Foreign-Trained Doctors May Fill a Critical Care Gap
The pandemic has worked like a pincer on the American health care system, dramatically increasing demand at the same time it has reduced the supply of doctors and other health care workers, many of whom have been leaving the field, suffering from fatigue, burnout and even PTSD. The American Association of Medical Colleges recently estimated that the U.S. could be short 54,100 to 139,000 doctors by 2033, noting that 40% of current practicing physicians will be over 65 within the next decade.
But as my colleague Tara Law reports, there is a solution: an estimated 270,000 unemployed or underemployed workers with foreign health care training, including doctors, are currently living in the U.S., hoping to be allowed to practice but often forced to wait years for work. Take Somali-born doctor Abdifitah Mohamed, who emigrated to the U.S. in 2015. Before moving, Mohamed believed that being allowed to practice meant passing the United States Medical Licensing Examination (USMLE)—a three-step exam that tests medical knowledge, principles and skills—and then completing a medical residency. However, he didn't expect that after spending thousands of dollars to apply to 150 residency programs, none of them would accept him.
Whether the problem is protectionism, as some believe, or simple lack of trust in medical degrees earned overseas, the numbers are telling. Nearly 40% of non-citizen international medical graduates failed to match with a hospital for a U.S. residency program in 2020, compared to just 6% of domestically-trained graduates.
The pandemic has made such choosiness a luxury the health care system can no longer afford. But a new program in Washington state could spell a way out. In May, governor Jay Inslee signed a law granting internationally trained medical graduates the opportunity to obtain two-year medical licenses to work as doctors, with the possibility of renewal. Participants can forgo residencies, but must meet certain other requirements, including English proficiency, passing all three steps of the USMLE, and working under the supervision of a fully-licensed doctor. Governors in six other states have taken similar, if not quite as far-reaching steps, signing executive orders that also make it easier for foreign-trained doctors to find work.
There are reasons to liberalize rules surrounding hiring doctors who learned their trade overseas beyond simply filling holes in the healthcare workforce. Many such doctors are polylingual and people of color, giving them an advantage in both communicating with and understanding a multicultural patient population. Mohamed, who lives in Washington State, and will potentially benefit from Inslee's move, knows that truth first hand. Washington's program, he told Tara, is "really a gift from God. Because at least I [will be] able to wear my lab coat, to help my community, my people."
About 487.2 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of last night, of which more than 401.8 million doses have been administered thus far, according to TIME's vaccine tracker. About 56.4% of Americans have been completely vaccinated.
More than 238.2 million people around the world had been diagnosed with COVID-19 as of 9 a.m. E.T. today, and more than 4.8 million people have died. On Oct. 11, there were 393,376 new cases and 5,834 new deaths confirmed globally.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here's every country that has reported over 4.5 million cases:
The U.S. had recorded more than 44.4 million coronavirus cases as of 9 a.m. E.T. today. More than 714,000 people have died. On Oct. 11, there were 116,202 new cases and 1,182 new deaths confirmed in the U.S.
Here's how the country as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Oct. 12, 9 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
Texas governor Greg Abbott issued an executive order yesterday that, for all intents and purposes, prohibits vaccine mandates in the state. The order allows individuals to refuse vaccines "for any reason of personal conscience, based on a religious belief, or for medical reasons, including prior recovery from COVID-19." The governor also formally submitted the issue to the state legislature, seeking to have the order codified as legislation. Abbott's actions clash with U.S. President Joe Biden's vaccine mandates for federal workers and businesses with 100 or more employees, setting up an all-but certain court challenge.
The U.S. Food and Drug Administration will begin considering whether to approve booster doses of the Moderna and Jannsen/Johnson & Johnson vaccines this week, the Associated Press reports. The question will first go to an FDA panel of independent advisers, who will issue a recommendation. The agency as a whole will then rule on whether or not to accept that conclusion. Assuming the FDA green-lights the shots, the U.S. Centers for Disease Control and Prevention (CDC) will decide who is eligible for them and when.
Moderna will not publicly share the formula for its vaccine,the Washington Post reports, despite calls from the Biden Administration, the World Health Organization and the United Nations for the company to do so in order to boost poor countries' vaccine supplies. Moderna chairman and co-founder Noubar Afeyan told the Associated Press that "the most reliable way" to get shots into more arms is for the company itself to scale up production. Critics point out that Moderna received billions of dollars in government funding and help to develop its RNA-based vaccine, and thus should be more receptive to calls to open up its work.
The U.K. government's pandemic response was "one of the most important public health failures the United Kingdom has ever experienced," per an analysis from British Parliament published today. The inquiry concluded that thousands of lives were lost as a result of delays in implementing widespread testing, public lockdowns, social distancing rules and border controls. The analysts concluded that policymakers wrongly assumed that the public would oppose restrictions, when in fact there was widespread compliance once the rules were belatedly imposed. The inquiry did, however, credit the government for its early investment in vaccine research.
U.S. workers are returning to offices in the highest numbers since the pandemic began, reports The Wall Street Journal. While an expected surge in employees coming back to work directly after Labor Day did not materialize, the numbers have slowly but steadily risen over the past month. In 10 bellwether cities, 31% of employees were working on-site at the beginning of September, a number that rose to 35% on the week of October 1 and to 36% a week later. Those figures are expected to increase further as major corporations like BlackRock, Whirlpool and Lion's Gate Entertainment call employees back to the office in late October and early November.
The Biden Administration is expelling hundreds of thousands of migrants arriving at the U.S.-Mexico border using a public health order that allows the government to sidestep normal procedures amid the pandemic, my colleague Jasmine Aguilera reports. However, critics argue that mass expulsions under the order, called Title 42, do nothing to slow or halt the spread of COVID-19, and may actually worsen transmission. The administration says the CDC backs its policy, but multiple rights groups, including the American Civil Liberties Union, have brought a class action lawsuit arguing that the White House's use of Title 42 violates federal immigration law.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
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