| |
This is
an interesting time to be assembling an ASA NEWSLETTER
issue dedicated to international educational opportunities.
As I write this introduction, the war in Iraq is escalating,
and the United Nations remains divided in response
to U.S. actions. Germany, France, China and Russia
all oppose the war, and anti-American protests continue
around the world.
On March 19, 2003, the United States Department of
State issued the following statement: “As a
result of military action in Iraq, there is a potential
for retaliatory actions to be taken against U.S. citizens
and interests throughout the world.” Currently,
specific travel warnings exist for countries in the
Middle East, Africa, eastern Europe, Indonesia, Colombia
and Venezuela. These warnings can be reviewed at the
state department’s Web site at <travel.state.gov/travel_warnings.html>.
This site should be checked before considering any
overseas medical mission trip.
Despite the instability of international relations,
I believe that the connections we make as anesthesiologists
can improve the perception of the United States around
the world. Medical missions not only help the people
they serve, they provide opportunities for humanitarian
aid, U.S. diplomacy, personal altruism and education
both of the volunteers and the local population. This
ASA NEWSLETTER issue highlights two programs,
the ASA Overseas Teaching Program and Rotoplast, but
additional opportunities can be researched through
Health Volunteer Overseas at <www.hvousa.org>
and the Greater Washington Society of Anesthesiology
at <www.G-W-S-A.com>.
At the same time that travel abroad has become more
complicated, it is now increasingly difficult for
international anesthesiology graduates to study or
work in the United States. Residency positions are
flush with U.S. graduates. The National Resident Matching
Program filled 94 percent of available anesthesiology
residency spots in 2003. With heightened homeland
security, additional headaches await international
medical graduates. For example, the Bureau of Immigration
now requires all men older than 16 from 25 countries
in the Middle East, Africa and Asia to register extensive
personal and financial data with the Immigration and
Naturalization Service or face arrest and deportation.
Nevertheless, opportunities for international medical
graduates (IMGs) continue to exist. The staffing shortages
in academic and rural anesthesiology have not disappeared.
Fellowship programs are also looking to IMGs to fill
their positions, and although the process to gain
approval for a J-1 visa to train in a nonaccredited
training program has become more complicated, it remains
possible. (Any nonboarded fellowship program is considered
nonaccredited, including cardiac and obstetrical anesthesiology.)
Moreover, new legislation in a number of states has
increased the number of waivers allowing graduates
with J-1 visas to stay and work in the United States
in underserved areas.
International anesthesiologists also are finding work
in the United States as visiting instructors in academic
departments. As they provide more than 60 percent
of submissions to the journal Anesthesiology,
international anesthesiologists are playing an increasingly
important role in the development of our field. At
the same time, U.S. academic departments continue
to face staff shortages as private practice opportunities
attract individual faculty with more lucrative compensation
packages. The “rotators,” as they are
known at the University of Michigan, offer novel and
enlightening perspectives on anesthetic management
decisions, on the role of the anesthesiology consultant
and on evidence-based medicine and can provide invaluable
tools in broadening the educational experience of
any particular residency department.
In conclusion, international engagement seems to be
increasingly difficult but remains both possible and
rewarding. An open exchange of education, services
and research can only strengthen the field of anesthesiology
both at home and abroad. Finally, I hope that by the
time this issue reaches you, the world feels more
secure.
| |
|
Jill M. Mhyre, M.D., is a CA-3 anesthesiology
resident at the University of Michigan, Ann
Arbor, Michigan. |
|
|
return to top
|