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'Brain Waste' Thwarts Immigrants' Career Dreams

By DEEPTI HAJELA   03/26/11 01:22 PM ET   AP

Immigrant Brain Waste

NEW YORK -- After finishing medical school in Bogota, Colombia, Maria Anjelica Montenegro did it all – obstetrics, pediatrics, emergency medicine, even surgery. By her estimate, she worked with thousands of patients.

None of that prepared her for the jobs she's had since she moved to the United States: Sales clerk. Babysitter. Medical assistant.

That last one definitely rubbed raw at times.

"I know I was working in my field," the 34-year-old New York resident said. "But that is medical assistant. I'm a doctor."

Montenegro is hardly unique, given the high U.S. unemployment rate these days. Her situation reflects a trend that some researchers call "brain waste" – a term applied to immigrants who were skilled professionals in their home countries, yet are stymied in their efforts to find work in the U.S. that makes full use of their education or training.

Most of these immigrants wind up underemployed because of barriers like language, lack of access to job networks, or credentialing requirements that are different from those in other countries. Some are held back even further because they're also in the U.S. illegally.

An analysis by researchers at the Migration Policy Institute, an immigration think tank, estimated that 1.2 million college-educated immigrants in the United States were underemployed, out of a population of 6.7 million. About another 350,000 were unemployed. The analysis, based on data from the Census Bureau's 2009 American Community Survey, did not differentiate between legal and illegal immigrants.

Brain waste has consequences for immigrants as well as American employers and the larger economy, said Jeanne Batalova, policy analyst at the institute and co-author of a study on the issue.

For immigrants, it means bringing home less money than they have the potential to earn. For employers, it means fewer skilled applicants in their hiring pools. For the country overall, it means a missed opportunity to leverage already trained professionals in areas where there may be a desperate need for them.

There's a "loss when human talent and potential is not maximized in the fullest," Batalova said.

Mohan Singh, 55, thought moving to the United States would be a smooth transition. Born and raised in India, he left his home country for Kuwait, where he worked in air conditioning and elevator maintenance. He lived in Kuwait for 25 years, started his own company and was successful enough to send his daughter and son to college in the United States.

At their urging, Singh came to the U.S. in 2000. He said he thought "that I'll be getting the same job, I'll be getting into a good field, make a good life."

It took seven years to complete the paperwork that allowed Singh to work here legally. When he applied for jobs, would-be employers focused on the fact that Singh had not worked in his field in the United States.

"They cancel all my experience," he said.

He now spends 12 hours a day, seven days a week, behind the wheel of a taxicab. It's a far cry from the work he's done for much of his life, Singh said, and the wages are much lower than those he once brought home. The whole experience has soured him on the idea of staying in America. He plans to move back to India in a couple of years, when his son is done with his post-graduate work.

"I used to have money, I used to have good life," Singh said. "Over here, I'm hand to mouth."

Nikki Cicerani, executive director of Upwardly Global, a nonprofit organization that helps legal immigrants find work in their chosen professions, said typically, immigrants come from environments where job-seeking is done differently. They may not know how to navigate the system, whether it's building a network to learn about job openings or having a resume formatted in a way that is familiar to American employers.

Interviewing can be especially tricky. "In many other countries, the resume and the educational experience is the clincher," Cicerani said, "whereas in the United States, the interview is make it or break it."

American employers can also have difficulty figuring out if an immigrant would be the kind of employee they are seeking, absent a ready way of understanding how foreign educational or professional expertise translates in the U.S. job market, Cicerani said.

"They're not really clear how to evaluate a foreign degree against a U.S.-educated candidate," she said.

Montenegro came to the United States in 2004 to care for her mother, who had been diagnosed with breast cancer. She stayed after marrying a man she met here, and became an American citizen. She now lives in the New York borough of Queens with her husband and two children.

Language was the first barrier that Montenegro encountered. She needed to improve her English, but she also needed to work. She took a job as a sales clerk in a local mall, and even though it felt strange to be a medical professional working in retail, she said, the position at least helped her polish her language skills.

Then came larger hurdles that no amount of perfect English could surmount. There's a series of exams, the first of which cost $1,000 alone, Montenegro said. She also has to complete a residency, a requirement for all graduates of American medical schools. There are a limited number of residency slots overall which makes it a very competitive process for everyone, but even more so for foreign medical school graduates.

Montenegro has one more exam to pass before she can apply for a residency, a process that will take at least a year or two. There's no guarantee that she'll be accepted for a residency; At times, she fears she may never work as a doctor here.

"So many times I want to get my things and my passport and go back to my country," Montenegro said. Over the years, she heard stories about the lifestyles her doctor friends in Colombia were able to afford as she worked at various low-wage jobs.

While Montenegro agrees that her credentials and her ability to provide good health care should be vetted before she's allowed to work in this country, she thinks having to train as a general practitioner all over again when she already has experience is a waste – especially for the U.S., she said, because she speaks fluent Spanish and could be an asset in any Spanish-speaking community in need of a doctor.

"I'm ready to do that and help people," she said.

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NEW YORK -- After finishing medical school in Bogota, Colombia, Maria Anjelica Montenegro did it all – obstetrics, pediatrics, emergency medicine, even surgery. By her estimate, she worked with ...
NEW YORK -- After finishing medical school in Bogota, Colombia, Maria Anjelica Montenegro did it all – obstetrics, pediatrics, emergency medicine, even surgery. By her estimate, she worked with ...
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10:15 PM on 04/01/2011
Our hospital is FULL of doctors from the former Soviet Union - they are working as 'housekeeping service' people (i.e. cleaners).
We now have a pharmacist who came from a different continent . She was a very successful pharmacist in her own country, but here, she had to start as an unpaid intern for a year, then she had to become a pharmacy technician, and THEN she finally was able to become a full-fledged pharmacist! (All the while SHE was the most qualified person in the whole pharmacy...)
05:05 PM on 03/30/2011
Very simple answer: Go Home. Use your skills at home and let an unemployed American citizen take your job here.
HUFFPOST SUPER USER
demilieu
Texas liberal...with reservations
01:18 PM on 03/29/2011
If we ever get to universal coverage, we'll need a lot more primary care & family practice doctors. Foreign doctors can fill this need, saving the specialty careers for American-trained doctors.
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HUFFPOST SUPER USER
dtairtime
It is what it is
05:39 PM on 03/29/2011
How about instead we spend money on giving bright inner city and other deserving kids who are citizens a free education in health care fields. They can pay us back by serving for lower then standard wages (but still very liveable) serving those millions of people who need the help.

Good basic care for the indigent, no insanely costly universal care needed, no likely unconstiti­onal mandate like Obamacare and no drop in care for those of us who spent decades working hard in our unions to get good medical care.
HUFFPOST SUPER USER
ritamary
11:07 PM on 03/28/2011
Don't tell me that immigrants were never told they might have difficulties practicing their professions in the United States. American citizens with advanced degrees are unemployed. Why should immigrants expect what American citizens don't have? If life is so difficult for them here they have the option to return to their countries.
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HUFFPOST SUPER USER
dtairtime
It is what it is
08:33 PM on 03/28/2011
Well since we legally and with open arms accept more people then the rest of the world does, combined, I think this criticism is unwarranted.

We are already pacing shortages of just about everything we need as people to continue any sort of quality of life so why does importing more scarce resource using bodies (educated or not) help US in any way? Sure it helps the wealthy keep wages low and profits up. Sure it helps some misguided people feel better that we allow a million or so poor people a year to come here, yet at the same time the impoverished numbers in the world climb by the hundreds of millions a year.

Instead of worrying about this person why not take the same energy, money and time and spend it insuring our own kids get the educations they need to be doctors?
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Soule23
Anti-micro-biol
08:51 PM on 03/28/2011
Agreed. We need to make sure that Joe Da Plumber can get that good-paying doctor job he's always he wanted. He wants it, and he's a Real American, so he should get it over some furriner who's got those credential thingies.
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HUFFPOST SUPER USER
frank day
Republican = FAIL
09:31 PM on 03/28/2011
Precisely.
We know Joe and can trust him. We know he will follow the rules.
We don't know if Anwar or Pablo received a good education or if they received one at all.
Indian immigrants created an entire FAKE school in California just to come here for jobs.
HUFFPOST SUPER USER
ritamary
11:08 PM on 03/28/2011
There are Americans with advanced degrees who are unemployed.
HUFFPOST SUPER USER
demilieu
Texas liberal...with reservations
06:49 PM on 03/28/2011
I have sympathy but we really don't have enough opportunity as it is for our own, much less for people who want to come here from other lands. Not everyone who was laid off over the course of the recession was a low-skilled worker. Many, many engineers, professionals and skilled people are out there looking to re-start their careers. Of all the professions, medicine has done the best job of locking out doctors from foreign countries-especially if they're coming from a developing one. Yet, it's common knowledge that we need more doctors-especially in family practice. But, again, doctors are generally among the smartest people out there, so that they figured out how to protect their interests way ahead of the curve should be no surprise.

On the other side, places like Australia or New Zealand woldn't allow me, as an experienced, college-educated & licensed professional, to go there and easily find legal work.
HUFFPOST SUPER USER
lezahgg
03:31 PM on 03/28/2011
It isn't always a matter of credentials or even the ability to speak English that keeps people with foreign degrees from getting jobs in the U.S. Sometimes it is just plain old prejudice on the part of the employer and sometimes people are not communicating well because of lack of knowledge of certain cultural cues, mores, etc. For example my former company has an English couse for doctors and one of the things doctors were told was to say "I need to..." instead of "I'd like to" as in saying "I'd like to see your breasts". We were asked to do a special training program for a computer tech company who hired a lot of foreign trained techs and were getting complaints from their clients about these techs being rude and abrupt. They were not intentionally being this way and the problems were all due to cross cultural miscommunication. Think about frustrating experiences many of you may have had when calling a company's help desk which had been outsourced to India.
HUFFPOST SUPER USER
demilieu
Texas liberal...with reservations
07:18 PM on 03/28/2011
Foreign-trained doctors from non-English speaking countries coming here to practice have to pass an exam where they are presented with fake 'patients' and must diagnose their fictional illness. A lot of it is a test of their mastery - or lack of it - of the English language.
07:47 PM on 03/28/2011
True doctors need a strong command of the English language. But remember alot of the medical terminology is derived from Greek and Latin. A person from a Latin American country could easily read and pronounce these terms. Also, a person with Dr. Montenegros education could easily learn English.
07:48 PM on 03/28/2011
Correction: Dr. Montenegro has learned English.
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azlegalcitizen
INDEPENDENT
02:45 AM on 03/29/2011
Think of trying to understand an indian doctor, taht is a feat beyond belief. They mumble and whisper as if your ARE NOT SUPPOSED TO HEAR THEM. When I was in the hospital they sent in 2 indian doc, after two frustrating sessions of them ignoring my requests to speak more clearly I got rid of them. The both of them were impossible to understand, so why should I make the adjustments to someone else in my land?
01:47 AM on 03/28/2011
With so many people claiming they don't understand the point of this article, I had to reread it to make sure it was not in a language I had no idea I was fluent in. But, no...it is indeed written in English. Which makes me wonder about some posters ability to read and comprehend our language. On the other hand, it is possible that we see only what we want to see. And what this article say, and that some people find so very difficult to see, is simply that professionals trained in foreign countries who immigrate to the US are encountering obstacles that make it quite difficult, though not necessarily impossible, for them to practice their profession. So some people find themselves in jobs that are way below what they trained for which makes it not only frustrating for them, but is actually a loss for us ("brain waste"), since these professionals could be actually contributing to this country more according to their capabilities.

That is pretty much what this article is about, I think. So why the confusion? I suspect that has a lot to do with people's inability to put aside preconceptions and prejudices aside and simply pay attention to their reading. You know, like the teacher said.
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HUFFPOST SUPER USER
whatwasthat
Hakuna Matata
08:15 PM on 03/27/2011
Time and time again, I have failed to understand why anyone would swap a life of relative comfort and esteem back in their home, to come to America and lose it all, especially the dignity.
01:27 AM on 03/28/2011
Of course, with the lady doctor in this article, it's possible that fro some crazy reason she wants to live with her husband (possibly a nutty Colombian custom).
HUFFPOST SUPER USER
demilieu
Texas liberal...with reservations
06:57 PM on 03/28/2011
Developing countries train doctors with the hope they'll remain there to tend to their own people. However, medicine here is so financially lucrative...for example, base salary in the VA Hospital system ranges from 100k on the low end to 300k + , plus other perks - like exisitng house buy out and relocation expenses for experienced pratcitioners. Medicine is demanding for sure, as is caring for people, but there is no other profession that promises this high standard of living. I've known a lot of foreign-trained doctors who've come here to practice over the years and I don't know of a single one who's decided to return to their native country to tend to its people.
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Soule23
Anti-micro-biol
04:27 PM on 03/27/2011
"Save the good-paying doctor jobs for Real Americans like Joe_Da_Plumber!"

Medical tourism: sounds better with each passing day.
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HUFFPOST SUPER USER
Summertown
A former traveler of the US now a country wife jus
04:07 PM on 03/27/2011
I don't understand the point of this article. Why is it a problem of the US that those that immigrated here could not find employment in their fields? Should the US change its policies regarding training standards and verification or should the people wanting to move here do their home work first to see what they would need to do to enter their chosen fields? Then be prepared when they arrive to meet those qualifications and standards. Its not like they are secret.

I would no sooner go bounding off to another country and expect them to believe me when I handed them credentials certifying me as a rocket scientist than the man in the moon.

So is this an article just to bait people? Obviously those that did fulfill the requirements went on to their chosen fields since some of my medical care personnel were obviously not US born. Engineers that work with my husband quite often were not US born, so again, the point of this article is what?
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Soule23
Anti-micro-biol
04:48 PM on 03/27/2011
But we would have been fools_not to recognize Werner Van Braun as a "certified rocket scientst" just because we didn't like immigrants. Welcome to 21st century Amerika.
01:22 AM on 03/28/2011
On the other had, if Van Braun had been from Colombia he may have had more problems, and, heck, some posters here may have just told him to go home.
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demilieu
Texas liberal...with reservations
07:08 PM on 03/28/2011
Yeah, pretty neato since he was also a NAZI war criminal who participated in the Holocaust! He's lucky he landed on our side of the fence rather than on the Soviet side.
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HUFFPOST SUPER USER
SmileAndActNice
Utilitarianism, the -ism that works.
07:32 PM on 03/27/2011
The problem is that we have a shortage of doctors in this country, particularly general practitioners, that is exacerbated by making qualified personnel cool their heels.

We are wasting our assets.
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demilieu
Texas liberal...with reservations
07:11 PM on 03/28/2011
We have a shortage only because the AMA restricts chartering new medical schools and keeps the total number of residency slots strictly controlled. Medical schools typically accept only 10% or so of applicants. Many of the 90% who are locked out are very capable, intelligent and qualified people.
03:02 PM on 03/27/2011
If a foreign nation wants to let its people come to the US for jobs great BUT FIRST they have to pay off our nation's debt of $14 trillion! If the people of India pay off our debt then fine.
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Soule23
Anti-micro-biol
03:14 PM on 03/27/2011
hate, hate, hate.
05:14 PM on 03/27/2011
Actually, foreign nations OWN our debt therefore WE have to pay off our debt.
02:58 PM on 03/27/2011
Also forgot to add: Is brain drain any different among U.S. citizens. How many college grads area working at Starbucks or as bank tellers right now?
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Soule23
Anti-micro-biol
03:26 PM on 03/27/2011
How many underemployed college grads are qualified to practice medicine right now?
04:07 PM on 03/27/2011
I just read about one - well not really because she isn't qualified to work practice here. But that's her problem if she refuses to not do what she needs to practice medicine here.
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HUFFPOST SUPER USER
dmherb
I don't even know how to read...so...yeah
03:27 PM on 03/27/2011
Most of us.
02:57 PM on 03/27/2011
I don't see what the problem is here. If she really wants to be a doctor here, she has to complete her requirements to do so. How do we know how fabulous she was back in her own country? Why should a teacher who moves to a different state have to update his credentials in order to teach there, but an immigrant should get a pass?
04:38 PM on 03/27/2011
Doctors actually have some level of skill. European and some South American doctors only have to take a couple of tests and practice under a provisional license in order to practice in the US. I don't believe India has that privilege.
06:03 PM on 03/27/2011
Teachers don't have skills?
05:12 PM on 03/27/2011
Actually she is completing her requirements in order to apply for a residency. It stated in the article, "Montenegro has one more exam to pass before she can apply for a residency, a process that will take at least a year or two. There's no guarantee that she'll be accepted for a residency; At times, she fears she may never work as a doctor here."
06:03 PM on 03/27/2011
Again, that doesn't make her any different from a lot of people. It doesn't make her different from a lot of people in nursing school either. She has two children so she has to be selective about her options. It stinks, but what are you going to do. It will be all the more worth it when she is done. That's what my neighbor who has four kids and just finished PA school will tell you.
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HUFFPOST SUPER USER
chip embere
Register Independent for change
02:53 PM on 03/27/2011
Tazmodius wrote:
-----------------------------------
I have no problem with people coming here to learn how to be successful if that is the case in school. However, you just made the case for going back to India or wherever you are from and making things better there.

Staying here is not going to help your friends and family who should enjoy success as you have, especially if you have a lot to teach them.

If anything staying here seems to be more self-servi­ng and does nothing to help others succeed.
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That is true, but it is also a numbers and politics game. In the case of India and China, the environment for quick business success exists, more so in China. That is the political part. As for people needing to go back, what you say is true, and it is an option. So from the large pool of H1Bs in the 90s, many stayed and adopted this country. Others went back. Stay or go, people that came here in the 90s - like I did, helped fuel the growth of economies back home.
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HUFFPOST SUPER USER
chip embere
Register Independent for change
02:55 PM on 03/27/2011
And helped economic growth here - in my opinion.
tazmodious
Left Hand of Darkness
03:04 PM on 03/27/2011
Then you have nothing to complain about.