My passion for serving others is what drew me to medicine. Beyond the fascination with science, I am driven by a fervent desire to improve the lives of marginalized communities. However, despite years of hard work, education, and personal sacrifice, it is still uncertain whether I will be able to use my education, abilities, and skills to contribute to healthcare in the U.S. — my home. As a recipient of the Deferred Action for Childhood Arrivals (DACA) program, I live in a state of limbo.
The DACA program, established in 2012, provides temporary work authorization and protection from deportation to undocumented individuals who came to the U.S. as children. Unfortunately, the program is at risk of ending at any time due to continued efforts to terminate the program, ongoing litigation, and Congress’ failure to provide a permanent solution to DACA recipients and others who are eligible. This leaves DACA recipients in danger of deportation and the threat of being unable to use their skills to contribute to patient care in the U.S.
I came to the U.S. at the age of 7 and even in the face of many obstacles, I managed to graduate in the top 10% of my high school class. Despite a lack of support and resources, I obtained my undergraduate degree through sheer tenacity and later pursued higher education, obtaining a master’s in public health and a master’s in business administration from Johns Hopkins University. Now, as a medical student, I have limited access to resources, valuable training, and educational opportunities as a result of my legal status. For example, I am ineligible for federal financial aid and federal work study, and I was limited in what medical schools I could apply to. Not to mention, I faced barriers to other experiences needed to fully participate in the medical school experience, such as rotations at the VA hospital, certain research opportunities through national institutions, and other internships that often require citizenship. Moreover, due to citizenship or permanent resident requirements for board certification and licensure in certain states, there are barriers to practicing medicine in many parts of the country.
More than anything, I want to utilize my skills and education in the future to improve population health, but this requires a legislative resolution from Congress. One option is the proposed Dream Act of 2023, which would establish processes for Dreamers like me to apply for legal status and would create a possible path to citizenship. Beyond helping DACA recipients achieve their dream, more security will also help prevent an even worse doctor shortage and promote better and more culturally competent patient care.
Many DACA recipients have made significant contributions to the U.S. healthcare system. There are currently 43,500 DACA recipients working in the healthcare and social assistance industries, including doctors, intensive care nurses, paramedics, and respiratory therapists. In recent years, more DACA recipients are in medical school or training to be doctors, with the Association of American Medical Colleges (AAMC) reporting a steady increase in DACA applicants. Currently, there are over 240 DACA recipients training to be doctors.
The U.S. healthcare system is already experiencing a shortage of healthcare professionals. This problem will only be exacerbated over the next decade. According to the AAMC, the U.S. could experience a shortage of up to 122,000 physicians by 2032. Removing DACA recipients from the healthcare system would be detrimental to patient care and physician staffing. Furthermore, allowing DACA recipients to practice medicine has benefits that extend beyond just addressing the current shortage. Because these individuals bring unique perspectives and experiences to the healthcare field, they often provide more culturally competent care, which can lead to better health outcomes for diverse patient populations.
The uncertainty surrounding the DACA program affects DACA recipients, their patients, and the U.S. healthcare system as a whole. As we continue to face a shortage of healthcare providers, it is paramount that policymakers recognize the valuable contributions that we are already making and the changes we can catalyze in the healthcare system by providing us with a pathway to permanent legal status and citizenship through legislation. By doing so, we can address various challenges faced by the healthcare system, including the diversification of medicine.
Having a more secure legal status and a way to achieve citizenship would not only help fill labor gaps, but would also allow me to continue pursuing my dream. Lawmakers must prioritize legislation that can help all of us Dreamers on our pathway to practice medicine.
Katherine Narvaez Mena, MPH, MBA, is a medical student and a DACA recipient from Syracuse, New York.
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