Ghislaine Bola moved to Maine from the Democratic Republic of Congo in 2015. Prior to that, she was a practicing physician for five years.
She’s a medical assistant in Maine – requiring less education and training than her role as a doctor in the Congo. To practice as a physician here, the state requires US and state-based exams and residency. Her foreign training does not meet the requirements.
The effort to meet America’s physician needs costs Bola time and money, neither of which she has in abundance. She recently received the funds to attend nursing school at Southern Maine Community College.
Bola, who has more than 15 years of experience and education in Congo, wants to do more.
“I don’t want what I have as a gift to go to waste,” she said. “I want to get back to who I am as close as possible.”
Foreign-trained health professionals face similar barriers after immigrating to the U.S., as the country — including Maine — faces a severe health care workforce shortage.
For many, immigrants are an untapped workforce. Maine in 2010 It had more than 47,000 immigrants in 2018, according to the American Council on Immigration.
Researchers at the Migration Policy Institute in Maine A 2020 study found that foreign-trained professionals are struggling to find jobs across the US.
“It is extremely important to effectively use people already in the workforce, maximizing their potential, skills and abilities,” said MPI researcher Jane Batalova, who co-authored the report.
Practicing medicine in Maine requires different degrees of training, education and costs depending on the role. To become a physician, at least a foreign-trained doctor must take the US medical licensing exam and complete residency.
While these steps may seem simple, they are not, and most immigrants to Maine are unaware of the challenges they may face.
New Mainer Resource Center Since its inception in 2013, it has worked to help refugees from a variety of professional backgrounds regain their skills by providing them with expertise and limited financial support. Their clients include foreign trained health professionals such as Bola.
“I was very naive about what it would take to make the change or solve their issues,” says Sally Sutton, NMRC program coordinator. We are still nowhere near doing what needs to be done.
Every immigrant’s story is different, Sutton says, but a common issue is the language barrier, and for undocumented immigrants, getting the documents needed to practice is a concern. Portland Adult Education – including NMRC – has English language learning services to combat the language barrier.
But even after an immigrant learns the language, Sutton said, many struggle financially.
“The only thing holding them back is they don’t have the means to pay for school,” Sutton said, adding that the cost to doctors can be thousands of dollars.
Because of this, as well as the time it takes to study for the licensing exam, many turn to roles in the medical field that do not have strict licensing requirements.
“Just because you’re a doctor doesn’t mean it’s going to be easy, and you’re probably never going to be a doctor again,” Sutton said. You may put too many eggs in one basket, which may never come to fruition.
There is also fierce competition to get selected for medical residency. There aren’t many openings, and foreign-trained professionals who may not have studied recently may be held back.
“You’re competing with American medical graduates who are fresh out of university and who are prioritized,” said David Ngala, a Portland medical resident and Congolese immigrant.
Ngala spent seven years searching and studying before finding a place to live. Following advice from the NMRC, he stayed in the medical field while studying for his exams, working as a phlebotomist, drawing blood from patients and donors, even though he was a doctor back home.
Although he struggled to become a resident, Ngala said it was possible to achieve. It may just take time, money and effort.
“It’s possible,” he said. I tell everyone, and you have to give some time and sacrifice to follow it.
He added that one of the best things the state can do is to provide literature to help refugees understand the process.
If becoming a physician fails, there are other roles such as physician assistant, nurse practitioner or senior practitioner that still allow externally trained professionals to contribute.
In Bola’s case, financial constraints and age barriers pushed her to pursue a career as a nurse practitioner. But she said she is very happy to be contributing where she is.
“I’m doing my best. As long as I’m still on health care, that’s fine with me,” she said. “I’m helping people; that’s my first goal in life.
Eric Steele, president of the Maine Medical Association, said it’s impossible to sacrifice proper training to remove barriers to foreign-trained physicians.
“While we absolutely support the idea of allowing well-trained foreign physicians to practice in Maine, this cannot happen at the cost of quality of care,” Steele said.
For now, Steele said, MMA is not actively recruiting foreign-trained physicians in Maine, even though the organization believes that professionals should be diverse. All aspects of the physician workforce are “of great concern to us.
At the same time, Bola, Ngala and Sutton said Maine could do more with externally trained health professionals. Providing scholarships or other means of financial support for education is a priority, but access to resources and opportunities is on the list.
Rep. Kristen Cloutier, D-Lewiston, is pushing state legislation to establish a commission to meet the needs of foreign-trained workers in the state, including health professionals. If approved, the commission will report on how to proceed with the legislation.
Removing barriers to employment for foreign-trained health workers is a “win-win” because they can support their families and the state can rely on them in times of crisis, he said.
“We have a real shortage of people in health care,” Cloutier said. “We have a shortage of people who speak people’s mother tongues and health care. So it seems like a good time to take the initiative here.
Colorado, Massachusetts, Oregon and Washington are considering similar legislation. Colorado’s bill directly addresses the removal of barriers to licensing.
The University of Southern Maine has its own educational efforts that encourage foreign-trained professionals.
Brenda Peterson, associate dean of the School of Nursing, has been working since the summer to strengthen and build a platform for multilingual students at the school. But something may fail at first before release.
“We’re definitely in the growth phase,” she says.