It’s Time, Mr. President
A Refugee Doctor Speaks Out For Immigrant Medical Professionals in America
By Dr. Lubab Al Quraishi
Edited by Seyeon Hwang & Kayla Byrd
Based in Parsippany, New Jersey, Dr. Lubab Al Quraishi is an international physician with a sub-specialty in Surgical Pathology from Baghdad, Iraq, as well as a wife and a mother of two girls. Currently working as a Pathologist Assistant, she was recently featured in the New York Times for her work as a volunteer medical professional in the face of COVID-19.
Dear Mr. President:
I am writing to you today to tell you my story as a doctor. I am also respectfully requesting a policy change that could save millions of Americans suffering not only from COVID-19, but various other diseases as well. A number of immigrant medical professionals have been working in low-wage jobs despite the excellent knowledge and skills they have acquired in medical science.
I am originally from Baghdad, Iraq, the region famously known as Mesopotamia; even more famously known as one of the earliest civilizations in history.
I was raised in a household where my parents’ main priority was education. My father was a writer and my mother was a teacher. Their emphasis in education resulted in all of my brothers becoming successful engineers, as well as my sister receiving a Master’s degree in Mathematics. They pushed us to our fullest capacity because they believed in the power of education, and its power to ignite change.
Growing Up in a War-Torn Iraq
Unfortunately, my life was marred by the atrocities of wars from early on.
Unlike other children, my first day of elementary school, September 22, 1980, was also the first time that I became haunted by my own vivid experiences of war. Active bombings had cut the power throughout the city, including my own house. Sitting in my father’s lap in complete darkness, I shivered and waited for the moment to pass. The horrors of the bombings continue to echo in my head even now.
After a long 8-year turmoil, the war finally ended on August 20, 1988. However, this moment of peace lasted only briefly.
Soon after, another war broke out in 1990.
This was due to Sadam Hussein’s engagement of Iraq in the invasion of Kuwait. I had just graduated from high school and was getting ready to start medical college.
Being a Doctor Under Economic Sanctions
On August 6, 1990, the United Nations (UN) imposed economic sanctions on Iraq, just four days after the invasion of Kuwait. These sanctions stayed largely in effect until May 22, 2003.
During those times, I had graduated from medical college and started my residency at Baghdad Medical City. The hospitals in the city felt the full effects of the financial penalties that resulted from the sanctions. Children and elderly patients were dying due to a shortage of medical supplies such as antibiotics and IV lines. Most hospitals at this time couldn’t even get the most basic medical supplies.
As a junior doctor, I did my best to meet the medical needs of all my patients, especially women, children, and the elderly. My colleagues and I worked tirelessly day and night to treat every patient; however the sanctions left us with barely any salary to live on, sometimes as little as $4 USD a month.
Throughout the course of my entire medical residency, from 1997 to 2001, it seemed as though my skills as a doctor were being tested to the extreme.
The lack of essential medical supplies, as well as very limited access to technologies that would’ve otherwise made our job so much easier, drove us to heavily rely on our knowledge and manual skills alone. We were endowed with the responsibility of carrying out tasks that ranged from saving a patient’s life to simply administering medication, all without any resources.
The technologies were there, just not for us; contemporary medical professionals in more privileged countries were carrying out the same tasks much more efficiently. They had access to the internet and working machinery.
Meanwhile in Iraq, the political crises had deprived medical professionals of the advantages other doctors had, and we were expected to operate on our knowledge alone.
Becoming a Surgical Pathologist Amid Civil Wars
In 2001, inspired by my mother’s struggle and eventual victory against breast cancer, I decided to specialize in Surgical Pathology. I aspired to help women that were experiencing the same thing that my own family went through.
However, once again, the war made it extremely difficult for me to pursue my chosen path.
The Iraqi Civil War brought severe violence, bombing, killing, and kidnapping into the daily lives of everyone like an invasive parasite.
From 2001 to 2006, I enrolled in a four-year fellowship program in Surgical Pathology rotating between numerous hospitals: Baghdad Teaching Hospital, the Oncology Hospital, nursing homes, private hospitals, and the Alkadhymia Hospital. Working at these hospitals involved many high risks for the medical professionals; doctors and scientists were being targeted and blacklisted.
As a doctor and scientist, I felt like I always had to be looking over my shoulder, and with this ever-looming sense of dread, I feared for my — at the time — only child’s safety.
In January 2006, I officially started my career at the University of Baghdad Medical College’s teaching laboratories as a Surgical Pathologist.
My daily routine consisted of giving lectures in the mornings to undergraduate and postgraduate medical students, and in the afternoons, I would go to the Early Detection of Breast Cancer Clinic to provide free medical services for Iraqi women trying to detect breast cancer. I tried to catch it in its early stages through the provision of physical exams, ultrasounds, mammography and fine needle aspiration cytology. All the while, I was conducting a lot of research and publishing in renowned medical journals in breast and female genital tract cancer studies.
During this time, I was driving to work and taking my kids to school everyday, all while the Civil War was still going on.
From a Doctor to a Refugee
One morning, a bullet was shot directly onto my car and shattered the windshield. That was the moment when I realized that it was time to leave.
I immediately applied for asylum through the IOM (International Organization of Migration) located in Baghdad’s Green Zone — a heavily fortified and securitized international zone in the city.
The approval process was very long, and lasted for five years.
On March 12, 2014, I received a phone call from the IOM informing me of the decision on my application — I had been approved to resettle in the U.S. and I had to leave Iraq in two weeks! I packed and left everything behind in a rush: my house, my car, my job…my entire life.
Later that month, my family and I arrived in Houston, Texas, to start a new life.
Rebuilding Medical Career in America
Up until our arrival, my family and I had gone through so much in Iraq. We had witnessed so much violence and had experienced too much fear.
Given my strong passion for my job as a doctor, I started looking for a job in the medical profession. I carried around a packet of my resume, medical diploma, and fellowship certificate hoping to get at least a chance to work as a volunteer at MD Anderson — the largest medical institute in Houston. I wanted to show them the wide range of knowledge and expertise I had gained through my medical practice in Iraq. I knew that I would be an asset to the hospital and just needed the chance to prove myself.
However, they didn’t take me seriously and cut my interview short simply because I did not have a U.S. medical license.
I persisted and kept looking for an opportunity until I began volunteering at the Lone Star College. For a year, I provided tutoring to college students in basic sciences: anatomy, physiology and biochemistry, in the hopes that it would turn into a permanent position. Yet in the end, I wasn’t hired.
When our government support ended after the first 90 days, my resettlement agency pushed me and my family to work for basic survival. I had no other option but to work as a cashier. Shortly after, I switched between jobs and ended up working at CVS, all the while I was reviewing papers in Oncology for my former students, for publication in major medical science journals.
In December 2016, I received the news that there was a job offer as a Pathologist Assistant in New Jersey. I had to discuss this opportunity with my family, and stress that, if I were to be hired, I would finally be able work in my field; regardless of the fact that the position had a very modest salary, much less than what I was originally earning in Iraq.
With my family’s support, I applied and thankfully, got the job.
Soon, we moved from Texas to New Jersey, an expensive state with terrible weather! My salary as a Pathologist Assistant in New Jersey barely covered our living expenses, but I was happy regardless. I finally had the opportunity to resume my career as a Pathologist in America.
In my current job, I perform the same tasks as any U.S. licensed physician would, just based upon the training and skills that I received from my education in Baghdad.
Even some of the U.S. licensed Pathologists I work with recognize that I am capable of doing far more than what’s expected of me. I have always had the skills necessary to write high quality reports and have always been able to administer a difficult diagnosis in the face of a patient’s challenging symptoms. Yet, I cannot deliver or approve a diagnosis nor report because I do not have the U.S. license.
In 2019, I learned that my employment in a U.S.-based medical lab qualified me to apply for the New York State license for Pathologist Assistant. So, I applied, and received my license as a certified Pathologist Assistant in January, 2019.
At that time, I rightfully asked for a raise, but the request was denied. Disappointed, I decided to find a job in any hospital that will rightfully pay me what my license was worth.
Luckily, I was able to land a better position in no time. But after a month, my previous employer contacted me to ask me to return to their lab. My absence had affected their work in a negative way, especially with their turnaround time for the delivery of results to their clients, and due to that, the company was falling apart.
I remember him telling me, “I will pay you what your license is worth,” which led to my decision to return to the lab.
Revived Passion as a Doctor in Pandemic
Then, at the end of 2019, the COVID-19 pandemic hit and our lives changed completely.
Immediately, my husband and I began looking for opportunities to help the community fight the pandemic. Then, we heard in the news that the Governor of New Jersey had decided to open temporary field hospitals. These field hospitals needed help from all medical professions, including international physicians.
There was nothing to think twice about. We put on our medical scrubs and went to one of the field hospitals in Edison, New Jersey. We informed them of our readiness to help fight on the front lines of the epidemic that was getting more out of hand by each passing day.
Soon after, my employer decided to get involved in the fight against COVID-19, and began looking for volunteers to perform testings at a drive thru facility in Bergen County. I remember being the first to volunteer and expressing my enthusiasm to him.
“As long as we are able to help, we are in this together.”
I felt as though all my experiences in Iraq had prepared me for that moment.
As a volunteer, my main duty has been conducting tests. I have to get up at 4 AM and drive to New York City to swab nursing home residents. Many of the elderly residents are often in a state of confusion, unaware of the pandemic. I plan to continue being a part of this process until the pandemic ends.
Several weeks into my volunteer work, the governor signed an executive order to give temporary medical licenses to the international physicians who are voluntarily supporting the fight against the pandemic. Without any reservation, I decided to apply. I wasn’t looking for a reward, I just wanted to serve in any way possible to give back to this country.
On April 22, I obtained my temporary U.S. medical license.
A Call to Action
Due to the pandemic, I came to a realization: the U.S. is suffering a shortage when it comes to well-trained medical professionals. This realization motivated me to apply for a permanent U.S. medical license.
One week after submitting my application, I received a letter of rejection:
“Dr. Quraishi,
I have reviewed your application for licensure in NJ. Your application does not list any USMLE scores or any ACGME accredited training. The NJ Board requires you have passed all three USMLE steps and have 3 years ACGME accredited training.
At this time you are not eligible for a full unrestricted license in NJ.”
In a word, I was ineligible simply because I wasn’t trained and educated in a U.S.-based institute. Decades of my education and practice as a medical doctor meant nothing in the eyes of the jury.
The letter stirred up a sense of duty in myself to fight against this injustice and I wrote them back right away:
“I proved myself during the pandemic, and I am currently working as a Pathologist, generating profit for my company solely based on my skills, knowledge and education from Baghdad, Iraq. My only question to you is: why do you ask me to go through a strenuous process that proves nothing about my capabilities?”
Not long after, they responded to my letter again. This time, citing the script of “regulations.”
While they claim to abide by regulations, I argue that all these regulations do is create a barrier to survival for patients with conditions. These patients could have been saved by medical professionals trained outside the U.S. if provided the opportunity. The sheer fact that I was given a temporary license to practice for 6 months shows that there is a chance for flexibility and change.
For medical professionals, I do not see what can be deemed more important than “saving lives.” If old regulations are getting in the way of saving more people, isn’t that alone a testament to the need for replacing the antiquated rules? Some medical doctors may be educated and trained outside the U.S., but don’t we all owe it to the universal Hippocratic Oath to prioritize the lives at stake?
I say it is time to change these old regulations and invest in the people that are desperately trying to help and make a difference. If the current pandemic has taught us anything, it is the urgency to stop the waste of good brains and allow international physicians to step out of the shadows.
Yours Sincerely,
Lubab Alquraishi
Disclaimer: The views, information, or opinions expressed in this article are those of the author and do not necessarily represent those of WeaveTales and its employees.
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