 Oct. 19, 2002 |
| ASSEMBLY EDITION • SAN DIEGO |
It's all about balance. The Congress of Delegates on Wednesday attempted to balance 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.
 Russell Kohl, M.D., a former student chair of the National Conference of Family Practice Residents and Medical Students, tells a reference committee his concerns about the federal J-1 visa waiver program. |
Simply put, the J-1 visa waiver program, sponsored by the U.S. Department of Agriculture, 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 physicians 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 is contingent on the unavailability or unwillingness of a U.S. medical graduate 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.
The Congress took action on several other education issues, including the following.
Medical errors reduction. Delegates approved a resolution calling for inclusion of an error-reduction component in family practice residency curricula. In effect, the vote recognized and supported the Accreditation Council for Graduate Medical Education for incorporating systems standardization and process improvement modules in its new core competencies.
Decline in applicants to the specialty. Evaluate the long-term consequences of declining medical student interest in the specialty and a shrinking pool of family practice residency applicants on the health care workforce, delegates directed the Academy.
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