Resolving Challenges for 200+ Young Physicians – Effective APPNA Advocacy
G. Naheed Usmani, MD, APPNA President 2020

Our young physicians and ECFMG approached APPNA in January about dissolution of PMDC and therefore lack of verification of MBBS degree by PMDC which was a required step for ECFMG to issue the required visa sponsorship form for training in US. I reached out to the Pakistani PM Health Taskforce, Federal health minister and Chairman of Higher Education Commission to find a way to address this issue. During my trip for APPNA MERIT Symposium in Pakistan in March, I personally met with top Pakistani officials and US ambassador to Pakistan to advocate for these youngsters who had worked so hard and successfully matched for residency in US.

Then Corona pandemic happened!

Travel was stopped, Pakistan went into lockdown, international mail was disrupted and all visas to US were stopped. APPNA Advocacy Committee was hit by a barrage of appeals from young physicians who saw so many insurmountable challenges in resolving these issues. I was deeply disturbed and worked with our Advocacy Committee and its Chair, Dr. Abdul Rashid Piracha to address the issues on multiple fronts. While the Committee concentrated on working on issues that needed to be addressed on the US side, I focused on Pakistan.

As President APPNA, I took it upon myself to use all my means to help these young doctors. Having met the US ambassador in March, I wrote to him personally, about special exceptions needed for emergency visa processing for these physicians coming to US for their postgraduate training (under State Dept. emergency visa rules for healthcare workers during COVID19), despite closure. Advocacy Committee set up a WhatsApp group of these young physicians requiring US visa going so that communication could be efficiently done. Very quickly 214 physicians joined the group and we started working on all the different steps from PMDC verification (PMC and PMDC dispute was in Pakistani courts), ECFMG to accept the verification of their degree, delays in receiving the DS19 from ECFMG by mail, educating the young physicians on the emergency visa interview process at US embassy, to even working on special flights to bring them to US while the routine air travel was suspended.

I am very grateful to Honorable Paul Jones, US Ambassador in Pakistan and Berenice Mariscal, Visa section leader, who not only arranged timely emergency interviews for these young doctors with a skeleton staff in Pakistan but worked with us in real time to accommodate all 200+ for interviews. Most of these young physicians have trickled into US, as and when air travel has been allowed. It has not been an easy journey. The new Presidential proclamation on

immigration has created hurdles for the last few young physicians trying to get H1 visas. Many of the physicians who had their visa application in administrative review are getting their visas, with the active help of our Advocacy Committee with US officials.

My heartfelt thanks also to Pakistani officials for all their help in removing hurdles for these young physicians under difficult COVID19 conditions, including Dr. Zafar Mirza, Federal Minister of Health, Dr. Tariq Banuri, Chairman of Higher Education Commission, Dr. Nausherwan Burki and Dr. Faisal Sultan of PM Healthcare Taskforce, and Pakistan Ambassador in US, Dr. Asad Majeed Khan.

This year’s journey has been like the board game “snakes and ladders” but our in-coming residents have made it to the end with a lot of effective APPNA advocacy. 2021 is already

bringing up unique issue with the suspension of some USMLE tests, putting even residency interviews in doubt. Our Advocacy Committee and I have more work ahead as we engage with ECFMG and Pakistan officials to help residents even qualify for match interviews. My thanks to our Advocacy Chair, Dr. Abdul Rashid Piracha and all our Committee members for their selfless work for these future APPNA members.

Joining my residency this year on time was real farfetched amidst this COVOD-19 pandemic .

We were completely hopeless during those global crisis and unprecedented times.

APPNA played huge role in advocating for young physicians from reasoning with PMDC and ministry of health to issue us SON as soon as possible, to negotiating with US embassies in Pakistan for emergency visa appointments.

APPNA made a platform to track record of documentation process and visa activities of all Pakistani candidates and list used to get updated regularly.

Not only I could join my residency on time, but I also made it to orientations in my program , a week prior to my actual date of joining.

There were many candidates from Asia in my program and some other programs, who were struggling with documentation and Visa process due to lack of strong alumina and they could not join on time. Infact some people are still left behind.

Thank you APPNA and Dr. Naheed Usmani for your efforts.

Farukhuddin, MD
Resident Internal Medicine
Lincoln Medical & Mental Health Center, NYC

I was born in Afghanistan and grown as a refugee in Pakistan. As a foreign citizen, I could never apply for a government seat in a medical school in Pakistan. We went back to Afghanistan in 2009 due to financial issues. My father could never afford to pay for a private medical school in Pakistan. Alhamdulillah, I got selected for a full grade scholarship for a private medical school in Pakistan.

My dream to take USMLE started in the very first year. I used to study bits and pieces of USMLE till the final year when l actually started the real preparation. Long story short, I started my USMLE preparation in 2017 and applied for match in 2019. The match was the most distressing time for me. I would have a month or 40 days when I didn’t get any email for an interview call. But, with God’s grace, I got 9 calls all over and got matched into Internal Medicine. In March my dream came to reality. I am a resident physician in one of the best countries in the world. I thought there won’t be any more stress. No more financial issues.

But, then comes corona. The monster that would destroy all my dreams in seconds. The United States closes all its embassies. They ban all foreign travelers and issuing any visas except the emergency J1 for healthcare workers. I was the only one from my country to get selected for a J1 alien physician category. I didn’t have any voice. I contacted the US embassy in my country multiple times but they didn’t understand my situation. They even hung up the phone once. This was the most stressful time in my life. I felt like I didn’t have any option left. My friends advised me to contact the president of All Pakistani Physicians of North America (APPNA). I can’t imagine the tremendous amount of help I received from the APPNA president “Dr. Naheed Usmani”. She would really spend the time to send me big emails about her communication with the US contacts. Even after her contact, the US embassy in Afghanistan denied to give me an appointment. But, she kept on looking for options. She even wanted to help me get to Pakistan. But, the borders were closed and I couldn’t make it there. I kept receiving emails from my program about my presence in the hospital. I was almost on the verge of giving up when I was able to travel to Pakistan and get an appointment. I reached Pakistan on June 21 and June 22 comes the announcement from the Department of State that bans all the J1 and H1b from entering the United States. Because of this proclamation, my visa went into administrative processing. I have never felt this unlucky ever in my life. But, APPNA helped me in this matter as well and cleared my process on time. I don’t know how to pay them back beside being thankful.

I would like to add up; my father didn’t have a penny when I started my preparation. My USMLE exam fee, he used to borrow from friends, and then he would pay back in pieces. But, I never stopped dreaming. I was always positive. There is a saying by RUMI “when you walk on the way, the way appears”. You just need to take a step at a time and Allah will make everything easy for you. I found some wonderful people in the United States who didn’t even know and helped me tremendously. I stayed with people who gave me accommodation and didn’t charge me any money. I met doctors, who used to buy me plane tickets which I couldn’t afford. I never looked back. So money should never be an excuse. If you dream it, you can do it.

All I want to say, life is full of struggles. It never ends at achieving your dreams. You have to be hard and stiff. Struggles are what makes you a strong person. You have to take every step positively. I see back and feel that the struggles I faced made me better and strong than ever before. I am a resident

physician now, but the struggles still go on. You got to strive to be a better doctor. And, Never stop asking for help from others. It would never hurt. Always help others whenever you can.

Best Regards,
Haris Asif

Respected Dr. Naheed Usmani. During these unpredictable times, APPNA helped us all the matched applicants to reach in time to persue thier career goals. Starting from obtaining statement of need when Ministry of Health, Pakistan and Pakistan Medical and Dental council suspended thier operations was a difficult task. APPNA helped us in acquisition of this document and streamed-lined the process process by talking to officials. Then the appointments at US consulate Pakistan and contacting ECFMG to expedite sponsorship process was a huge favor. Even scheduling issues were dealt with so professionally. And then APPNA arranged flights and provided assistance with administrative processing of Visa. I can speak for myself and for my colleagues that APPNA helped us every step of the way to make this process as comfortable as possible for young graduates. We are highly indebted for these efforts.

My visa processing journey was no different than any other IMG, as I got matched in March and got my contract, the main issue was the SON. APPNA helped right from the day we matched. They made sure that we get our SON processed very quickly during that difficult time of lockdown. Then they helped by convincing US embassy to accept our emergency @ppointments and day by day updated through messages on WhatsApp, spreadsheets and emails. It was a big relief seeing such massive support by Appna during challenging time of pandemic and my last trimester.As I got my DS 2019, me and my husband applied for appointment at Islamabad embassy that was approved quickly. We got our visas on 29 May.Seeing APPNA members helping everyone including those whose visas went in administrative processing was so  strengthening to me. MAY Allah bless Appna a lot for their sincere efforts.

In these unprecedented times, there was little hope that anyone manages to complete documents for visa processing let alone fly to the USA in order to begin residency on time. APPNA being proactive, not only provided step by step guidance at each part of the application process but also went beyond to ensure that we all reach the USA safe and begin our residency career on time for which we all have strived for years to come this far. I am grateful to APPNA for making this happen and for being there when we needed you the most. Thank you.

The 2020 match process was fascinating to me. I matched into one of the renowned programs in US during my second match cycle. But it wasn’t easy as it came at the cost of Covid 19 Pandemic. There came a point where it felt almost impossible to me to start my residency on time due to Global crisis. APPNA then played a role of limelight for me. APPNA Advocacy Committee put in good words for my visa interview and my visa was approved within no time. I’m glad that our association has been there for me at these times of need. I look forward to help others being a part of APPNA as I was helped during these times, if provided an opportunity.

Dr. Ali Raza Talpur
Psychiatry Resident,, University of Louisville