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Medical Students in Limbo as Young Immigrant Program Ends

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Zarna Patel poses for a portrait at the Loyola University Medical
Zarna Patel poses for a portrait at the Loyola University Medical School in Maywood, Ill, Patel, a third year student

Chicago, October 21: Medical students such as Alejandra Duran  Arreola are trying to shape the debate, and they have the backing of influential medical groups, including the American Medical Association.

Arreola dreams of becoming an OB-GYN in her home state of Georgia, where there’s a shortage of doctors and one of the highest maternal mortality rates in the U.S.

But the 26-year-old Mexican immigrant’s goal is now trapped in the debate over a program protecting hundreds of thousands of immigrants like her from deportation. Whether she becomes a doctor depends on whether Congress finds an alternative to the Deferred Action for Childhood Arrivals program that President Donald Trump phased out last month.

Arreola, who was brought to the U.S. illegally at age 14, is among about 100 medical students nationwide who are enrolled in DACA, and many have become a powerful voice in the immigration debate. Their stories have resonated with leaders in Washington. Having excelled in school and gained admission into competitive medical schools, they’re on the verge of starting residencies to treat patients, a move experts say could help address the nation’s worsening doctor shortage.

“It’s mostly a tragedy of wasted talent and resources,” said Mark Kuczewski, who leads the medical education department at Loyola University’s medical school, where Arreola is in her second year. “Our country will have said, ‘You cannot go treat patients.’”

The Chicago-area medical school was the first to openly accept DACA students and has the largest concentration nationwide at 32. California and New York also have significant populations, according to the Association of American Medical Colleges.

DACA gives protection to about 800,000 immigrants who were brought to the U.S. as children and who otherwise would lack legal permission to be in the country. The immigrants must meet strict criteria to receive two-year permits that shield them from deportation and allow them to work.

Then-President Barack Obama created DACA in 2012. Critics call it an illegal amnesty program that is taking jobs from U.S. citizens. In rescinding it last month, Trump gave lawmakers until March to come up with a replacement.

Public support for DACA is wide. A recent poll by The Associated Press-NORC Center for Public Affairs Research showed that just 1 in 5 Americans want to deport DACA recipients.

Arreola took a break from her studies last month to travel to Washington with fellow Loyola medical students and DACA recipient Cesar Montelongo Hernandez to talk to stakeholders. In their meetings with lawmakers, they framed the program as a medical necessity but also want a solution for others with DACA.

A 2017 report by the Association of American Medical Colleges predicts a shortfall of between about 35,000 and 83,000 doctors in 2025. That shortage is expected to increase with population growth and aging.

Hernandez, a 28-year-old from Mexico simultaneously pursuing a Ph.D., wants to focus his research on early detection of diseases. His work permit expires next September, and he’s worried he won’t qualify for scientific research funding without the program.

“I’ve shown I deserve to be here,” said Hernandez, who met with Illinois Sen. Dick Durbin, a Democrat who’s called for Congress to quickly pass a replacement for DACA.

For Arreola it’s about returning to the state she’s called home since she was 14 and giving back to areas in need of doctors.

“My family is from there; I know those people,” Arreola said. “Those are the people that inspired to really give this a push.”

Among those Arreola met with were policy staff for Georgia Republican Sen. Johnny Isakson, who believes the Obama program was “an overreach of executive power” but also wants Congress to write a plan to protect DACA recipients.

Medical school administrators say the immigrant medical students stand out even among their accomplished peers: They’re often bilingual and bicultural, have overcome adversity and are more likely to work with underserved populations or rural areas.

“They come with a cultural competency for how to best treat the individuals from their background, whether immigrants or different races and ethnicities,” said Matthew Shick, a government relations director for the Association of American Medical Colleges. “That gets translated over to their peers in education and training.”

Zarna Patel, 24, is a third-year student at Loyola who was brought to the U.S. from India as a 3-year-old without any legal documents. Her DACA permit expires in January, and she’s trying to renew it so she can continue medical school rotations that require clinical work. If she’s able to work in U.S., Patel will work in disadvantaged areas of Illinois for four years, part of her agreement to get school loans.

“Growing up, I didn’t have insurance,” she said. “I knew what that felt like, being locked out of the whole system.”

For others, there’s added worry of being stuck with debt they can’t repay.

Marcela Zhou, who was born in Mexico after her family moved there from China, is in her third year at the University of California at Los Angeles’ medical school. She wants to work in public health.

“Can I even afford to finish medical school?” said Zhou, who was 12 when she came to the U.S. on a visitor visa that eventually expired. “It’s sort of hard sometimes to keep going.”(VOA)

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Border Security Bill: Debate Furies Over U.S. Presidential “Emergency Powers”

Well it's clear one side is losing and that's the American public, and particularly the hundreds of thousands of federal workers who are not being paid or who are not going to work. In terms of the political actors, you know, the polling that we have suggests that most Americans blame President Trump for the shutdown.

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A U.S. Border Patrol agent rides a vehicle on the beach in San Diego, Jan. 9, 2019, seen through the border wall from Tijuana, Mexico. VOA

U.S. President Donald Trump will sign a border security bill, averting a government shutdown on Friday, but plans to formally declare the southern U.S. border a “national emergency,” Senate Majority Leader Mitch McConnell said Thursday.

The declaration would clear the way for Trump to authorize new funding for a permanent physical barrier. The move would end contentious negotiations with Congress over funding for the wall, but some legal analysts worry it will set a dangerous precedent for presidents trying to negotiate with Congress.

In January, during a 35-day partial government shutdown caused by a dispute over border wall funding, VOA spoke with John Hudak, deputy director of the Center for Effective Public Management at The Brooking Institute, about the legal issues around a possible emergency declaration by the president.

QUESTION: What powers does a president have to declare a national emergency? Could he simply order government funds to be used to build a border wall?

So there are really two questions here. First, under the national emergencies act, the president has a fairly broad power to declare a national emergency. Now the declaration of that emergency is simply that — a declaration. And according to a pretty firm reading of that law, it’s hard to see where there is an exception to the president’s ability to do it.

Donald Trump
In terms of the political actors, you know, the polling that we have suggests that most Americans blame President Trump for the shutdown. Pixabay

The next part of that, though, involves the powers that the president can exercise under that law and there are obvious limitations on that, constitutional limitations and other limitations within the law that the president can’t violate. And unfortunately, or perhaps fortunately, we haven’t experienced serious questions about presidential power in this space. So it’s really left as an open question right now, in terms of the extent of presidential power that courts will need to sort out.

Q: Could Democrats block this in Congress? Is there any constitutional precedent for presidents simply going around Congress to fund a priority policy item?

So there is, within the law, the ability of Congress to stop a national emergency. It requires both houses of Congress to vote to say that the national emergency is over. Now democrats can certainly do that alone, in the House. They cannot, however, do it alone in the Senate, it would require several Republican votes.

However, this is the type of exercise of executive power that leaves a lot of Republicans uneasy. And you’re already starting to see those conversations among Senate Republicans, saying that if we’re all right with President Trump doing this over a border wall, would we also be all right with a Democratic president doing this over climate change or other issues?

And so I think it remains to be seen whether Congress will have the votes to stop presidential action in this area, whether they’ll have the political will to do it. But they certainly have the power to stop this type of behavior.

To the second part of your question, you know, presidents have tried to go around Congress in terms of spending money in the past or even moving money around within or across budget lines or accounts in the past.

And frequently presidents are stopped because the spending power in the constitution rests with the Congress and so this creates a real challenge for President Trump if he wants to start moving funds or re-appropriating funds or using funds that are not even appropriated, pushing up against that constitutional protection against that power. So he might have the power to declare a national emergency, but he cannot usurp the Constitution in the exercise of powers during that emergency.

The entrance to the Smithsonian's National Gallery of Art is padlocked as a partial government shutdown continues, in Washington, U.S., Jan. 7, 2019.
The entrance to the Smithsonian’s National Gallery of Art is padlocked as a partial government shutdown continues, in Washington, U.S., Jan. 7, 2019. VOA

Q: On the politics of the current shutdown, is one side or the other winning? Which sides appears to have an advantage at the moment? How does it end?

Well it’s clear one side is losing and that’s the American public, and particularly the hundreds of thousands of federal workers who are not being paid or who are not going to work. In terms of the political actors, you know, the polling that we have suggests that most Americans blame President Trump for the shutdown.

Also Read: Is 2020 U.S. Presidential Election Going To Be The Costliest In History?

A smaller percentage of Americans blame congressional Democrats and smaller still blame congressional Republicans. I think a lot of Americans look at this skeptically and say, “What has changed between the beginning of the president’s term and now that makes this such a dire emergency?” And I think it leaves a lot of Americans scratching their head. President Trump is playing to his base here, but unfortunately his base is a small percentage of the population. And most of the rest of the population is not with him on this issue of the wall. (VOA)