Med Societies Support 'Dreamers' After Trump Rescinds DACA

September 06, 2017

The American Medical Association (AMA) and other major medical societies have rallied around nearly 800,000 undocumented immigrants brought here as children who risk deportation now that President Donald Trump has rescinded an Obama-era program that let them study and work here.

Trump announced yesterday that he is delaying the demise of the program for 6 months so Congress can pass legislation to resolve the issue of the so-called Dreamers with "heart and compassion."

Among those protected by that program, called Deferred Action for Childhood Arrivals (DACA), are some 70 medical students and residents. Loss of DACA status for these trainees will aggravate the nation's physician shortage, particularly in underserved areas, said AMA Executive Vice President and CEO James Madara, MD, in a letter yesterday to Congressional leaders.

"Those with DACA status help contribute to a diverse and culturally responsive physician workforce, which benefits all patients," Dr Madara added.

Former President Barack Obama created DACA by executive order in 2012. The program provides a work permit and protection from deportation for undocumented immigrants who came to the United States before their 16th birthday and were aged less than 31 years as of June 15, 2012. Among other DACA requirements, an individual must be in school, or else have graduated from high school or earned a general education development certificate. And Dreamers must not have been convicted of a felony or a significant misdemeanor.

"They Say They're the Best and the Brightest"

Trump has characterized DACA as one more example of federal policy that allows undocumented immigration to run amok and endanger the country, although recently he has professed "love" for Dreamers. In the announcement yesterday to rescind DACA, the White House said it was replacing an illegal executive-branch program with the "rule of law." The president called on Congress to craft a legislative solution that is fair not only to Dreamers, but also "American families, students, taxpayers and jobseekers."

Legislation aiming to do that already has been introduced. One bill garnering substantial support in healthcare circles is the bipartisan Dream Act, which would create a path toward permanent residency for undocumented immigrants who arrive in the United States before 18 years of age. Critics of Trump's decision to scrap DACA say Obama's executive order should have remained in place until Congress fixed the problem with the likes of the Dream Act.

Fernando Stein, MD, president of the American Academy of Pediatrics, called the end of DACA "the latest cruel setback for immigrant children, youth, and families across the country."

"To punish individuals who were brought to the United States by their parents as children, some even as babies, and characterize them as lawbreakers, is immoral and unjust," Dr Stein said in a news release, noting that some Dreamers have earned college degrees and served in the military.

Like the AMA, the American College of Physicians (ACP) warned that the medical careers of Dreamers are at stake with the elimination of DACA. Trump's action also threatens public health, said ACP President Jack Ende, MD, in a news release yesterday.

With the loss of DACA status, many Dreamers "will avoid seeking health care in order to reduce the risk of detection and deportation," said Dr Ende. "Many will be forced to return to violent, war-torn and dangerous countries with poor health care services."

The Association of American Medical Colleges (AAMC) expressed "dismay" over the end of DACA, noting in a news release that physicians-in-training with DACA status bring much-needed diversity to the healthcare workforce. The number of Dreamers enrolled in medical school has doubled since 2012, hitting 65 in the 2016-2017 academic year. Topping that off are a handful of DACA-status residents, said Matthew Shick, the AAMC's director of government relations and regulatory affairs, in an interview with Medscape Medical News. Shick was expecting these numbers to keep growing before Trump's decision.

Medical schools are very supportive of DACA, and most are willing to accept Dreamer applicants if state law permits it. Shick said. "They say they're the best and the brightest.

While deportation may never occur, the threat of it is a huge distraction for Dreamer students, said Karen Fisher, the AAMC's chief public policy officer.

"Medical students who have waited all their lives to serve, who are excited to go to school — they shouldn't have to worry about not being able to continue their studies," Fisher told Medscape Medical News.

"Medical school is hard enough."

Follow Robert Lowes on Twitter @LowesRobert

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