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Cuts halt program to qualify immigrant doctors for residency

A state-funded program that helps immigrant doctors qualify to practice in Minnesota has become a casualty of the state budget agreement.

After lawmakers eliminated funding for the $150,000 program during last-minute negotiations last month, it shut down.

Unless the program’s funding is restored, its legacy will be the three doctors from Somalia who, after years of professional limbo, were finally able to begin residency training, a difficult proposition for immigrant doctors who received their training years ago.

"I knew that there was some obstacles," said Dr. Jibril Elabe, a Somali doctor who came to the United States 11 years ago. "But I never thought they would be so hard and it will take so long to overcome."

Elabe was in his early 30s when he fled Somalia's civil war. With a medical degree and eight years of intense field experience to his credit, he hoped he would be able to continue his career in his new home in Minnesota. Now 44, Elabe is finally getting his chance.

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It's not a simple thing for doctors served by the program to work in the United States, even if they have been a practicing physician elsewhere for many years.

Dr. Liban Farah discovered that his 10 years spent delivering babies and treating gunshot victims in Somalia didn't matter to Minnesota providers.

"Every place that you go they will ask you when did you graduate? And I graduated a long time ago," Farah said. "Then they will say to you, 'Do you have experience in the United States?' How can I get a United States experience if they don't give the opportunity to practice here? So it was a difficult time for me."

Medical requirements

Most U.S. hospitals and clinics require physicians to complete a residency program before they will hire them. Residency programs typically will only accept doctors who have graduated within the last five years.

That made qualifying for a residency seemingly impossible for the 45-year-old Farah, who had graduated from medical school in 1989. While he searched for a way to get around the rules, he took whatever work he could find.

"I did everything, everything that you can imagine from driving taxi to working as an interpreter or doing some other jobs to support me and my family," he said.

Eventually, Farah, Elabe and some other out-of-work Somali doctors convinced state lawmakers to help them. In 2010, the Legislature gave the University of Minnesota $150,000 dollars to set up an intensive, seven-month training program that would help the doctors meet the qualifications for a U.S. residency program.

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Farah, Elabe and Liban Hired, another Somali doctor, were selected for the first class, which began last December.

In seven months, the program instructed them on how the U.S. health care system works, including insurance billing and electronic record-keeping. They also worked three-month rotations in a hospital and a clinic.

More physicians needed

Dr. Will Nicholson, a U of M professor who helped teach the inaugural class of immigrant physicians, said Minnesota needs doctors like Elabe and Farah who are willing to treat under-served and immigrant communities.

An estimated 200 foreign-trained doctors living in Minnesota face similar barriers to becoming a practicing physician. The University of Minnesota program was their best hope for reviving their career. But now that there's no money for the program that possibility has dimmed considerably.

That’s a shame, Nicholson said, because re-training foreign doctors is much more cost-effective than training a new student.

"By cutting our funding they've save a dime and lost a dollar," he said. "You know I wouldn't want to be a lawmaker, but my guess is if they had the time to listen to what we did and look at the math, they probably would have done something different. It's unfortunate that politics has to play out in these sort of last-minute, midnight kind of deals."

The three Somali doctors who graduated from the U of M's program must still finish three-year residencies. After that, they're required to work for one year in an under-served Minnesota community.

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