Jul 8, 2022 - News

Massachusetts falls behind in attracting foreign-trained doctors

Illustration of a stethoscope with a "no" symbol on the bell/diaphragm.
Illustration: Allie Carl/Axios

Massachusetts is losing doctors, nurses and dentists to other states, even during a historic labor shortage and a pandemic.

What's happening: That's because many of those health professionals got their degrees outside of the U.S., and they can't easily transfer their credentials here, according to a state legislative panel's new report.

Driving the news: A long-awaited report from the Special Commission on Foreign-Trained Medical Professionals confirms what health and immigration advocates have argued for years: The state's requirements to license foreign medical workers are at times unnecessarily strict, and they're driving candidates away.

  • Foreign medical workers must take extra steps to practice medicine in any state, such as redoing their residency or passing medical exams accredited in the U.S. Massachusetts requires additional English testing and more training than other states do.
  • In Massachusetts, 22% of foreign-trained physicians and about 18% of nurses are unemployed, employed only part-time, or out of the health care labor force entirely.

Why it matters: While Massachusetts is seen as a health care leader, the state has several underserved communities.

  • More than 130 cities and towns are designated "health professional shortage areas" by the federal government because they lack primary care, dental and mental health care providers, according to the report.
  • Legislators, immigration advocates and hospital leaders are looking at foreign-educated workers as a possible solution, but they say other states are attracting those workers with funding for workforce development and other resources, along with less rigid requirements.
  • "When you have a shortage of health care professionals and a lot of people who are ready, willing and able to work in that field, it behooves you to figure out how to streamline the registration process," said Laurie Millman, executive director of the Center for New Americans and one of the commissioners.

The 22-member special commission calls for the state to authorize a licensing board to create a pipeline for foreign-trained medical professionals.

  • Such a pipeline for doctors, for example, would involve a limited licensing whereby a doctor could eventually practice in an underserved part of the state and ultimately qualify for a full medical license.

What they're saying: "Several states are recognizing the value of the foreign-trained professionals, and they are coming up with different programs and resources to integrate them in their workforce," said Emmanuel Owusu, founder and executive director of the African Bridge Network.

  • Owusu, who studied sociology and political science at the University of Ghana, couldn’t find work in any relevant field in Massachusetts until after obtaining a master’s degree in urban planning from Tufts University.
  • He founded the network in 2014 to offer foreign-trained workers across the African diaspora the assistance he struggled to find when he first arrived in the U.S. 16 years ago.

One solution the report cites is the program at Bunker Hill Community College's Welcome Back Center, which helps 40-50 foreign-trained nurses obtain state nursing licenses a year.

  • The center's roles range from helping nurses prepare for English and licensing exams to navigating the bureaucratic nightmare of getting foreign certifications evaluated by accrediting agencies.
  • The report calls for putting state funding behind the center and expanding it to cover doctors and dentists

Other recommendations: The panel also seeks to eliminate some requirements entirely, like the seven-year deadline for passing the U.S. medical exams (other states have a 10-year deadline, or none at all).

  • The commission also seeks to create a loan program to cover the cost of test prep, exam and licensing fees, and more. The program would be funded by state revenue and private donations.

What's next: The commission calls on state agencies and licensing boards to tackle some smaller short-term recommendations, such as cultural competency training.

  • But the report's long-term recommendations would be up to the legislature, which ends its session in three weeks. The panel proposed no timeline on when lawmakers should make those changes.
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