Visa crackdown puts these rural doctors at risk

How Trump's travel ban hits this South Dakota doctor

In his pediatric practice in Sioux Falls, South Dakota, Dr. Alaa Al Nofal sees up to 10 patients per day. He has known some of them since their birth. Others he still treats after graduating from high school.

“I am treating these children for type 1 diabetes, thyroid problems, thyroid cancer, puberty disorders, and adrenal disease,” he said.

Al Nofal’s expertise is essential. He is one of five full-time pediatric endocrinologists in a 150,000 square mile area that covers both South Dakota and North Dakota.

Like most of rural America, it is a region plagued by a physician shortage.

“We are very fortunate to have Dr Al Nofal here. We cannot afford to lose someone with their specialization,” said Cindy Morrison, marketing director for Sanford Health, a nonprofit healthcare system. based in Sioux Falls which operates 300 hospitals and clinics in predominantly rural communities.

Related: Visa Ban Could Worsen Doctor Shortage in Rural America

Still, Sanford Health could lose Al Nofal and several other doctors essential to its healthcare network.

dr nofal patient
Dr Alaa Al Nofal [here with a patient] is one of five pediatric endocrinologists united in South and North Dakota.

A Syrian citizen, Al Nofal is in Sioux Falls on a special workforce development program called the Conrad 30 visa waiver – which essentially waives the requirement that doctors who complete their residency with a J-1 exchange visitor visa must return to their home country for two years before applying for another US visa. The Conrad 30 exemption allows him to stay in the United States for up to three years as long as he commits to practice in an area where there is a physician shortage.

After President Donald Trump issued a temporary immigration ban Barring people from seven Muslim-majority countries – including Syria – from entering the United States, Al Nofal is unsure of his future in America.

“We agree that something more needs to be done to protect the country, but this decree will have a negative effect on doctors from these badly needed countries across America,” Al Nofal said. “They may no longer want to practice in the United States.” The action is currently in legal limbo after a federal appeals court temporarily stopped the ban.

Related: Trump Furious After Court Upholds Travel Ban Blockage

In the past 15 years, the Conrad 30 visa waiver channeled 15,000 foreign doctors to underserved communities.

Sanford Health has a total of 75 doctors benefiting from these visa waivers and seven are from the countries listed in the decree. “If we lost Dr Al Nofal and our other J-1 doctors, we would be unable to close critical gaps in access to health care for rural families,” said Morrison of Sanford Health.

And the ban could also hurt the pipeline of new doctors. The Conrad 30 Visa Waiver Program is powered by medical graduates with nonimmigrant J-1 visas who have completed their residency in the United States

Rural South Dakota
Cows in a field just outside Sioux Falls.

More than 6,000 medical trainees from foreign countries enroll in residency programs in the United States each year using J-1 visas. About 1,000 of these interns come from countries affected by the ban, according to the American Association of Medical Colleges. J-1 visa holders who were abroad when the ban took effect were prohibited from entering the United States and could not begin or complete their studies while the ban was in effect.

The State Department told CNNMoney that the government could issue J-1 visas to people from one of the stranded countries if it is of “national interest”, but would not confirm whether a doctor shortage would be. qualify for such consideration.

“The stress and worries generated by the executive order in the short term could have long term implications, with fewer physicians choosing training programs in the United States and subsequently exacerbating the shortage of providers willing to practice in the areas. underserved and rural, ”said Dr. Larry. Dial, Associate Dean of Clinical Affairs at Marshall University School of Medicine in Huntington, West Virginia.

Related: Obamacare’s Impact On This Alaskan Town With Just One Doctor’s Office

Al Nofal attended medical school in Damascus, the capital of Syria, and completed his residency at the University of Texas on a J-1 visa. He then got a scholarship at the Mayo Clinic, then applied for a D-1 waiver, which placed him in Sioux Falls.

Nineteen months after his three-year engagement, Al Nofal deals directly with or serves as consulting physician with more than 400 pediatric patients per month on average.

He sees most of his patients at the Sanford Children’s Specialty Clinic in Sioux Falls, where families often drive hours for appointments. Once a month, he flies on a small plane to see patients at a clinic in Aberdeen, about 200 miles away.

sanford children
Many of Dr. Al Nofal’s patients drive for hours to see him at the Sanford Children’s Clinic in Sioux Falls.
aberdeen hospital
Once a month, Dr Nofal travels to Aberdeen, SD to see patients at a nearby clinic.

“It’s not easy being a doctor in this environment,” Al Nofal said, citing South Dakota’s long hours and freezing winters. “But as a doctor, I’m trained to help people no matter what and I’m proud of it.”

This is one of the reasons why Al Nofal and his American wife Alyssa struggled to accept the visa ban..

“I have a 10 month old baby and I cannot travel to Syria now. My family in Syria cannot come here,” he said. “Now my family cannot meet their first grandson.”

“I know that if we go, I will probably never be able to come back,” he said. He also doesn’t want to travel anywhere in the country at the moment. “I am afraid of the way I will be treated,” he said. He is also afraid of being arrested at the airport, even if he is traveling to another state.

Related: Trump Travel Ban & What You Need To Know

Almatmed Abdelsalam, originally from Benghazi, Libya, had planned to start practicing as a family doctor in Macon, Georgia as part of the visa waiver program after completing his residency at the College of Medicine of the University of Central Florida in July.

Everything was going fine. Abdelsalam, who treats inpatients and veterans, requested visa waiver and was accepted. He signed an employment contract with Magna Care, which supplies doctors to three hospitals in the Macon area, and he had started looking for homes to relocate himself, his wife and their two young children over the summer.

almatmed abdelsalam
Dr Almatmed Adbelsalam with his family.

But there was one last step. In order for her J-1 waiver request to be fully completed, she must obtain final approval from the Department of State and the United States Citizenship and Immigration Services.

“The executive order came in the middle of this process, blocking my request to the State Department,” he said.

Because he is a Libyan citizen (Libya is also subject to the visa ban), Abdelsalam fears the outcome.

“Macon hospital is in urgent need of doctors. Even though they hired me, I don’t know how long they can wait for me,” he said.

“No one can claim that it is necessary to keep the country safe, but we also have to keep the country healthy,” he said. “Doctors like me, trained in the United States at some of the best schools, are an asset, not a handicap.”

CNNMoney (New York) First published on February 10, 2017: 7:47 p.m. ET