The sun had already set in Ghana, but medical student Jeffery Owusu Boateng was wide awake, working the night shift in the gynecology department of a local hospital. During his shift, a woman was rushed through the door. She was disoriented and bloody, shivering in a cold sweat from a fever onset by infection that would quickly escalate to sepsis. Boateng remembers that despite her daze, she looked terrified. This woman was one of four who came in that night after botched at-home abortions. Two of the women died.
Since then, Boateng has sought training so that he is able to treat patients and advocate for systemic changes to keep people like those women safe and healthy.
“I know I have always wanted to achieve the best and highest form of education to be able to adequately equip me with the ability to improve health, especially among vulnerable populations,” said Boateng. “One of my driving motivations is the fact that there are still millions of people in unfavorable conditions, and the best I can do as an individual is to contribute to improving their health through research and clinical practice.”
In September of 2018, Boateng came to the U.S. on an F-1 visa, looking to expand on his existing research and clinical training.
But recently, the U.S. Department of Homeland Security proposed a rule change that could prevent Boateng from meeting those goals. The proposal would introduce a time limit on the authorized period of stay for F, J, and I nonimmigrants, a group that includes international students and scholars like Boateng. Legal experts and advocates say the proposal could potentially be the largest regulatory change for this demographic in 20 years.
The proposal seeks to eliminate the preexisting “Duration of Status” clause that allows individuals to reside in the U.S. for the duration of their degree or until they have fulfilled the requirements of their vocational position. The new proposal specifies that students, exchange visitors and media representatives may only stay in the U.S. for a maximum of four years. But people like Boateng seeking advanced degrees need several more years to complete their specialty training programs.
Boateng recently completed his master’s program in epidemiology and maternal and child health at Boston University School of Public Health. He now intends to begin a postgraduate residency program to specialize in pediatrics. This program would take three years to complete, followed by another three years of participation in a medical fellowship.
Many of the international students and scholars who would be affected by the DHS proposal, like Boateng, are medical professionals, critical personnel in healthcare facilities. In fact, according to the Educational Commission for Foreign Medical Graduates (ECFMG), the proposed rule change would disrupt patient care provided by approximately 12,000 foreign-trained physicians, including health care professionals working with COVID patients, as they pursue postdoctoral experience in hospitals across the U.S.
“If implemented, this will affect thousands of physicians who already have been thoroughly vetted and are serving in nearly 750 teaching hospitals across the nation,” said ECFMG president and CEO William W. Pinsky.
In defense of the proposal, DHS asserts that without a concrete time limit, there have been ongoing issues with students overstaying their visas. The proposed rule states that ICE officials are currently unable to track visa holders if they “are maintaining their status,” which “poses a challenge to the Department’s ability to effectively monitor and oversee these categories of nonimmigrants.”
The only way under this rule change that Boateng would be able to stay in the U.S. for the length of his training programs is if he can prove to DHS that the extension is justified by what the proposal refers to as “compelling academic reasons.” What qualifies as a “compelling academic reason” would allegedly be defined on a case-to-case basis by immigration officers.
“It presents an unwarranted, again misguided or uninformed, intrusion into academic decision-making,” said Miriam Feldblum, co-founder and executive director of the Presidents’ Alliance on Higher Education and Immigration. During the proposal’s 30-day comment period, the Presidents’ Alliance voiced a series of concerns regarding the rule change.
Despite vocal opposition from the Presidents’ Alliance, ECFMG and a number of other advocacy organizations, it is possible that the rule change will go into effect before President-elect Joe Biden takes office on January 20.
According to immigration lawyer Dan Berger, policy change proposals usually take several months to advance. But under the Trump administration, this process has been expedited on multiple different occasions. For example, on October 8, the Trump administration implemented a rule change that increased the required wage for employers to sponsor immigrant workers on H-1B visas. This change went into effect before the end of the mandatory public comment period, suddenly leaving many immigrant workers without sufficient sponsorships under the revised policy.
“In some cases, the Trump administration has implemented a regulation without changes shortly after the comment period. I think that is possible now,” explained Berger. “The administration probably wants to get as many regulations in place before Biden takes over.”
It is commonplace for administrations to push through as many policy changes as possible before the next president’s inauguration. Known as “midnight regulations,” these policy changes are usually symbolic of the outgoing administration’s policy priorities. But it is rare for one of these potential midnight regulations to have such immediate life-altering effects on such a large number of individuals.
“I am definitely worried about this,” said Boateng. “This will mean wasted years if I’m unable to complete my training, and even more worrying is not being able to achieve my goal of getting the best training to help my patients both here and in my home country.”
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