For eight years, I had a second family: my brothers and sisters in the U.S. Marine Corps Reserves. It was an honor to serve with them, and – after my time in Iraq was done – I knew my service would not be over. As a medical student at the American University of Antigua College of Medicine, I had my sights set on the Department of Veterans Affairs (VA).
The VA was like a home to me. I had my physical at VA hospitals and received routine treatment for minor life injuries. I couldn’t think of a better way to follow up my service than to serve our wounded warriors. Then I got the news that would leave me heartbroken: because of a policy enacted decades ago, I would not be able to participate in clinical rotations as a medical student at any VA hospital.{mosads}
The VA operates the nation’s largest integrated health care system, with more than 1,700 medical facilities nationwide. While U.S. international medical school graduates (USIMGs) like myself are permitted to work as residents in VA hospitals, we are prohibited from training in clerkships at VA hospitals. Medical students spend the last two years of our education in clinical settings at hospitals. This clerkship experience is fundamental to our education. Not being able to train at VA hospitals puts USIMGs at a disadvantage. We don’t get the chance to practice in that setting, so we don’t get the chance to make an impression on key clinical staff. That makes a big difference when applying for a residency.
I did my residency at Roger Williams Medical Center in Providence, Rhode Island, and every day I was reminded of the barrier that prevented me from serving my brothers and sisters in uniform during my years as a medical student. Right across the street was the Providence VA Medical Center.
According to the VA’s most recent data, 526,000 veterans are waiting more than a month for care. One reason for this is the estimated 1,400 unfilled positions at VA hospitals across the country, which could eventually be filled by future USIMGs if they were given an early exposure to the VA. If we’re going to get these brave veterans the care they deserve, the VA should change their policy on clinical rotations.
To be sure, this policy is not the sole cause of the physician shortage. A recent Washington Post report detailed management issues and pay that doesn’t compete with private hospitals. Those issues need to be addressed too, but changes won’t come overnight. The VA’s policy on clerkships, on the other hand, could be reversed with comparative ease.
The physician shortage at VA hospitals is part of a nationwide shortfall. According to the Association of American Medical Colleges, the U.S. could see a shortage of 120,000 doctors by 2030. As the physician shortage grows and U.S.-based medical schools are unable to train enough qualified students to fit the demand, international medical schools increasingly fill this critical gap. Since 2012, the number of graduates of international medical schools (IMGs) who obtained residencies in the US has risen by almost 25 percent.
If we’re good enough for those hospitals, we should qualify for the VA.
Offering clerkships at the VA to qualified USIMGs like myself would reduce the workload of those currently in the system, providing much needed medical care for those in need, and preparing a new cadre of physicians for generations to come.
While my residency was not affiliated with the VA, I still got the chance to serve fellow veterans. While at Roger Williams Medical Center, I cared for retired servicemen and women brought to the Emergency Department. Today, I work at NYU Winthrop Hospital in Long Island, NY, which has one of the largest veteran populations in the country. But there are too many veterans in the VA hospital system waiting for care. We’re doing them a disservice by not doing everything in our power to get qualified doctors in the door.
Dr. Eddie Copelin II is a Marine Corps Reserves veteran who served in Iraq. He graduated from American University of Antigua College of Medicine and is currently a Gastroenterology Fellow at NYU Winthrop in Mineola, NY.