On a busy day in the adult medicine clinic at Highland Hospital, the safety-net hospital for Alameda County, patients keep clinicians on their toes as we navigate strategies to meet complex medical and social needs.
With an already booked afternoon clinic, I was paired with Laura, a high school student originally from Guatemala through the HEAL program, a pipeline program of the Alameda Health System Foundation, geared to expose and motivate Oakland youth to pursue healthcare careers.
Her eagerness and humility made the busyness of the clinic dissipate as she shared her dream of becoming a doctor or nurse; her voice quivered as she shared that she was undocumented.
As the daughter of immigrants, and now as a resident physician, I understand her deeply rooted desire to pursue a health care profession, because the sacrifices our parents made in order to let us pursue our dreams are immense.
Laura’s dream is now in limbo as the Trump administration has announced the planned repeal of Deferred Action for Childhood Arrivals (DACA), a program that has enabled almost 800,000 eligible young adults to work lawfully, pursue higher education, and lead productive lives without the constant threat of deportation.
DACA does not come free of cost; recipients must show they have clean criminal records, be enrolled in high school or college, or serve in the military.
The six-month delay before dismantling DACA does not mitigate the injustice or harm it inflicts upon individuals who were brought to the United States as children and for whom the United States is the only country they have ever known.
Like the vast majority of immigrants, these young people are not criminals, in fact, they represent 108 students applying to medical school and 70 current medical school students as of 2016, according to the Association of American Medical Colleges (AAMC).
They fill gaps in care, especially in rural and urban underserved areas like Oakland.
The reversal of this policy will interfere with current medical student training, future care of patients, and contribute to the already dire shortage of primary care practitioners. Rescinding DACA will also have large quantitative economic impact on our nation with the Center for American Progress estimating a reduction in gross domestic product (GDP) by $433.4 billion over the next decade.
California, with an estimated 187,972 DACA workers, would have an estimated annual GDP loss of $11.3 billion, if it loses it’s DACA workers. DACA status health professional students are an integral part of the U.S. health care system, representing a culturally congruent healthcare workforce needed to meet the needs of an increasingly diverse patient population.
Diversity in the health professions leads to better quality care, improvements in access to care for the underserved, and learning environments that create more well rounded students.
Organizations like the American College of Physicians (ACP), American Academy of Pediatrics (AAP), and AAMC understand the valuable contributions and potential of DACA recipients as they have issued statements opposing the administration’s decision to end DACA.
President Trump has said that “we love the DREAMers”, a statement of empathy that stands in blatant contradiction to the harsh actions of his administration.
Mr. President, we want to encourage youth like Laura to become doctors, nurses, physician assistants, or EMTs who can serve as first responders at not only code blues but also natural disasters; we want to encourage them to dream.
Nurses, like Maria Mendoza-Sanchez, a colleague at Highland Hospital who despite having a previous legal visa to work was recently deported.
Her contribution to caring for the most underserved patients in our health care system was cut short. Our healthcare system and patients will benefit from solutions to our broken immigration system, not divisive hate that only serves to make America sicker.
Dr. Jessica Herrera is an internal medicine resident physician at Highland Hospital and a member of the Committee of Interns and Residents (CIR/SEIU Healthcare).
Edited on June 18, 2018.