DOcOMENT BESUNE ED 192 707 HE 013 195 TITLE Admission of Alien Ph__cians for Graduate Medical Education: Hearing Before the Subcommittee on Immigration, Refugees, and international Lawcf the Committee on the Judiciary, House ofRepresentatives, Ninety-Sixth Congress, Second Session on H.R. 7118. PUB DATE 14 May BO NOTE 252p.: Not available in paper copy dueto marginal legibility of original document. EDFS PRICE = Jl PlusPostage. PC Not Available from EDBS. DESCBIETCRS College Admission: *Compliance (Legal) ;*Federal Legislation: Federal Regulation: *ForeignMedical Graduates; *Graduate Medical Education; Higher Education: *Hospitals: International Educational Exchange: Mcdical Services: *Physicians IDENTIFIERS *Immigration and Nationality Act 1965 ABSTRACT Congressional hearings on H.E. 7118, a billto amend the Immigration and Nationality Actwith respect to the admission of foreign medical graduates for graduatemedical education, are presented.. The bill would allow anextension of the time by which hospitals are required to reduce theirreliance on foreign medical graduates. In particular the billwould authorize: a two-year extension of the substantial disruptionwaiver authority for those hospitals that make a clear showing by meansof a comprehensive plan that they are phasing downreliance on foreign medical graduatesby recruiting D.S. medical graduates,improving the quality of the program, and attempting to usealternative health care providers.The bill suggests that the NationalHealth Service Corps should play a prominent part in providing medicalservices while hospitals and programs develop andimplement their plans.. Testimony by representatives of the federal government,the City and State of New York, and the medical community arepresented. Statements regarding the bill and alternative proposals areappended (SW) ****** * ** **** * ****** ** ** *311 *** *** ** Reproductions supplied by EDRS arethe best that can be made from the original document. ******************************************************* **** 4=3 ADMISSION OF ALIENPHYSICIANS FOR GRADUATE MEDICALEDUCATION L.LJ HEARING BEFORE THE SUBCOMMITTEE ON IMMIGRATION,REM- AND INTERNATIONALLAW OF THE COMMITTEE ON THEJUDICIARY HOUSE OF REPRESENTATIVES NINETY-SIXTH CONGRESS SECONI ) SESSION ON 11.R 7118 A BILL TO AMEND THE IMMIGRATIONAND NATIONALITY ACT WITH RESPECT TO THE ADMISSIONOF ALIEN PHYSICIANS FOR GRADUATE MEDICAL EDUCATION MAY 14, 1980 US DEPARTMENT OF HEALTH. EDUCATIONS. WELFARE NATIONAL INSTITUTE OF Serial No 38 EDUCATION THIS DOCUMENT HAS BEEN REPRO- OOCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIGIN- ATING IT POINTS OF VIEW Ok OPINIONS STATED DO NOT NECESSARILY REPRE- sENroFF ICIAL NATIONAL INSTITUTE OF EDUCATION POSITION OR POLICY Frioii use Be Com e Judiei Ty U.S GOVERNMENT PRINTING, OFFICE 54-477 0 WASHINGTON: 19So 11:WIMITTEE oN TUE PETEI NV 1:1)DINaJ.w.ymtws came wr&Ailmi _RS EDISERT NIcri..011.Y, Illinois 21111:KT KASTEN:11E1E1 gill ti OAMCI )s. Owifornia ISII, Ja New Vork ;DOIN ,NVEILS, Michigan NI. c 111,5TI21C Virginia .f I'. 'IERI.ING,mm iA it LDS .1, » MIMEAD, Cantu-a-11a 41'.91?.GE E. I ANIEI,S9N, California .14 KiBERT r- DRINA N, Massaaluspus 111:NitY J.ling.:.1111e& mJqi (1,41.TZM AN, New York N. @x I* 06o RMANt) Kointicky 11A11I)1.1.) NANA-VER. Michigan \VII r 1.01 .f111"11,11ES, N..w 1),,N 1,1'\ U\ California NAMet. Toxas .1.0(ES SENY;ENIMENNEft. JR., LANIAR, uttiGER. North Carolina Wi,vonsin I:if .NIJINS 11, Virginia NIKE NA It. mu horn!' DAN GLICKMAN. Kane. BIM Nikhigma 1411..1.Y LEE EVANS, Georgii, Jos 41 NI:r.lAs,wvmlw«m (DitNric J. CLINK. stall' Director D'HANKLiN (;. Poz.K, ,18.4(fttftifCotitirtel Si'fit OM NI rinThp; ON I mMICItArioN. REFUGEEN, ANo LEItN.IoN I-Axv Iq lioLTZMAN,. Npw York. Chairwoman GEORGE E. DANIELSON, CallfornIn FISHTa., New York Virginia SAM HALL, Texl NI. CALDWELL MICHAEl. 8ARNES, 5taryland DAN I.U.NWIEN.Gamma HUH CARR, MIvIligimi 1311.1.Y L.F.1-1 EVANS, Georgia ( ()NT EN TS TEXT OF BILL Pngi 11.ft. 711$ 3 NVITNFSS ES Bellamy. Carol, pr,sident, f 'ity Council of Ne/.,- York: Prepared statement _ _ _ 29 Tier/non, Itichard, diteetor, NI`W York State Difice of health.- Sv-dems NIsinagemene ii Prepared statement 33 Pluriel,11, .1pti A., Assistant Cerieral Counel, 1_-.S. Internatimuil Cr)m- laardeatien Agency ' 11 Casterline, Itav L., Educational (ninission for rif,igli :llt`iiil'alI ir:11(1- 11;ttr, _ _ SO Pn-pared ,tatemnt 38 Cre-Are, 1/r. Itoltert 25 Ensinger,I)(', liarry, counsel, (._'1e..y Council of New York 25 Fetininger, Dr. I,eom/rd I) :Medical Associettion _ _ 10; Prepared ,Tatement,_ SO 1 I":,11eary A., Administrator, llealth Resources Administration Depart- ment nf livalth and Human Serviees _ 11 Prepared statement _ 14 Cla,s, :/,lichael A., ;1ener:11 llllllllllllll C.S. International Communication _ 11 Prepareci statement_ 11 Hitt, 3,1ary, C.S. Inn.rrettional C ommunic:Ltion Agertey 11 Memnis David, director, Intergovernmental rekitions for the New York City llealth and llospital, Corp 11 Prepared statement_ IsiS AhtritsItgu, Kell. lbrector, 1)ivisiiiil Of Medicine. Ilcalth Itesialrees Mona- i,tratit,n, Department if flealth and Human SriA.-eel-A 11 MillIzalDr. Fitzhugh, Neetional Health Service Corps 11 MYcr,', Jack D, University of Pitt,Ialrgh, A,soeintiun id Artie Aledi- eat Colleges _ SO Prepared statement_ 51 APPENDIX Letter from Honorable Evans, M.C. regarding Foreign medical graduates in the U.S. Virgin Island, 113 ,111,111itst(11 fir the hearing reeoril May 14, 19SiJ 142 Statements submitted for the hearing reoird All 168 Niaelarang 173 Article from. American College of SurgeonA 179 Itepoit of Office of the City Cenincil Presitiint, 1=- There a Doctor 111 the 184 Letter frGm Dr. Franklin C BefoTh. 227 Proposal submitted lv 1111C for lief-111611g Reliance on Foreign Medical StudentA" 228 OCT 2 8 1980 ADMISSION OF ALIEN PHYSICIANS FOR G ADUATE MEDICAL EDUCATION 'WEDNESDAY, MAY 14. 1980 HOUSE OF REPRESENTAIITES, St18(70241TrITEE ox fit/tumuli N, REFTIGRES, AND INTERNATIONAL LAW or za-re ColfMTrIZE oti TIM (Tun/ MART,. TV 497zingtan, D.C. The subcommittee met )7 p.m. in room 2237 of the Rayburn House Office _ Elizabeth Holtzman (chairwoman of the subcommittee) presi. Present; Representatives Holtzman, Hall, Butler, and Lungren_ Also present : Arthur P. EndresTr., counsel: .Taires B. Schweitzer. assistant counsel. and Alexander B. Cook. associate counsel. Ms_ Timir73tA.N. The subcommittee hearing on H.R. 7118 relating to the admission of foreign medical graduates will commetnT. My opening statement will be incorporated at this point in. the , ecord. {Material referred to follows .1 )rZZNFNL; STATEMENT OF HON. ELIZ-Lii=.711 HOLTZMAN Today's hearing has been called to consider legislation (H.R. 7118), which I have introduced relating to the admission of foreign medical graduates (FiNIG's) to the United States. Almost 4 years have passed since Congress paszied legigation to Insure that only medically and English-language qualified FMG's could eater the U.S. as immigrants or noniunnigrants. Because it was anticipated that the legislation. would abruptly reduce the ti ail:title supply of FMC's that tins served many piddle hospitals for years. the 1976 law attempted to provide a reasonabi and orderly transition period_ particular, it authorized ii waiver of the Visa Quali- fying Examination (YQE) until December 1950 for those institutions which would experience a substantial disruption of health services if FMG's were not available_ Regrettably, many municipal and viiitint.try limitt.:elis did not take advantage of this grace period anti as a result continue tat rely he!Lvilyif not exclusively in some Instanceson FAIG's for house ata ding and patient care. Theunderlying purpose of the 197d law was to upgrade the educational standards forFMG entry to this country and I do not believe that we can Indefinitely postpone the achievement of thst objective. Likewise, we cannot continue a system of -second class.' medical care for the poor said disadvantaged in our inner-city neighbor- hoods. who are in many rases totally denendent on FMG's for primarymedical care. On the other hand. I am troubled by the findings contained in arep_ort rez-atly issued by Carol Bellamy, Prerddent of the New York City Council to theeffect that failure to extend the substantial disruption waiver authority could seriously disrupt medical care in New York City'a public hospitals. The report alsonotes that "FMG's now make op 93 percent or the Health andHospital Corporation pediatricians in Brooklyn anti that new policy could leave the Borcmgh without any children's services in its municipal hospitals.- and complex proble1 have introducel a bill (H V: 7115) ntension of the transition period but at theSame time re- v the hopsitals to reducetheir rvlianee of FNIG's. In par- uthorize : A 2 -year extension of thesubstantial disruption showing by means of a uilhuc lose hospitals which make a vicar it they are phasing clown reliance onFliG's by (1) recruit- ..aprenensiv, ;lates; (2) improving the quality of the Program:(3) and ...g U.S. rneclk .r-native health care proviti_em Anadditional one year exten- qttempring to the institution during -Ion anthori7 etantial progress has been made b its 2-year by somewill unduly delay I firmly ve ,,it a longer periodas proposed of municipal hospitals. tailed pla-e. _ And active remit:tient on the part in mast be addressed enicklyand we mustas my bill does. ._-asivo planning and rigid reporting on theefforts that are being Srito d for all terminate dependency onFMG's. reflects may view that the Nationalhealth Service Corps should ;lent part in providing medicalservices while hospitals and programs implement their plans. By deeminghospitals receiving wilvers as ipmer Shortage areas andallowing National Health ServicesCorps to count residence towardtheir service obligation, we couldInsure or:iy and smooth. phase out of FMG relitence. ;ler to discuss the difficult issuessurrounding the MUG problem and to at on my proposal, I naveinvited officials from the FederalGovernment.