Refugees find path back to medicine

By Katie Kerwin McCrimmon

After arriving in the U.S., the Cuban refugees darkest moments came when he had to scrub dishes and install wood floors. He missed being respected in his community and practicing medicine, especially caring for babies.

Then, when he moved to Denver in 2007 after brief stints in Miami and New Mexico, the doctor with nearly 15 years of medical training in Cuba who is a specialist in both family medicine and radiology, couldnt get a single employer to call him back.

All Dr. Edilberto Edy Diaz Rodriguez wanted was a basic health care job like drawing blood or working as a medical assistant.

I would apply for 20 or more jobs a day. Nobody called me, said Rodriguez, now 41.

Even preliminary interviews led nowhere.

I felt like when they heard my accent, right away, they said, OK, well call you, but they didnt mean it, he said. I was so disappointed when I came here.

Before escaping Cuba via Venezuela, Rodriguez had heard that foreign-trained doctors would get help re-launching their careers in the U.S.

It wasnt true, Rodriguez said.

After floundering for years, Rodriguez finally is on track to take the required tests and apply for a U.S. residency in family medicine so he can once again practice. He eventually found work in Denver as a medical assistant at a private clinic and is now a technician at the Bonfils Blood Center in Denver.

A national program pioneered in San Francisco called Welcome Back now has a Colorado affiliate among its nine programs across the country. The Colorado program helps refugees like Rodriguez find their way back into medical professions.

The Colorado Welcome Back Center opened in October and is run by the Spring Institute for Intercultural Learning and funded by a $200,000 grant from the Colorado Refugee Services Program. So far, Colorado Welcome Back has helped 40 medical professionals take steps to return to their fields. The center offers an educational case manager who works one-on-one with refugees to figure out what schooling they will need to obtain U.S. licenses and helps troubleshoot problems they are having. Sometimes the medical professionals find they want to venture into a new health career that requires fewer years of education, rather than starting over again with their education. Colorado Welcome Back also offers English classes and programs that explain the complicated U.S. health care system.

Dr. "Edy" Diaz Rodriguez

Dr. “Edy” Diaz Rodriguez was both a family physician and a radiologist in Cuba. But, when he arrived in Denver, no one would consider him for jobs far beneath his skill levels. He finally is on track to reignite his medical career after obtaining school records from Cuba.

We cannot offer shortcuts to people. The U.S. has very high standards of health care practice that all health care providers need to meet, said Susan Downs-Karkos, director of Colorado Welcome Back. We can offer information and support as they take the steps necessary to get their health care career back on track.

For some people, it may not be realistic to become a doctor again. It may take too much time, and money. But rather than giving up on health care careers altogether, we help them understand their options and that their unique language and cultural skills can be a huge asset.

Today the Migration Policy Institute and the J.M. Kaplan Fund are honoring the national Welcome Back program with a $50,000 E Pluribus Unum Prize. The prize honors groups that help integrate newcomers.

The Welcome Back program benefits the refugees. But, it also could help Colorado fill critical jobs.

Data from the Colorado Health Institute predicts that Colorado will have a shortage of 2,200 primary care providers by 2025. Colorado already has too few registered nurses. By 2018, this shortage is expected to triple, with Colorado needing an estimated 6,300 nurses according to the most recent study of the Colorado Health Professions Workforce Policy Collaborative. Shortages are also expected to increase among dental and behavioral health providers.

On top of filling gaps, foreign-trained health professionals may improve care for other immigrants or people of color who live in the U.S.

We know that there are long-term ethnic and racial health disparities in the quality of care that is provided, Downs-Karkos said. Diversity in the health care work force is part of the solution to that problem. And this is a great way to diversify our health care work force.

We already have people who have the passion and experience to work in health care. What they need is some retraining to be able to provide high quality care.

Downs-Karkos said healers around the world often are revered and seen as leaders in their communities. Putting them back to work can counter the displacement that many like Edy Rodriguez feel once they have fled their homeland.

There is a huge sense of loss when they come to the U.S. and are not able to practice, she said. It can be personally devastating and hard on families economically. Its very difficult for them to work in low-wage, low-skill jobs knowing that they have so much potential.

As the Colorado program has developed, Downs-Karkos has been surprised at how emotional the education sessions often are. She said the refugee will seem perfectly fine until they recount their frustrations at finding a way to use their skills in the U.S.

Many break down in tears. These people have overcome a lot of hardship to come to the U.S. They come from countries where there has been war trauma. They have people back home whom they worry about. They have a responsibility to help their family as much as they can.

Edy Rodriguez felt exactly that pressure when no one would consider hiring him.

I have to take care of my family in Cuba, he said of his mother, a younger brother and a sister who is a successful musician, but has been forbidden to travel because of Rodriguez decision to flee Cuba.

Rodriguez was born and raised in Bayamo in the province of Granma. At 18, he started his medical training. In Cuba, college and the first years of medical school are combined in a six-year program. After that, Rodriguez had to do two years of social service where he worked as a doctor for the Army. He then did a three-year residency in family medicine, followed by another year of mandatory service, then a three-year residency in radiology.

While working as a family doctor in Cuba, Rodriguez was much like the old small-town doctors once portrayed in Life magazine. He lived in the community with his patients. The medical office was on the first floor and his living quarters were upstairs. Whenever people needed him for any reason day or night, they came to his home. While the hours were long, Rodriguez found that he loved the contact with his patients. He missed that later when he worked as a radiologist and spent much of his time alone reviewing images. Eventually, Rodriguez hospital asked him to go work as a doctor in Venezuela.

Unmarried and then 33, he jumped at the chance, knowing he might eventually be able to flee to freedom. In addition to the economic struggles that his families and others in Cuba faced, Rodriguez said he found the restrictions on free speech most oppressive.

I like to think and say what I think. You cant do that in Cuba. You are part of the system, he said.

Rodriguez said that the Cuban education and health systems are strong in many ways.

But you have to pay a really high price, he said.

While he aches to see his mother, sister, brother and nieces and nephews, he has no regrets about leaving. With his income from his job at the blood center, Rodriguez now is able to send about $100 a month to his family, which he says amounts to a huge sum for them. His mother has been able to buy a washing machine and an air conditioner.

After arriving in the U.S., Rodriguez met an American woman whom he has now married. She later got a job in Denver and while there are few Cubans here, Rodriguez fell in the love with cycling and running in the mountains.

His biggest struggle on the road to practicing as a physician again was getting a copy of his transcripts from Cuba to prove that he had attended medical school there. It took years and a $300 payment. Once, the documents arrived with the proper signature, but the U.S. authorities said too much time had elapsed.

It was almost a miracle, but the signature wasnt good, he said.

So his wife recently made a trip to Cuba to hand-deliver the transcript request and fee. This time, the signed documents came through, and Rodriguez can now take exams to prove his knowledge.

Through the Welcome Back program, Rodriguez has gained essential support on his journey and has befriended a group of doctors from around the world. They meet to study at the University of Colorado medical school library in gatherings that look like United Nations sessions.

One of Rodriguez closest friends is a doctor from the Congo who is just ahead of him in the process and shares medical books.

Rodriguez wakes at 4:30 a.m. on workdays to get some studying in before starting his 12-hour shift at the blood center at 6:45 a.m.

He insists he will take the exams just once.

Im a fighter. I can do this, he said.