Different Routes out, Different Routes in: Practicing Health after Arriving in the US

Most studies of the global distribution of physicians and nurses focus on members of the health professions from middle- and low-income countries (as defined by the World Bank) who are recruited by high income countries. The present study explores the resources for and experiences of internationally educated refugee physicians and nurses in the United States. It asks, first, what happens when internationally educated health professionals seek employment after arriving in the United States as refugees and asylum seekers? It draws upon the examples of two states: Maine (pop 1.33 million) and Pennsylvania (pop 12.79 million). What governmental and nongovernmental programs of assistance are provided to internationally educated health professionals? What is the reskilling process for them? What pathways can they take and (how) can they work? Second, how do refugee regimes intersect with national regulations for health professionals? The paper situates the experiences of individual health professionals in the context of national and international refugee policies. Finally, it considers the relationship of refugee health professionals to internationally educated nurses and physicians that are recruited by the United States. According to Frenk et al (2010), the health professions workforce is distributed unequally and this distribution exacerbates global health inequality. How does the global flow of refugee physicians and nurses affect global health inequality?