This story is fiction however impressed by the true and worsening challenges confronted by worldwide medical graduates navigating U.S. immigration coverage.
The acceptance letter sat printed on high of Nabeel Khan’s passport, nonetheless heat from the outdated inkjet printer in his household’s lounge in Lahore. The phrases glowed like prophecy: “Congratulations! We’re thrilled to welcome you to our Inside Medication Residency Program at St. Julian’s Hospital, Topeka, Kansas, starting July 1, 2025.”
Nabeel, twenty-eight, sensible, humble, and sleep-deprived, had spent years chasing this dream—late nights learning for USMLE exams, tutoring biology college students to fund his prep programs, and studying each doable cultural idiom which may ease the transition to American drugs. He had watched YouTube clips of morning report, memorized differentials like psalms, and practiced his “Inform me extra about that” for simulated sufferers.
And now? Now he refreshed the U.S. consulate appointment web page each twenty minutes like an addict. Every time, it returned the identical message: No appointments presently accessible.
“It’s like standing on the gate of your dream,” he instructed his mom in Urdu, “with somebody on the opposite facet deciding whether or not you seem like hassle.”
She positioned a comfortable hand on his shoulder, her eyes rimmed pink from prayer and fear. “You’re going to get there,” she mentioned. “Simply maintain your head excessive and your telephone charged.”
***
Dr. Carla Miron, Affiliate Director for Residency Packages at St. Julian’s, had a spreadsheet open with extra pink than inexperienced. 9 incoming interns. 5 delayed by visa points. One, a common surgical procedure match from Ethiopia, had his visa denied outright. No clarification. Simply ineligible at the moment.
The hospital’s management urged endurance. “They’ll trickle in,” mentioned the Chief Medical Officer. “They at all times do.”
Carla knew higher. Yearly it received worse. Extra scrutiny. Extra delays. Extra political theater performed out on the backs of idealistic trainees. And this 12 months? With the administration’s new government order tightening the journey ban and mandating full disclosure of social media accounts, even probably the most benign on-line put up might grow to be a pink flag.
She clicked on Nabeel’s title within the spreadsheet and opened his e-mail thread. His final message was heartbreaking in its politeness:
Pricey Dr. Miron,
Thanks to your continued help. I nonetheless haven’t secured a visa appointment, although I’ve expanded my search to embassies in Jordan, Sri Lanka, and the UAE. I’m very keen to start. Please let me know if there’s something I can do on my finish to maintain my place.
Sincerely,
Nabeel Khan
***
In a rented house in Novi Unhappy, Serbia, Drs. Vera Kovačević and Milos Đorđević stared throughout from one another at a kitchen desk crowded with embassy paperwork and half-drunk espresso.
“They’re asking us to make our Instagram accounts public,” Vera mentioned, disbelief in her voice. “Mine has photos of cats and my nephew’s birthday. Is that hostile?”
Milos shook his head. “I posted a meme throughout medical faculty of a burning examination paper. What in the event that they assume that’s anti-American?”
“You studied at NYU for a summer season!” she shot again. “You like scorching canine!”
“Doesn’t matter,” he mentioned. “They don’t see that. They see the passport.”
The 2 had matched to household drugs in rural Ohio—locations the place physicians like them weren’t simply welcomed however wanted, and the place unmatched American college students shunned regardless of their very own desperation to observe drugs. However the visa system didn’t appear to know—or care—in regards to the a whole bunch of worldwide docs who have been as a consequence of begin medical residencies and whose visas have been in limbo.
***
Again at St. Julian’s, July 1 approached like a siren’s wail. Carla attended orientation with a hole pit in her chest. 5 empty chairs sat within the again row of the auditorium the place new residents filed in carrying ill-fitting white coats and nervous smiles.
“Are they nonetheless coming?” requested a curious U.S. graduate from Missouri.
Carla hesitated. “We hope so.”
Behind the scenes, the hospital’s HR crew had submitted waiver requests to defer a number of the affected residents to the next 12 months. Others they may lose completely—ghosted by forms.
Carla pulled Nabeel’s file one final time that night. His last be aware had simply are available.
Pricey Dr. Miron,
I’m sorry to tell you that regardless of checking each embassy and consulate inside attain, I used to be unable to safe an interview. I perceive the hospital might not have the ability to maintain my spot. Please understand how grateful I’m for the chance and the way arduous I attempted.
Sincerely,
Nabeel Khan
She printed it. Folded it. And slid it quietly into her drawer subsequent to final 12 months’s letter from one other unmatched dream.
***
Someplace in Lahore, Nabeel walked the sting of the rooftop at nightfall, the decision to prayer drifting via the nice and cozy air like reminiscence. He didn’t know what got here subsequent. Possibly subsequent 12 months. Possibly Canada. Possibly the fireplace would exit.
Under, his youthful cousin pointed to the laptop computer display the place a breaking information banner ran throughout a world channel: U.S. faces doctor scarcity in underserved areas.
A flash of irony. A deeper burn of injustice.
“I might’ve helped,” Nabeel whispered.
He nonetheless would possibly.
Sometime.
However not right now.
Not as a result of he wasn’t prepared.
As a result of the nation wasn’t.
Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Affiliation for Doctor Management, and an adjunct professor of psychiatry on the Lewis Katz Faculty of Medication at Temple College in Philadelphia, PA. He’s the writer of a number of books on narrative drugs, together with Narrative Medication: New and Chosen Essays, and Narrative Rx: A Fast Information to Narrative Medication for College students, Residents, and Attendings, accessible as a free obtain.
