November 2002 • Volume 8 • Number 11 |
 Russell Kohl, M.D., student chair of the 2002 National Conference of Family Practice Residents and Medical Students, tells a reference committee his concerns about the federal J-1 visa waiver program. |
In a finely tuned balancing act, the Congress of Delegates on Oct. 15 considered two divergent priorities when deciding the fate of a resolution asking for Academy affirmation of the J-1 visa waiver program. At issue was supporting an individual's right to self-betterment versus supporting the responsibility of wealthier nations to assist developing countries in improving the health of their citizens.
Simply put, the J-1 visa waiver program allows sponsored foreign physicians to remain in the United States for three to five years after completing medical school in return for agreeing to practice in medically underserved areas. The physicians gain valuable training experience; patients gain equally valuable access to health care they might otherwise be denied.
But at what cost?
Nevada delegate Daniel Spogen, M.D., of Sparks cited concerns among members of the international community that the program siphons off the best and the brightest of poorer countries. "We're seen as taking away doctors from their own countries when they're badly needed there," he observed.
Tim Hallinan, M.D., of Gillette, Wyo., chapter executive of the Wyoming AFP, turned that viewpoint around: "I can't think of any Third World country that has a greater need than certain areas in our own country."
Although successful application for a J-1 visa waiver requires that no U.S. medical graduate is available to fill a given job opening, the program can still adversely affect U.S. medical grads, according to Russell Kohl, M.D., of Oklahoma City. The problem, he said, involves new physicians attempting to enter a market in which a J-1 physician has already established a practice. In short, said Kohl, "This stop-gap doesn't necessarily work as we'd like it to."
Apparently delegates agreed, sending the measure to the AAFP Board of Directors. It's an issue the Board has dealt with before, deciding in August not to throw its support behind the program. But recent actions at the federal level -- including the Senate's Oct. 3 passage of a House measure to reauthorize and expand the program -- merit a second look at the topic, delegates said.
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Copyright © 2002 by
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