A single email in 2011 set Mark Kuczewski, chair of medical education at the Loyola University Chicago Stritch School of Medicine, on a journey to help undocumented immigrants become doctors. A colleague had written saying he had received an application from one of the most talented candidates he had ever seen. The problem: She was undocumented, and medical schools at the time didn’t accept undocumented immigrants, who are not eligible to work in a residency program, a requirement for medical certification “When I saw that email, it was eye-opening,” says Kuczewski, “I had no idea there were so many students who had been making it this far with so many barriers against them. This woman had a 3.94 GPA.”
People told them that they couldn’t be doctors, and they decided not to take No for an answer. That’s the American spirit.
A year later, the dilemma was temporarily resolved when President Barack Obama signed Deferred Action for Childhood Arrivals (DACA), a 2012 policy that allows qualifying undocumented immigrants who were brought to the country as children to defer deportation for renewable two-year periods and to work legally in the United States. “That was a Friday. The next week we made the decision to open our doors to undocumented students and accepted seven our first year,” says Kuczewski. Today, 32 of the school’s 600 medical students are DACA recipients.
Still, another hurdle remained: DACA recipients remained ineligible for either state or federal financial aid. So Kuczewski helped negotiate an agreement with the Illinois Finance Authority — and later Trinity Health, a national Catholic healthcare system — to offer undocumented students interest-free loans on the condition that they practice in underserved Illinois communities following graduation. Illinois is one of dozens of states facing a shortage of healthcare workers that is so severe in rural areas that at least one county lacks even a single practicing physician. Meanwhile, with the population aging and demands on the healthcare system expected to increase, the American Medical Association (AMA) estimates that DACA could introduce 5,400 previously ineligible physicians into the system in coming decades. “It’s a win-win,” says Kuczwski “Diversity is a huge problem in medicine, and we were able to bring a group of bilingual doctors to areas where other physicians don’t want to go.”
Now Kuczewki’s program and the future of his medical students, along with the healthcare needs of the Illinois residents they plan to serve, are in jeopardy. In September, President Donald Trump announced that the administration would phase out DACA by March 2018 unless Congress takes action. Kuczewski has joined a chorus of healthcare experts urging Congress to save DACA. In December, 60 of the country’s leading medical associations penned a letter to Congressional leaders calling for a permanent legislative remedy to “help our country produce a diverse and culturally responsive health care workforce to meet the needs of underserved populations, promote health equity, and avoid unnecessary disruption in our education and training systems.”
Kuczewski believes that saving DACA is good for the American healthcare system and the economy more broadly, but his advocacy is also deeply personal. “My mother grew up dirt poor in Portugal, and my dad was a coal miner from Pennsylvania,” he says. “Whenever I would talk about wanting to go to college, my mom would say, ‘Things like that aren’t possible for people like us.’ I remember being floored by that.” Kuczewski eventually earned a scholarship to New York University. “When I hear about DACA students, I hear an echo of my parents,” Kuczewski says. “People told them that they couldn’t be doctors, and they decided not to take No for an answer. That’s the American spirit.”