Dr. Alaa Al Nofal operates a pediatrics practice in Sioux Falls, South Dakota, where he sees around 10 patients per day. Some of his patients have been under his care since birth, while others continue to receive treatment even after graduating high school. Dr. Al Nofal specializes in treating Type 1 diabetes, thyroid problems, thyroid cancer, puberty disorders, and adrenal gland diseases. His expertise is crucial, considering that he is one of only five full-time pediatric endocrinologists in a 150,000 square-mile area covering both South and North Dakota. Unfortunately, like many rural areas in America, this region is experiencing a shortage of doctors. Sanford Health, a non-profit healthcare system based in Sioux Falls, operates 300 hospitals and clinics in predominantly rural communities and considers Dr. Al Nofal and other doctors like him to be invaluable assets. However, due to the recent immigration ban, Sanford Health risks losing Dr. Al Nofal and several other doctors who are vital to their healthcare network. Dr. Al Nofal is originally from Syria and is in Sioux Falls under a special visa program called the Conrad 30 visa waiver. This program allows doctors who complete their residency on a J-1 exchange visitor visa to stay in the US for up to three years as long as they commit to practicing in areas with doctor shortages. However, the recent executive order on immigration has left Dr. Al Nofal uncertain about his future in America. He expresses concerns that doctors from countries affected by the ban may no longer want to practice in the US, thereby exacerbating the existing doctor shortage issue in rural and underserved areas. The Conrad 30 program has brought 15,000 foreign physicians into underserved communities over the past 15 years, and Sanford Health currently has 75 physicians under this visa waiver program, with seven from the countries listed in the executive order. Losing doctors like Dr. Al Nofal and the others on J-1 visas would make it even more challenging to provide healthcare access to rural families. Furthermore, the ban could also negatively impact the pipeline of new doctors. The Conrad 30 visa waiver program relies on medical school graduates with J-1 visas who have completed their residencies in the US. Approximately 6,000 medical trainees from foreign countries enroll in US residency programs through J-1 visas each year, with around 1,000 of them from the countries affected by the ban. Those who were out of the country when the ban was put into effect are currently prohibited from entering the US, hindering their ability to continue or complete their medical education. The stress and uncertainty caused by the executive order could have long-lasting effects, with fewer physicians choosing US training programs and exacerbating the shortage of healthcare providers in underserved and rural areas. Dr. Al Nofal, who studied in Damascus, Syria, and completed his residency in the US, is serving over 400 pediatric patients a month on average. Although he finds the work challenging, particularly in South Dakota’s harsh winters, he is devoted to helping people and takes pride in his profession. However, the visa ban has taken a toll on him and his American wife Alyssa as they are unable to travel to Syria or have their family visit them in the US. Dr. Al Nofal fears leaving the country as he may not be able to return, and he also worries about how he will be treated even when traveling within the US. Another affected physician, Almatmed Abdelsalam, who is from Libya, had plans to start practicing as a family physician in Macon, Georgia, after completing his residency but may face delays due to the immigration ban. Abdelsalam acknowledges the need for national security but emphasizes the importance of keeping the country healthy as well. Physicians like him, who have been trained in the US, are assets rather than liabilities.
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