Foreign doctors lured by Maine’s need, way of life

Maine ranks among the least culturally diverse states in the nation, according to census data. Yet here in the Bangor area, there’s a medical melting pot of physicians from other countries, including the four profiled here.

Of the roughly 3,000 doctors practicing in Maine, several hundred are foreign-born, according to the Maine Medical Association. They practice in specialties ranging from radiology to intensive care to neurosurgery, but many also are filling front-line roles in providing primary care to Maine residents.

Job openings for physicians in northern and eastern areas of the state, where it’s harder to attract health care professionals, are the most likely to be filled by foreign-born doctors, according to the medical association. Some are working off temporary obligations to practice in such medically underserved areas, but others have settled in and become permanent residents of the communities they serve.

According to Charles Dwyer in Maine’s Office of Rural Health and Primary Care, Maine has participated in the federal J-1 visa waiver program since 1997. The waiver allows newly minted doctors to stay in the United States after they finish their education instead of returning to their countries of origin, providing they spend three years working in a medically underserved area of the U.S. At any given time, a participating state can have as many as 30 J-1 doctors, educated and trained in American institutions, practicing at pre-qualified sites.

As of 2006, 83 primary care physicians and 72 specialists had been recruited to Maine through the J-1 visa program, Dwyer said. Most have stayed in Maine beyond their three-year service contract, and about half of these have continued to practice in the same community where they were first hired.

Dwyer said J-1s are a valuable resource in Maine and other states where it’s hard to attract and retain enough doctors to meet the needs of the population.

For the doctors, the experience of moving to a small community in rural Maine can “run the gamut,” he said. Although his office doesn’t officially track the J-1s once they’re hired, Dwyer said he gets some anecdotal feedback.

“I hear from some doctors that it’s a tremendously positive experience, that they’ve found a community they fit into comfortably, the schools are good and it’s a safe place to raise their families,” he said.

Dwyer said he has heard only a few negative reports of doctors being treated with suspicion or disrespect because they’re from a different culture. For the most part, he said, any initial mistrust or misunderstandings are soon resolved.

Foreign-born physicians choose the Bangor area for pretty much the same reason other people do, according to Ann Homola, who recruits doctors for Eastern Maine Medical Center in Bangor. Dozens of foreign-born physicians are now living and practicing in the immediate Bangor area, she said.

“They’re looking for a mid-sized city without a lot of crime, without a lot of traffic, with good schools,” she said. Doctors are often surprised when they come for an interview, she said, to find that EMMC is as big and as medically sophisticated as it is and that the area has a robust population, an active arts community, easy access to higher education, and good shopping. They appreciate the natural beauty of the region as well as the proximity of the University of Maine and the educational and cultural opportunities it offers.

Homola said some foreign doctors and their families have important dietary restrictions, religious beliefs and educational needs. Most of these interests can be accommodated in the area, she said.

For example, Homola said, some Jewish families need to know that kosher meats are available in local markets. People caring for special-needs children want information about the educational services available in the area. Muslim candidates are typically pleased to learn of the presence of a mosque in Orono. For many, Homola said, the nearby University of Maine provides an important connection to other families from their own cultures, as well as a variety professional opportunities for spouses.

Homola pointed out that many doctors who come here from other countries have to repeat portions of their training in the U.S. They must become familiar with the seemingly nonsensical intricacies of the U.S. health care system. They often face significant language and cultural barriers as well as the bewildering requirements of the immigration bureaucracy. Homes, families and familiar landscapes are often left far behind.

“I’m always impressed at how much they love their profession to take all the steps they need to in order to practice in this country,” Homola said. “But those of us who have been their patients are awfully glad they did.”