trump issued a temporary immigration ban By banning people from seven predominantly Muslim countries – including Syria – from entering the United States, Al Nofal is unsure of his future in America.

“We agree that something more needs to be done to protect the country, but this executive order will have a negative effect on the doctors in these countries that America desperately needs,” Al Nofal said. “They may no longer want to practice in the United States.” The suit is currently in legal limbo after a federal appeals court. temporarily stopped the ban.

Related: Trump Furious After Court Upholds Travel Ban Block

Over the past 15 years, Conrad 30 visa waiver you funneled 15,000 foreign doctors to underserved communities.

Sanford Health has 75 total physicians benefiting from these visa waivers and seven are from countries listed in the executive order. “If we lost Dr. Al Nofal and our other J-1 physicians, we would be unable to fill critical gaps in health care access for rural families,” said Morrison of Sanford Health.

And the ban could also hurt the recruitment of new doctors. The Conrad 30 Visa Waiver Program is sponsored by medical school graduates on nonimmigrant J-1 visas who have completed their residency in the United States.

Cows in a field just outside of Sioux Falls.

More than 6,000 medical interns from foreign countries enroll in U.S. residency programs each year using J-1 visas. About 1,000 of those trainees come from countries covered by the ban, according to the American Association of Medical Colleges. J-1 visa holders who were outside the country when the ban took effect were barred from entering the United States and could not begin or end their studies while the ban was in force.

The State Department told CNNMoney that the government could issue J-1 visas to people from one of the blocked countries if it is in the “national interest,” but it did not confirm whether a shortage of doctors could lead to a shortage of doctors. be eligible for such consideration.

“The stress and worry generated by the executive order in the short term could have long-term implications, with fewer doctors choosing training programs in the states and subsequently amplifying the deficit of providers willing to practice in rural areas and underserved,” said Dr. Larry. Dial, associate dean for clinical affairs at Marshall University School of Medicine in Huntington, West Virginia.

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Al Nofal studied medicine in Damascus, the Syrian capital, and completed his residency at the University of Texas on a J-1 visa. He earned a fellowship at the Mayo Clinic, then applied for a J-1 waiver, which placed him in Sioux Falls.

Nineteen months into his three-year commitment, Al Nofal directly deals with or serves as consulting physicians to more than 400 pediatric patients per month on average.

He sees most of his patients at Sanford Children’s Specialty Clinic in Sioux Falls, where families often drive hours for an appointment. Once a month, he takes a small plane to see patients at a clinic in Aberdeen, about 200 miles away.

Many of Dr. Al Nofal’s patients drive hours to see him at Sanford Children’s Clinic in Sioux Falls.
Once a month, Dr. Nofal travels to Aberdeen, SD, to see patients at a local clinic.

“It’s not easy being a doctor in this setting,” Al Nofal said, citing South Dakota’s long hours and frigid winters. “But as a doctor, I am trained to help people no matter the circumstances and I pride myself on that.”

This is one of the reasons why Al Nofal and his American wife Alyssa found it difficult to accept the visa ban..

“I have a 10 month old baby and I cannot travel to Syria at the moment. My family in Syria cannot come here,” he said. “Now my family can’t meet their first grandson.”

“I know if we leave, I’ll probably never be able to come back,” he said. He also doesn’t want to travel anywhere in the country right now. “I’m afraid of how I will be treated,” he said. He is also afraid of being arrested at the airport, even if he goes to another state.

Related: Trump’s Travel Ban and What You Need to Know

Almatmed Abdelsalam, originally from Benghazi, Libya, had planned to begin practicing as a family physician in Macon, Georgia, through the visa waiver program, after completing his residency at the University of Central Florida in July.

Everything was going fine. Abdelsalam, who treats hospital patients and veterans, applied for the visa waiver and was accepted. He signed an employment contract with Magna Care, which supplies doctors to three Macon-area hospitals, and he began looking for homes to relocate him, his wife and their two young children over the summer. .

Dr Almatmed Adbelsalam with his family.

But there was one last step left. For her J-1 waiver application to be fully completed, she must obtain final approval from the Department of State and U.S. Citizenship and Immigration Services.

“The executive order came in the middle of this process, blocking my candidacy for the State Department,” he said.

Because he is a Libyan citizen (Libya is also subject to a visa ban), Abdelsalam fears the outcome of this case.

“The Mâcon hospital urgently needs doctors. Even if they hired me, I don’t know how long they can wait for me,” he said.

“No one can argue that it is necessary to keep the country safe, but we also need to keep it healthy,” he said. “Doctors like me, trained in the United States at some of the best schools, are an asset, not a liability.”

CNNMoney (New York) First published February 10, 2017: 7:47 p.m. ET