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Linda H. Aiken, James Buchan, Julie Sochalski, Barbara Nichols, and Mary Powell Trends In International Nurse Migration Health Affairs, May/June 2004; 23(3): 69-77. [Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

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The Internationally Trained Domestic Alternative

Dave Ramos   ( 19 July 2004 )

The Internationally Trained Domestic Alternative 19 July 2004
Dave Ramos, Executive Director Consortium of Physicians from Latin America (COPHYLA) Send letter to journal: Re: The Internationally Trained Domestic Alternative dramos{at}cophyla.org Dave Ramos	I was pleased to see that your article reflected issues that not many recruiters these days are willing to discuss. The effect of recruiting abroad for the U.S.'s domestic health care workforce needs is not only selfish, but also somewhat mind-boggling when one considers the domestic alternative. The domestic alternative is that policymakers and grant funders have enough vision to invest in and support groups that assist internationally trained nurses and other international health care graduates already living in the U.S. In the United States, one in ten immigrants in the 1990s had a bachelor's degree or graduated from a medical school in their country of origin. One in every ten -- that's a lot of untapped human potential. Our organization has been a witness to such since 1990. The Consortium of Physicians from Latin America (COPHYLA) is a community-based nonprofit organization that was founded over 14 years ago to assist international medical graduates (IMGs) with their goals of professional integration. COPHYLA's founders initiated a feasibility study in 1988 that determined that there was a huge lack of access to primary care health providers in underserved areas, and at the same time, there was a large presence of IMGs working in menial, low-paying jobs. In 1992, 1993, and 1994 we took the same concept and began assisting international dental graduates (IDGs), internationally trained nurses, health technicians, psychologists, and others who were just as eager to reintegrate professionally. The response was overwhelming, even though we never advertised -- people came to us via word of mouth. In California alone, there are tens of thousands of international nurses who are just languishing in menial employment not related to their professions, looking for information to integrate professionally. But with the lack of information, cultural and linguistic barriers, a "barely making it" economic status, institutional bias, at times personal fear of failure, and other obstacles, many are just wasting their talent. As an organization we have helped hundreds if not thousands, but there is still much work to be done. With the economic limitations that most nonprofit organizations face, especially these days, it is no wonder that we do not have the funding to advertise to the thousands who have never heard of our organization. (And that's just in California, our geographical service area.) Just recently, our idea has been duplicated by the Workforce Investment in International Nurses (WIN) program in Oregon. COPHYLA was also the first group in the nation to retrain IMGs (foreign-trained doctors) as registered nurses in 2000. That model to ease the nursing shortage was also copied by Florida International University (FIU) with funding in the hundreds of thousands by major hospitals such as the Hospital Corporation of America. Though you mainly wrote of English-speaking international nurses, you must not forget that in the U.S., there are tens if not hundreds of thousands of Latino immigrant health care professionals. If they are already here, half of the battle is already won. Many have already been studying English, understand the culture a bit more than others, and possess a cultural affinity for Spanish-speaking patients, who in this part of the country are a huge population to deal with. Please think of this solution, because these immigrant professionals are here to stay, they already have children here, form part of the communities, and are not thinking of going back, so why not take advantage of their presence? It's the logical thing to do.