Cuban doctors struggle to prove credentials in US
By LAURA WIDES-MUNOZ
AP Hispanic Affairs Writer
MIAMI -- Roberto Carmona sneaked away from his superiors disguised as a
South African cowboy. While working in Namibia, the doctor donned boots
and a big hat so he could slip out to the American Embassy, where he
asked about qualifying for a special program for Cuban physicians that
he hoped would let him defect to the U.S.
Nearly a year later, he was accepted, just days before his overseas job
ended. Carmona fled to Tampa, but escaping his homeland turned out to be
the easy part.
Carmona and a number of other Cuban physicians who defected while on
overseas assignments have confronted a frustrating contradiction in
American medicine: They were allowed into the U.S. because they are
doctors. But, once here, they cannot treat patients because Cuba has
refused to release or certify their academic records.
Without transcripts, it's nearly impossible for the doctors to take the
required medical board exams and to get approval from the U.S. group
that accredits foreign physicians.
"To come to this country, we have to spend so much time demonstrating to
U.S. immigration officials we are doctors and show them so many
documents," Carmona said. "Then why is it once we are here, they don't
believe us and make it so difficult for us to work in our profession?"
Cuba, which views the defectors as traitors, pays for its doctors'
training and has for years sent them on goodwill missions abroad to
provide free health care in poor countries.
In 2006, the U.S. created a special visa program specifically for Cubans
on those missions, and more than 1,500 Cuban doctors, dentists and other
medical professionals have used the visas to flee to the U.S., according
to the State Department.
It's unclear how many doctors face the same problem as Carmona. The
Educational Commission for Foreign Medical Graduates, a private
nonprofit that oversees the accrediting process, said at least 20 have
asked for waivers because of problems getting documents. And the numbers
are likely to grow.
Emilio Gonzalez, former head of U.S. Citizenship and Immigration
Services who helped create the Cuban Medical Professional Parole
Program, said the problem was relatively new. He suggested allowing
doctors to begin residency programs or other retraining as they await
approval to take the boards.
"There is a credentialing problem," Gonzalez said. But, he added, "there
are ways to be creative."
Even when paperwork is readily available, the American accreditation
system for foreign doctors is difficult. They must pass three lengthy
exams in English, which often cost thousands of dollars. But without
academic transcripts, they cannot prove they studied medicine.
Carmona was among a half-dozen Cuban doctors interviewed by The
Associated Press about their decision to defect while working abroad - a
move that risks not seeing loved ones again for many years. The doctors
are allowed to stay in the U.S. regardless of whether they practice
medicine. The federal government's "wet-foot, dry-foot" policy says any
Cuban who makes it to American shores can remain in the country.
Some became disillusioned with Cuba's communist system and left to
escape economic and political repression. Others were frustrated by poor
living and working conditions in their host country.
The defectors described taking extreme steps, like Carmona's cowboy
getup, to avoid raising the suspicion of Cuban and local officials. Most
spoke on condition of anonymity, fearing retribution against family in
Cuba or further problems in obtaining transcripts. Some have yet to
apply for accreditation.
Carmona said he became disillusioned with the Cuban system in medical
school when he saw doctors paid $25 a month and forced to moonlight in
other jobs to buy food when government rations ran out.
His application was denied to work in Venezuela, where the Cuban
government has sent more than 30,000 health professionals in exchange
for subsidized oil shipments. Then in 2007, he was offered a post in
Namibia on the West African coast just north of South Africa.
At the time, his girlfriend was four months' pregnant and had already
requested a U.S. visa through a separate process. It seemed his only
chance to leave.
Since the Cuban medical parole program began, 444 graduates of Cuban
medical schools have passed their board exams and been accredited,
according to the Educational Commission. However, it's unclear how many
of those came to the U.S. under the special program.
Educational Commission Vice President Bill Kelly said physicians can
submit affidavits from other doctors who attended medical school with
them or request a waiver from the commission's executive board.
"Anybody who indicates they don't have their transcripts, we point them
in the right direction," Kelly said.
Carmona said he had tried to talk to someone at the commission about an
alternative and enlisted help from state politicians, all to no avail.
Following an inquiry by the AP, he suggested Carmona contact him
directly and then offered to allow Carmona to provide the affidavits.
Dr. Julio Cesar Alfonso, head of the South Florida group Solidarity
Without Borders Inc., which helps Cuban medical professionals with the
parole program, has been lobbying to change the accrediting procedure.
He said he's talked with more than two dozen doctors in the same
predicament as Carmona.
Getting transcripts authenticated can be tough even when Cubans come to
the U.S. with their government's permission.
Dentist Yenia Lopez left Cuba with that government's permission in 2008
after getting a U.S. visa, which is done through a lottery program
because so many people apply. Milwaukee-based Educational Credential
Evaluators, which accredits foreign dentists, rejected her application
because it could not reconcile two versions of her transcripts.
Lopez said she initially sent an unofficial version and then provided
her original copy, but there were discrepancies between the two. The
company said it tried five times to verify the documents with Cuba, then
closed her case in 2010, effectively ending her chances of working as a
dentist in the U.S.
"I feel like they are in Wisconsin, and they just don't understand how
things work in Cuba, and how complicated it is even to obtain the
simplest documents," said Lopez, who has offered to pay the cost of
additional verification attempts and now works as a dental assistant.
"This is the rest of my life they are deciding."
As for Carmona, he is now a medical assistant and is saving money with
his girlfriend, who came to the U.S. with their baby. He said he hoped
his case would help other doctors like himself.
"I just want to do what I love," he said, "to be a doctor."
http://www.miamiherald.com/2011/03/26/v-fullstory/2135308/cuban-doctors-struggle-to-prove.html
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