Center provides new hope to U.S. immigrant health workers

EDUCATION, Slideshow — By admin on July 5, 2010 at 12:21 pm

by Nicole Kidder

When Nigerian immigrant, Tokunbo Ajayi, arrived in Seattle two years ago, he dreamed of making a difference as a doctor of internal medicine. He soon found out, however, that obtaining a job in America would require much more than he bargained for since he didn’t have U.S. certifications and credentials.

Trying to at least get his foot in the door, Ajayi began applying at dozens of Pacific Northwest health facilities as a medical assistant. But, employment rejection after rejection left him discouraged. Ajayi says many facilities were concerned about how satisfied he would be and how long he would stick around.

Six months after he arrived, Ajayi came across the Welcome Back Center (WBC) at Highline Community College, which once again gave him hope that his dreams could come true.

The WBC is part of a national initiative to bridge the gap between the pool of internationally-trained health professionals (ITHP) living in the U.S. and the need for linguistically and culturally competent health services. Founded in San Francisco a decade ago by Dr. José Ramón Fernández-Peña, a physician who emigrated from Mexico, the program has helped nearly 10,000 immigrants validate their credentials. Currently, the nonprofit operates in seven states, including California, Maryland, Massachusetts, New York, Rhode Island, Texas and Washington.

“I really appreciate that the Welcome Back program gives us an organization that can speak for us. [It] is like a home for a lot of people. When you’re just by yourself, it’s really difficult. You have no family, no friends and you’re thinking, ‘Should I just go back?’ The Center gives you someone who calls back, who replies to your e-mails. That helps and gives you hope.”

Today, Ajayi is working as a medical assistant in a dermatology clinic thanks to a WBC-sponsored tour of a local Seattle hospital. He is also studying for his U.S. medical credentials so that he can practice again and is one of two doctors who have been recently matched for a residency. He hopes to one day open his own kidney disease practice.

Ajayi is not alone among the WBC’s many success stories. Eulalia Galarza, who was a nurse in her native country of Mexico, is now employed as a phlebotomist at the Sea Mar Health Center in Seattle and Jorgo Birri, who was a nurse in Ethiopia, was able to quit his job cleaning airplane cabins when he was hired as a nurse’s assistant.

Thirty-year-old immigrant Ismael Nana, who has earned two master’s degrees in biology and microbiology in Burkina Faso, West Africa, has settled for working at Old Country Buffet in Federal Way for the meantime after being rejected by hundreds of lab and hospital jobs.

WBC Director Kris Mason says she has heard similar stories from the more than 300 immigrants who have accessed the center’s assistance during the past two years. In a report for the Migration Policy Institute, Jeanne Batalova found that despite holding a college degree, one in four U.S. immigrants – or roughly 1.3 million – are employed in an unskilled job. Most have emigrated from Asia, Eastern Europe and Africa.

Giving up their dreams, they settle for flipping burgers, swinging a hammer or driving taxis – low-paying jobs that allow them to support the family. But, that choice comes with the high price of a profound loss of professional identity, social standing and financial independence. Most find the challenge of redefining themselves in a new society too overwhelming.

“These are highly trained professionals who simply don’t know how to navigate the system to get into more meaningful employment,” Mason says. “They have been told ‘no’ so many times that they come to us very depressed. When we tell them we can help, they are afraid to get their hopes up because they have hit brick walls everywhere they turn. They think it is too good to be true. It takes time, but it can be done.”

Mason says there is a critical need for qualified health workers, especially doctors and nurses. In the U.S. last year, nearly 100,000 nursing jobs remained unfilled, making it the most in-demand occupation in Washington state. The new Healthcare Reform bill will open many more positions, as will the $500 million included in the stimulus bill to address the healthcare worker shortage.

To fill these positions, hospitals spend thousands of dollars each year on recruiting and training internationally-trained nurses.

“Health facilities have a new mandate to diversify their workforce and many of them are doing that by importing workers from other countries who aren’t committed to that community,” Mason says. “It is such a waste of resources if we aren’t tapping into internationally-trained health workers who already live in our communities, who are already invested in this area.”

Just how many qualified workers exist out there among the nation’s 6.1 million immigrants is unknown. But, those closest to the issue are aware that a vast pool of talented, qualified professionals is being wasted. U.S. laws, they say, must be revised to recognize education and training programs from abroad if there is any hope of addressing the critical shortage.

As of the 2000 U.S. Census, only 12 percent of nurses and 18 percent of doctors were foreign born, with nearly half originating from Asia. One reason for this is lack of knowledge about U.S. health care professions and U.S. workplace culture.

Overcoming the language barrier is also another major hurdle. Licensed professionals must pass the English as a Foreign Language (TOFL) test, yet typical ESL programs, which heavily focus on reading and writing, take three to five years to complete. The WBC offers a free lab that helps participants practice pronunciation of medical terminology by recording their voice and comparing it to the software. More than 60 percent of WBC participants say their English skills have improved greatly since beginning the program.

Still, the biggest obstacle appears to be the financially-burdensome and time-consuming process immigrants must go through in order to validate their credentials. Because of cultural practices and legal regulations, it is nearly impossible for prior careers to translate into similar positions in the U.S. without additional training of one to four years.

However, Mason notes, many skills do transfer. “Bilingual and bicultural skills are highly sought after for working with non-native patients because treatment regiments are more closely adhered to if patients hear the information from someone who has a similar cultural background. If someone has been out of the profession for a long time, they may just need to go through a short-term certification program. That will at least help them get a job in the field.”

Several groups are seeking new ways to build upon the medical training and experience of internationally trained health providers. In California, an accelerated 14-month pilot program assists internationally-trained nurses obtain their associate degree, a program that typically takes two years to complete. In Washington, 14 new nurses will soon graduated from a special training program at Renton Technical College. Gov. Christine Gregoire is also looking at ways Washington immigrants can transfer their skills, certifications and professional credentials based on the recommendations on the New Americans Policy Council.

Finding the money to pay for such programs, however, is another matter entirely. Financial aid and scholarships, especially for those who have high levels of training and education from their home country, are extremely difficult to obtain. Plus, Mason says, most people have to work to support their family, which means accepting low-wage, unskilled jobs that require irregular hours. This leaves little time and money for schooling.

Since the Puget Sound WBC opened its doors in 2008 on the Highline Community College campus, it has helped more than 300 participants begin the steps necessary to re-enter the healthcare workforce. Some students have received validations of their credentials or passed their licensing exams, while dozens more have obtained employment or started new careers in the health sector.

The program has mostly served female nurses, although more than 80 doctors, 16 dentists and 63 other professionals have taken advantage of the services offered. Ethiopian, Ukrainian, Indian, Filipino and Russian immigrants account for more than a third of the participants.

“Our ZIP code is one of the most diverse in the U.S.,” Mason says. “For years, Highline administrators have come across many highly-trained professionals who are driving cabs or working at Wendy’s. They are starting from scratch, thinking they need a new education to have a career, when they don’t.”

Most of the participants are identified via ESL classes at Highline, but Mason says she is giving presentations to anyone in the Puget Sound who will listen. The WBC has also developed partnerships with Tacoma Community College and Renton Technical College. Eventually, program hopes to expand outreach services to other professions, including engineering, accounting, science, teaching, technology and finance.

The WBC program is sponsored by The Washington State Board for Community and Technical Colleges and BuRSST for Prosperity, a Washington state poverty-reduction initiative that stands behind innovative models that help people become self-sufficient and financially independent. All internationally trained health professionals who reside in Washington are eligible to access the program’s resources.

Participants include doctors, nurses, dentists, pharmacists, psychologists, speech and occupational therapists, lab technicians, health educators, social workers and other healthcare professionals. Professional courses, work experiences, workshops, ESL assistance, career planning, counseling and help navigating the licensing process is available, as are a variety of free classes, including a 10-week Communication in Health Care course that reviews medical terminology and the cultural aspects of working in a healthcare setting. Participants can also sign up for workshops that strengthen their interview skills, join support groups and attend alumni events.

Although the WBC does not make direct job placements, several steps have been taken to introduce participants to the local industry. Mason is working hard to build relationships with local facilities, including Sea Mar, Highline Medical Center and Children’s Hospital, as well as with area HR administrators. She is also trying to start a job shadowing program and doctor “observerships” to help open the employment pipelines.

Mason describes it as a win-win for everyone. A recent tour of Harborview gave participants “practical exposure to a medical setting, since many haven’t even set foot in one, while the healthcare providers were able to see the quality and caliber of people who are seeking our help. It is also highly motivating because they realize how much they want to get back into this field.”

In order to reach that long-term goal, shorter goals must be developed. Doctors like Tokunbo Ajayi might work as medical assistants, while nurses like Eulalia Galarza might first enroll in the two-quarter phlebotomy certification program in order to get a foot in health-sector door. Although these are considered entry-level positions, it provides much better wages than the unskilled jobs they are often working in and gives them some experience to list on a resume. In also provides 12 credits toward a medical assisting program.

If their financial situation allows, some participants may just study for the required tests to verify the credentials or will participate in externships. Still other participants may decide to pursue a different occupation through a community college or university.

“This isn’t a shortcut back into healthcare. The WBC is not a program that you start and finish,” says Mason, who notes that reentering the work force in an original profession within eight months is rare. “Obtaining that goal depends on the person – where they come from, how long ago they worked, what their English skills are like, how much time they have available to study, what their family situation is like, how much income they have to pay the testing fees. The path is different for everybody.”

Still, the WBC has many success stories to celebrate. On average, participants’ incomes have doubled, while more than a third has reported an increase in wages.

“This is because the healthcare industry provides high-wage jobs with benefits, which lead families on the path to self-sufficiency, lifts them out of poverty,” Mason says. “And, when their kids see them going to work in scrubs instead of a fast food uniform, it’s good for whole family.”

For more information, contact the Welcome Back Center at welcomeback@highline.edu or 206-878-3710, ext. 3345.