AAIM Statement on the Executive Order on Immigration

February 2, 2017

As a result of the recent Executive Order on immigration, members of the Alliance for Academic Internal Medicine, the largest association of faculty and staff in departments of internal medicine in medical schools and teaching hospitals in the United States, are now acutely faced with consequences that negatively impact what we do daily: care for and care about patients and train physicians who will continue our strong tradition of providing professional, compassionate, and holistic care to all.

Much of medical education entails service learning -- basically on-the-job training. Thus, learners at all levels provide large amounts of patient care; a disproportionate amount of this care in teaching health systems is delivered to the underserved. Since approximately one-half of internal medicine residents are international medical graduates, including a number who are citizens of the countries targeted in the Executive Order, one clear effect will be to compromise patient care in US teaching health systems. Let us be clear that this order translates to potentially preventable suffering and death for patients in affected organizations.

The integrity of educational programs at all levels is threatened by the Executive Order. The opportunity to attract the best and brightest learners from other countries benefits patients in the United States as well as contributes to improvement in the quality of care in other countries when these new physicians return home. Jeopardizing this positive dynamic is most unwise and counterproductive to both American and international educational and medical interests. In addition to providing direct patient care, many individuals hailing from countries targeted by the executive order contribute to our research mission as learners, collaborators, and scientists. The order presents an immense obstruction to research and threatens team-based research efforts.

The young people we nurture to become care-giving professionals are being denied the opportunity to follow their dreams both in the United States and abroad, which is not only distressing but also discriminatory. In the context of a shortage of physicians in the United States, the health of our country depends on the availability of talented trainees from outside our borders. In addition, our ability to collaborate with physicians and scientists around the world to improve the health of our global population will be compromised.

The Alliance for Academic Internal Medicine believes the fundamental values of the United States of America include providing opportunity, celebrating diversity, and believing in the basic goodness of individuals and of the human spirit. Internal medicine is committed to professionalism's expectation of placing service to others above one’s own needs. The Alliance condemns the adverse effects of this Executive Order on our community of internal medicine educators, scientists, and scholars.

Sara B. Fazio, MD Craig Brater

Sara B. Fazio, MD, Chair, AAIM Board of Directors | D. Craig Brater, MD, AAIM President

The Alliance for Academic Internal Medicine is the consortium of five academically focused specialty organizations representing department chairs and chiefs; clerkship, residency, and fellowship program directors; division chiefs; and academic and business administrators as well as other faculty and staff in departments of internal medicine and their divisions. at medical schools and teaching hospitals in the United States and Canada. The Alliance empowers academic internal medicine professionals and enhances health care through professional development, research, and advocacy.

AAIM Reviewing New Executive Order on Immigration

A Message from AAIM President D. Craig Brater, MD

Dear Colleagues:

AAIM is reviewing the new Executive Order on Immigration. It differs from the prior executive order in several ways that are relevant to the Alliance community. First, it is more welcoming of individuals from Iraq. Second, there is a provision that allows discretionary latitude if "the foreign national seeks to enter the United States for significant business or professional obligations and the denial of entry during the suspension period would impair those obligations." Theoretically, you could argue that an individual who has matched to one of our programs could be granted a waiver and be "processed" for a visa before the 90-day ban has been lifted (assuming it will be lifted). However, you would be in the position of arguing that a resident met this waiver requirement and there is no way to predict whether immigration authorities will be receptive to this argument. For our constituency, this new executive order varies little from the prior executive order that AAIM condemned. ACP has released a statement with similar conclusions. AAIM is in contact with ECFMG and will pass along their thoughts. In addition, remember that senior ECFMG officers will be attending Academic Internal Medicine Week 2017 to give us the latest information they have.

Another immigration change relative to H-1 visas has also been just released. On Friday, March 3, the US Citizenship and Immigration Services issued a press release indicating it will suspend premium processing of all H-1B petitions effective April 3, 2017, for up to six months. This change has important implications for individuals who wish to transfer their H-1b visas. Residents who are applying to extend their H-1B visas for the last six weeks of their training and are using the expedited process should file before the April 3 deadline, as this program would be discontinued in a few weeks.

The Alliance is monitoring these situations and will report information to the community in a timely manner.


D. Craig Brater, MD AAIM President

D. Craig Brater, MD
AAIM President

AAIM Prepares to Address Executive Order on Immigration

January 27, 2018

Dear Colleagues:

We are all reeling from the recently released Executive Order on immigration. I will offer my personal feeling that I think this is abominable from the perspective of what I believe our country represents. There is also the obvious in terms of how adversely it will affect our medical students and internal medicine residency programs, not to mention the talented faculty and staff who are personally affected. We need to think about this from two perspectives. One is the short term of making sure that all our members have accurate information. The other is more long term; namely, what position should we take and how do we best make certain that position is most effective. We have already made contact with most of our stakeholder partners to see where they stand and how we may collaborate. The AAIM leadership is also considering what to do in concert with our partners in the Internal Medicine Education Advisory Board.

At a human level, something like this always provokes an emotional response, myself included. Not all will agree with my own response, but all the email traffic in our internal medicine community I have seen suggests my perspective is generally shared. It is important that we channel that rage in as constructive a fashion as possible. First, we need to be pragmatic and focus on our trainees and our programs. To do so, we need accurate information. AAIM pledges to provide that; we plan to have a position statement available shortly. In parallel, we also pledge to do whatever we can to right this wrong.


D. Craig Brater, MD

D. Craig Brater, MD
AAIM President