Pakistan is the 3rd Largest Source of Foreign Doctors in America

[Riaz Haq]

Pakistan is the third biggest source of foreign doctors who make up a third of all practicing physicians in the United States, according to OECD. Vast majority of Muslim doctors in America are of Pakistani origin.

Foreign Doctors in America:

About 30% of the 800,000 doctors, or about 240,000 doctors, currently practicing in America are of foreign origin, according to Catholic Health Association of the United States. Predictions vary, but according to the American Association of Medical Colleges, by 2025 the U.S. will be short about 160,000 physicians. This gap will most likely be filled by more foreign doctors.

Foreign Doctors in US, UK. Source: OECD

Pakistani Doctors in United States:

As of 2013, there are over 12,000 Pakistani doctors, or about 5% of all foreign physicians and surgeons, in practice in the United States.  Pakistan is the third largest source of foreign-trained doctors. India tops with 22%, or 52,800 doctors. It is followed by the Philippines with 6%, or 14,400 foreign-trained doctors. India and Pakistan also rank as the top two sources of foreign doctors in the United Kingdom.

Dow University of Health Sciences, Karachi, Pakistan

Dow Medical University of Health Sciences:

There are 3,100 graduates of Karachi's Dow University of Health Sciences, contributing the largest pool of doctors among the 12,000 Pakistani doctors in the United States. About 1,900 are from Lahore's King Edward Medical College and the rest from Karachi's Agha Khan University, Lahore's Allama Iqbal Medical College and other medical colleges in Pakistan, according to Dr. Humayun Chaudhry, President and Chief Executive Officer of the Federation of State Medical Boards in the United States.

Doctor Shortages:

India has six doctors for 10,000 people and Pakistan has eight. The comparable figure for the United States is 25 doctors per 10,000. And yet, the United States continues to import thousands of doctors from these two South Asian nations. Predictions vary, but according to the American Association of Medical Colleges, by 2025 the U.S. will be short about 160,000 physicians. This shortfall will most likely be filled by foreign doctors from countries like India and Pakistan.

Summary:

Pakistani doctors make up the third largest source of practicing physicians and surgeons in the United States. And more are coming to make up the continuing shortages in spite of the fact that Pakistan has only eight doctors per 10,000 people, only a third of the 25 doctors per 10,000 in the United States. Will this change after President-elect Donald Trump takes office on January 20, 2017? Only time will tell.

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[Riaz Haq]

The US Distribution of Physicians from Lower Income Countries
E. Fuller Torrey1,* and Barbara Boyle Torrey2

The origin and distribution of the IMGs from lower income countries are both concentrated; 85 percent of them come from just 8 countries, and 67 percent of all IMGs are living in just 10 states (see Table S1). Forty-one percent of all IMGs from lower income countries come from India, and 22 percent of them are practicing in New York and California. The Philippines is the second largest provider of physicians from lower income countries (16 percent), and they are also practicing in disproportionate numbers in New York and California. Physicians trained in Pakistan, the third most important country of origin of IMGs in the United States (10 percent), practice disproportionately in Texas, New York, and Illinois.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310056/

[Riaz Haq]

#Pakistan to build first #nursing university named after #Bahrain's King Hamad, affiliated with RCS of #Ireland
http://tribune.com.pk/story/1286260/pm-nawaz-performs-groundbreakin...

Prime Minister Nawaz Sharif on Friday performed the groundbreaking of the country’s first nursing university.

“The Bahrain funded state-of-the-art King Hamad University of Nursing and Associated Medical Sciences will help the country’s health sector prosper,” PM Nawaz said while addressing the groundbreaking ceremony. The university, being built in Chak Shehzad, is a gift from Bahrain and will be affiliated with Royal College of Surgeons, Ireland.

Addressing the event, the prime minister said in view of the dearth of trained nursing and training staff in the country, the noble project by Bahrain would help fill gap in healthcare sector.

Regional security: Bahraini commander meets army chief

PM Nawaz further said the university will raise the level of standard of health and will be significant in bringing quality nursing care in the country.

The prime minister stressed that health is one of the top priorities of the government. “The government aims to provide integrated healthcare spanning over the entire health spectrum from primary to tertiary care,” the premier said. He added that the “programme is unprecedented in terms of its magnitude and is being implemented in a phased manner and would provide coverage to 100 million people eventually. Work in this regard is being undertaken expeditiously.”

The ceremony also saw the announcement of construction for another 50 state-of-the-art hospitals throughout the country.

PM Nawaz to lay foundation of 1156MW power plant in Sheikhupura

The premeir said the government is focused on preventative measures and pointed out that the national immunisation programme provides free of cost vaccines to every Pakistani mother and child. “There has been significant improvement in the coverage of the programme and concrete steps are being taken to arrest the spread of polio,” he said.

PM Nawaz thanked the government of Bahrain, especially King Hamad for his generousity in offering support for the establishment of the university, saying “the university symbolises strong bonds of brotherhood and friendship between the two countries.”

“This is reflective of leadership of Bahrain’s love for the people of Pakistan and its commitment to help improve the quality of life of our people,” he added.

[Riaz Haq]

Karachi to gain its own cancer hospital by Dec 2019

http://tribune.com.pk/story/1278799/evolving-healthcare-system-kara...

KARACHI: The groundbreaking ceremony of the third Shaukat Khanum Cancer Hospital in the country was performed by a 10-year-old cancer patient, Waleed Iqbal. Together with Shaukat Khanum Memorial Trust (SKMT) board of governors chairperson Imran Khan, Waleed unveiled the groundbreaking plaque on Thursday.

Waleed and many other cancer patients from Sindh and Balochistan previously had to travel to Lahore for cancer treatment but now patients will not have to bear expense of accommodation and travelling with the establishment of a cancer hospital in Karachi.

The ceremony, which was held at the site of the hospital in Defence Housing Authority (DHA) City near the Superhighway, was attended by board members of the SKMT, the hospital’s senior management, dignitaries, donors and celebrities.

The hospital will be built on 20 acres of land allotted by DHA, for which we are very grateful, said SKMT’s chief executive officer Dr Faisal Sultan. He told participants that the total cost of constructing the hospital is Rs4.5 billion and the facility will be completed on December 29, 2019.


Dr Sultan added that the hospital will have the similar state-of-the-art facilities as are being provided at the other Shaukat Khanum hospitals in Peshawar and Lahore. This includes surgery, radiotherapy, chemotherapy, hormone therapy and biological therapy facilities. The hospital will enhance and raise the healthcare standards in the region, claimed Dr Sultan.

Highlighting the details of the project, Dr Sultan said the new facility will have operating rooms, an intensive care unit, a chemo-bay facility, inpatient rooms, and outpatient clinics, initially. The hospital will have nine clinical departments – medical oncology, paediatric oncology, radiation oncology, brachy-therapy, CT simulation services, surgical oncology, anaesthesia, radiology with CT scanners, MRI scanners, X-ray machines, fluoroscopy, ultrasound machines, mammography scanners and a PET CT scanner. The pathology department will have haematology, clinical chemistry, microbiology, cytology, and a blood bank.


He added that this enormous facility would open up opportunities for oncologists, doctors, nurses and other health professionals to get training in the management, diagnosis and treatment of cancer.

Dr Sultan said around 75 to 80% of the patients at the facility are treated free of charge, while the remaining 20 to 25% of patients pay their own expenses. He also clarified that the hospital’s income depends on 40 to 45% of the revenue it generates, 25% on zakat and 35% on other donations.

[Riaz Haq]

#UK #NHS to bring 200 doctors each from #India and #Pakistan in 2017.

http://www.telegraph.co.uk/news/2017/01/12/nhs-could-bring-hundreds...


Hundreds of doctors may be drafted in from India and Pakistan to plug a spiralling crisis in Accident & Emergency departments, health officials say.

The scheme will start in Greater Manchester, with 20 medics due to be flown from India this year for up to three years.

The region’s eight Accident & Emergency departments have been under severe strain in recent weeks amid staffing shortages.


Officials behind the plans said the scheme, backed by Health Education England, could be expanded in respond to widespread shortages of A&E doctors across the country. The project is being run by the Greater Manchester devolution team and Wrightington, Wigan and Leigh Foundation Trust.


Andrew Foster, trust chief executive told Health Service Journal said the region's A&E departments were now "very reliant on locums."

Most of the trusts needed around 10 to 12 "middle grade" doctors, but only had two or three. "They're very reliant on locums," he said. 

Such medics are junior doctors, who have finished basic training but are still learning specialist skills and have yet to qualify as a consultant. 

Mr Foster, who was formerly Department of Health director of of human resources, said the plans could form part of a national recruitment exercise.

"We are talking about the possibility of getting 200 [trainees] from India and the same number from Pakistan," he said. 

In November a report by the Commons health select committee warned that A&E departments need at least 8,000 doctors – 50 per cent more than the 5,300 currently employed - to keep pace with the rise in emergency admissions in the last five years.

Under the new scheme, the NHS will pay £16,000 towards the training costs for each recruit, as well as paying their salary. The middle grade doctors would be placed in emergency departments for 2-3 years while completing their training in emergency medicine, before returning to India.

Ged Byrne, director of education and quality for Health Education England in the North West, said: “This work is helping to increase the number of doctors who are available to support acutely ill patients.

"The relationship benefits both the UK as it helps to fill an immediate need and the doctors themselves who gain access to high quality training and a unique skills set.”

[Riaz Haq]

#US Patient Mortality Lower With Foreign-Trained #Physicians from #India, #Pakistan, #Philipinnes, etc http://www.medscape.com/viewarticle/875356 … via @medscape


Medicare patients admitted to the hospital and treated by internists who graduated from medical schools outside the United States had lower 30-day mortality than matched patients cared for by graduates of US schools, according to results of a study published online today in the British Medical Journal (BMJ).

To practice in the US, international medical school graduates must pass two exams on medical knowledge and one assessment of clinical skills, and complete accredited residency training here. However, medical schools outside the US are not accredited by any domestic agency. In response to concerns about quality of care from internationally trained physicians, the Educational Commission for Foreign Medical Graduates will require accreditation of medical schools outside the US by 2023.

Studies comparing the quality of care provided by internationally trained physicians with that by domestically trained physicians are few and small in scope. Yet, physicians trained outside the US may be perceived by some as not as competent as physicians who attended medical school in the US.

To compare the two, Yusuke Tsugawa, MD, MPH, PhD, from the TH Chan School of Public Health at Harvard, and colleagues conducted a large observational study of hospitalized Medicare beneficiaries to assess whether outcomes differ depending upon whether or not their general internists were trained domestically or abroad. The study excluded graduates from Central America and the Caribbean to minimize inclusion of US citizens trained outside the country. The countries that contributed the most internists to US hospitals were China, Egypt, India, Mexico, Nigeria, Pakistan, the Philippines, and Syria.

The researchers assessed 30-day mortality rate (the primary outcome), readmission rate, and costs of care (total part B spending), and whether clinical condition influences differences in patient outcomes and care costs between the two groups of patients. In addition, they adjusted their models for patient characteristics (age, sex, race or ethnic group, diagnosis, and income), physician characteristics (age, sex, and patient volume,) and hospital fixed effects (characteristics of hospitals).

Results indicated that 44.3% (19,589 of 44,227) of general internists in the US graduated from medical schools outside the country. They were slightly younger than US graduates (46.1 v 47.9 years; P < .001), and were more likely to work in medium-sized, nonteaching, for-profit hospitals without intensive care units.

In addition, their patients were more likely to be nonwhite, have Medicaid, have lower median household income, and have more chronic comorbidities (congestive heart failure [CHF], chronic obstructive pulmonary disease [COPD], and diabetes)


The mortality analysis included 1,215,490 patients admitted to the hospital under the care of 44,227 general internists between 2011 and 2014. Patients treated by international graduates had lower mortality (adjusted mortality, 11.2% v 11.6%; adjusted odds ratio, 0.95; 95% confidence interval [CI], 0.93 - 0.96; P < .001).

"Based on the risk difference of 0.4 percentage points, for every 250 patients treated by US medical graduates, one patient's life would be saved if the quality of care were equivalent between the international graduates and US graduates," the authors write.

The cost analysis included 1,276,559 patients treated by 44,680 physicians during the same study period.

Overall, patients of internationally trained internists had slightly higher adjusted costs of care per admission ($1145 v $1098; adjusted difference, $47; 95% CI, $39 - $55; P < .001).

Meanwhile, adjusted readmission rates among 1,182,268 patients who were treated by 44,201 physicians did not differ between the two patient groups.

[Riaz Haq]

$15 million Gift to Notre Dame Catholic University from #Pakistani-#American #Muslim Physician Couple in #Indiana

https://www.nytimes.com/2017/03/17/your-money/norte-dame-muslim-phi...

Rafat and Zoreen Ansari, medical doctors who were born in Pakistan, have spent the last four decades working and raising their three children in a suburb of South Bend, Ind., where they also have earned a reputation as civic leaders.

By their estimation, they have given at least $1 million and thousands of hours of their time to nonprofits focused on children with autism, which afflicts their youngest child, Sonya.

But a year and a half ago the couple and their children, all Muslim, began working on a larger gift in terms of money, impact and risk: Their goal was to fund something that would foster better understanding of religion, including Islam, Judaism and Christianity, with the belief that all religions should be treated with equal respect.

The family’s inclination to leave a legacy is not uncommon among people who have grown wealthy. But their focus could land them in the middle of one of the most charged issues of the day.

“We came as immigrants, and this country has given us so much,” Mrs. Ansari said in an interview ahead of the announcement. “We want to give something back to America, but also to humanity. We want to promote the idea of equality.”

On Friday, the Ansaris announced a $15 million gift to the University of Notre Dame, one of the top Catholic universities, to create the Rafat and Zoreen Ansari Institute for Global Engagement With Religion. The institute will aim to deepen knowledge of religion and look to explain how the traditions and practice of various religions influence world events.

“Whenever you get a gift of this size, it’s tremendous, but particularly to have this named for the Ansari family, who is Muslim, is tremendously meaningful to us,” said the Rev. John I. Jenkins, the president of Notre Dame, in an interview. “We believe religion is very important in our world. It can have a negative impact, but it should be possible to study the ways religion can be a force for human development and peace.”

Father Jenkins said the institute would look at religion not through a sociological or political lens, but through one focused on the religions themselves.

While the couple and the university said the gift, which was 18 months in the making, was not conceived as a way to make a political statement, all parties acknowledged that it came at a politically charged time, given the debate over Muslim immigration in America and Europe.

“In the last couple of years, the majority of problems have been created by the misunderstandings among the religions,” said Mr. Ansari, an oncologist and hematologist. “Is this the right time for the announcement? Yes, because there is so much going on.”

The Ansaris thought long and hard about how to achieve their goal. Their hometown, Granger, Ind., is just a few miles from Notre Dame. While the Ansaris were educated in Pakistan, their daughter Sarah graduated from Notre Dame Law School.

[Riaz Haq]

#Pakistani researcher at #UPenn: MIssing gene in some people in #Pakistan prevents heart disease. Via @dailypenn

http://www.thedp.com/article/2017/04/penn-heart-disease-pakistan

A study led in part by Penn scientists examined the DNA of over 10,500 Pakistanis in order to guide research on treatments for heart disease.

Many drugs developed to lower heart disease have targeted a gene linked to arterial plaque, Science Magazine explained. But this study found that the absence of this gene may not greatly affect one's risk for heart disease. 

Instead, the study found that the absence of a different gene — called APOC3 — might help.

Penn professor Danish Saleheen and other researchers searched Pakistan for individuals missing a functional copy of the gene. Many Pakistanis marry their first cousins, so parents more frequently pass on identical copies of a gene to their children — meaning that they're also more likely to pass on two nonfunctional copies. 

People with these deficient copies of a gene are known as genetic “knockouts,” Philly.com explained. Scientists can deliberately breed animals to produce knockouts, but they must survey large numbers of people to find them in humans. 

The researchers found a man, woman and their nine children in Pakistan who were all APOC3 knockouts. 

When they consumed a high-fat meal, study participants without functioning APOC3 genes did not experience elevated levels of plasma triglycerides, according to Penn Medicine. Higher levels of triglycerides are a biomarker of heart disease risk. 

The family seemed healthy otherwise, which could suggest that missing the function of the APOC3 gene could help treat heart disease without other, harmful effects, Science Magazine noted. 

Saleheen told Penn Medicine that these were the world’s first APOC3 knockouts found. He’s been working in Pakistan for over 10 years, amassing as many blood samples as possible, to identify different genetic knockouts — so far he’s found over 1,300 — in over 70,000 participants, a figure he hopes will eventually surpass 200,000 as the work continues.

The study was led by Penn's Perelman School of Medicine, the Center For Non-Communicable Diseases in Pakistan, the Broad Institute of MIT and Harvard and the University of Cambridge.

Co-senior author of the study Sekar Kathiresan told Science Magazine that he hopes this work will lead to a "Human Knockout Project," similar in caliber to the Human Genome Project, in order to aggregate data on knockouts.

[Riaz Haq]

AMERICAN MUSLIMS – VITAL PART OF U.S. HEALTH CARE SERVICES AND MEDICAL ACHIEVEMENTS
Around 10 % of all physicians in the U.S. are Muslims; An example of remarkable American success story

http://www.viewsnews.net/2017/06/10/american-muslims-vital-part-u-s...

Under unprecedented spotlight since the 2016 election campaign, American and immigrant Muslims have found a new ally in the form of a treasure trove of authentic statistics springing from research institutions, analyses and informed sources.

President Donald Trump’s decision last week to seek Supreme Court’s reinstatement of his federal court frozen travel ban for citizens from six Muslim majority countries provides another opportunity to showcase the role American Muslims play in wide-ranging areas.

One area, where immigrants from Muslim majority countries have contributed crucially to the United States’ well-being is health care services.

For example, The Medicus Firm, a company recruiting medics, reveals that 15,000 doctors working in the U. S. came from the seven Muslim majority countries – Libya, Iraq, Iran, Somalia, Syria, Sudan, Yemen – initially included in the travel ban executive order.

Of these, 9,000 doctors emigrated to the U. S. from Iran, while 3,500 came from Syria and more than 1,500 from Iraq, which no longer is on the list of countries covered under the proposed travel ban.

Just one percent of the total population, American Muslims have contributed to the American health care sector enormously. In several rural areas and small towns Americans get health care services from immigrant medical practitioners, including Muslim doctors.
Pakistan, a large Muslim majority country, is one of the top five countries contributing medical experts including doctors to the U. S. According to a Pakistani organization, the number of Pakistani-American doctors is nearing 20,000. They work all over the United States, with many of them practicing in states which need them the most, in rural areas far away from the East and West coasts.

In fact, one of the most prominent doctors in recent world history was a Pakistani-American neurosurgeon, Dr. Ayub Ommaya, who famously invented the Ommaya reservoir, which is employed to provide chemotherapy drugs directly to the tumor site for treating brain tumors.

He has been described as one of the most important Americans ever who shaped America with their individual achievements.

According to figures cited by organization IntraHealth International, there are 656,000 doctors and surgeons working in the U. S. with 254,000 of them being immigrants. 

[Riaz Haq]

Hospitals in #Trump country suffer as #Muslim #doctors denied visas to U.S. https://interc.pt/2x7ChDd by @MaryamSaleh_

EVERY MARCH, DOCTORS across the United States and the world eagerly await “Match Day” — the day they find out what residency, internship, or fellowship program they’ve been matched with. By that point, residency candidates have completed medical school and passed a series of rigorous qualifying exams. For those who are not American — about a quarter of all doctors in the U.S. are foreign-born — there’s one additional step: securing a J-1 visa, a nonimmigrant exchange visa conditioned on an individual’s return to their home country for at least two years at the conclusion of the program.

In the weeks following the March 17 match, dozens of Pakistani physicians had their J-1 applications denied in Islamabad and Karachi, said Shahzad Iqbal, a Pakistani-American physician in New York.

Jan Pederson has spent the last 30 years of her legal career representing foreign-born physicians coming to the U.S. for residency or fellowship programs. It’s an unheralded but essential line of work, because without foreign doctors, the U.S. healthcare system would simply collapse, with the pain felt most acutely in rural areas. U.S. medical schools don’t produce anywhere near enough graduates to meet the needs of the country, particularly in places where people are reluctant to move to.

Like any legal practice, Pederson’s hasn’t always been smooth. Every so often, a client’s visa application is denied. It happens. In the years following the Sept. 11 terror attacks, doctors from countries, such as Iran and Syria, saw their applications get stuck in administrative processing until U.S. officials could affirmatively say the physicians posed no national security threat, she said.

But this spring, weeks after President Donald Trump issued a revised version of an executive order restricting immigration from six Muslim-majority countries, Pederson saw the same thing Iqbal did — what she called an “epidemic of Pakistani visa denials.”

Advocates say there is no way to separate the attempted Pakistani physician ban from the so-called Muslim ban and other Trump administration immigration policies.

“I think it’s a confluence of factors” that caused the visa denials, Pederson said. “It would be hard to escape the conclusion” that there is a correlation between the visa denials and the president’s anti-immigration rhetoric and policies.

“This year, we had about 34 J-1 refusals that were reported to us. This is kind of a historic number,” said Iqbal, who chairs the Committee on Young Physicians, which is a part of the Association of Physicians of Pakistani Descent of North America. APPNA only knows about denials that rejected applicants reported to them, so it may be just the tip of the iceberg. Many reapplied, starting from scratch, and were successful, but started their programs late.

APPNA has lobbied on behalf of Pakistani doctors hoping to train in the United States since 2003, Iqbal said. Heightened post-9/11 security measures meant that many visa applications were held up in administrative processing, but “it never happened before that there was a mass number of denials,” he said. “Before, there were security clearances, and people were placed in security clearance for six months to two years.”

For the last five years, APPNA received reports of, at most, one or two physicians whose visa applications were denied, and usually it was because of an issue with an applicant’s immigration history.

This is concerning, Iqbal said, since Pakistan is one of the top suppliers of foreign doctors to the U.S. In 2015, 12,125 doctors of Pakistani descent were practicing medicine in the U.S., second only to India’s 46,137 doctors, according to the U.S. Organization for Economic Cooperation and Development.

[Riaz Haq]

#Pakistani-#American #medical grad Dr. Faisal Cheema from #Karachi's Aga Khan University gets $4 million research grant for heart transplant #research

https://dailytimes.com.pk/213442/pakistani-scientist-awarded-4-mill...

ISLAMABAD: A Pakistani physician/scientist Dr Faisal H Cheema was awarded $4 million to lead a cutting edge research on heart transplantation.

Dr Faisal H Cheema belongs to the rural areas of Wazirabad and Hafizabad and got his education from Crescent Model School as well as the Government College, Lahore before moving to Karachi to attend medical school at Aga Khan University.

After graduation, he moved to the United States and further trained and worked at Columbia University , Loyola University, Johns Hopkins University, University of Maryland and University of California Berkley. He is currently a faculty member at Baylor College of Medicine and Texas Heart Institute in Houston, TX.

He has served as Senator for the Ivy-League Columbia University and is involved with several professional, academic, community and philanthropic organisations. Dr Cheema’s passionate and selfless work for young physicians culminated in the establishment of Committee for Young Physicians within Association of Physicians of Pakistani-descent of North America, on which he served for more than a decade that included chairing it. He has helped hundreds of students in their search for residencies and or advancing their medical careers in the US. He loves to mentor medical students and young physicians.

Ever since he left his motherland, he continues to collaborate with various institutions in Pakistan and guides students from medical schools across the country. Dr Cheema has published more than 110 scientific manuscripts in high impact journals. In due course of time, through strategic partnerships among academic, corporate, governmental and philanthropic institutions, Dr Cheema’s mission is to make heart and lung transplant and artificial devices for end-stage heart failure and lung disease a reality in Pakistan.

He also aspires to develop a national organ donation and allocation system for Pakistan. Dr Cheema and his colleague Dr Jeffrey A Morgan have been awarded $4 million in funding from Brockman Medical Research Foundation to lead cutting edge research on heart transplantation.