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FOREIGN DOCTORS

A New Group of Interns

In 1948 Congress voted to let foreign medical-school graduates come to the United States for further training, inadvertently establishing a two-tier system of medical practice. American graduates generally took their internship and residency at prestigious university-based hospitals. The foreign graduates went mostly to fourteen hundred smaller community and veterans' hospitals, where they staffed emergency rooms and treated the poor who could not pay for care.

Tough Exam

The Educational Council for Foreign Medical Graduates (ECFMG), an agency developed by the American Medical Association (AMA) with legal backing from the government, was created to regulate the placement of these interns. This agency required special seven-hour tests in English and general medicine for the fifteen thousand foreign-trained doctors. The grueling and deliberately tricky tests were meant to fail 50 percent, causing some eight thousand foreigners to lose their visas. The exams were first given in November 1960. About twenty-five hundred foreign doctors failed and faced having their visas revoked by 31 December.

Reconsideration

There was an outcry from the hospitals where these physicians worked. Who would care for charity patients if foreign doctors were forced to leave? Public concern began to mount over the loss of medical service and the unfair way the tests were handled. The AMA strongly pressured the ECFMG to enforce its regulations strictly until State Department officials, realizing the issue could create a foreign-relations disaster, advised a reconsideration. As a result, the twenty-five hundred fired physicians received temporary reinstatements of their visas and were allowed to stay in the United States for six months to study for a repeat exam in April. They could work in their hospitals in the mean-time but not see patients.