There’s an effort to bring more immigrants into medicine through the International Medical Graduates Program. International Institute of Minnesota enrolled its first participants at the end of last year.

“When this program got up and running again, I think some of the first feedback we got was there’s some hope finally people can resume their careers and resume their practice,” said Nicholas Bubak, the program coordinator. “Some people they were physicians for years, they moved here, and they’ve been working in fields and careers and odd jobs in some cases outside of medicine.”

As the coordinator of the International Medical Graduates career guidance program, he helps immigrants with resumes, applications and connecting with others in their field to get clinical experience, which will hopefully lead to acceptance into a residency program.

The program also provides financial support to pay for study materials, residency application fees and licensing exam fees.

There are 26 people currently enrolled from at least a dozen countries.

“Somalia, Iran, Scotland, Ecuador, China, Pakistan,” Bubak said. “We have clients who just finished medical school last year and moved to Minnesota shortly afterward. We have some clients who had 20, 30 years of very successful, prestigious careers in their home country.”

Dr. Sara Tarokh never had any doubt about pursuing a career in medicine while growing up in Iran.

“As far as I can remember from childhood, that’s what I wanted to be,” she said.

She spent three years as a family medicine physician in the suburbs of Tehran before moving to the United States to reunite with her family.

“You make this bond with people, you help them, you cure them, and it’s not just a physical curing, sometimes you psychologically cure them,” she said. “The smile on their face, it really makes their day. For me, it’s really helping, especially those who need it. In rural areas and in underprivileged areas who cannot afford or don’t have insurance, they’re the ones who really need help.”

Despite her experience, her journey to become a licensed doctor in Minnesota is still ongoing. It started in 2015 when she began taking the United States Medical Licensing Examination program tests. She explained she traveled to Pakistan, Dubai and Turkey to complete the first two steps.

“Due to the sanctions that my country has, we don’t have permit centers or test centers in my country,” said Dr. Tarokh.

Her goal was further delayed when President Donald Trump imposed a travel ban on Iran in 2017, which wasn’t lifted by President Joe Biden until 2021. Finally, in June 2022, she moved to Minnesota to continue her goal of practicing medicine in the U.S.

“After finishing Step 1 and Step 2 [exams] and all of the hurdles when I came to the U.S., they were asking me to do U.S. clinical experience,” Tarokh said. “I was literally begging doctors, ‘Can I shadow you? Can I come observe along with you?’ and not many people were willing to do that.”

Bubak explained immigrants leave their career networks in their home country, which can create challenges in America where clinical experience is necessary.

“In order to get into a residency program, what is necessary is having clinical experience and having patient-facing career experience,” he said. “We connect them with our hospital partners, our university partners to either to help them get a job right now, an entry-level job that’s unfortunately below their qualifications but still necessary to have that experience, or shadow opportunities that are in some cases volunteer experiences just to make sure they’re working in a clinical setting with patients.”

The program is funded by the state, with a goal of increasing access specifically to primary care in rural and underserved areas. According to a Minnesota Department of Health report from November, a third of rural doctors in Minnesota will retire in the next five years.

There’s expected to be a nationwide shortage of between 37,800 and 124,000 physicians by 2034, according to the Association of American Medical Colleges. The report explains 40% of active doctors are expected to be 65 years old or up in the next decade as the population and demand for health care grows.

“We’re in this situation where we do have a physician shortage, yet there are a lot of eager, well-skilled, highly qualified physicians who live in Minnesota,” Bubak said.

The Minnesota Legislature has funded an International Graduates Program since 2015, working with other organizations. Recently, there was a rebuilding period.

International Institute was selected for a two-year contract to administer the program, which started last summer.  

“The timing just seemed right,” said Brooke Anttila-Escoto, the IMG program manager at International Institute. “This fits into the larger work we’re doing, and we’re able to build on partnerships in the industry, in higher ed that we’ve established over the years.”

She explained International Institute has been providing training for nurses for years through its other programs.

“The institute has trained between 3,000 and 4,000 nursing assistants,” she said. “We’ve helped internationally trained and nurses trained in Minnesota upgrade their careers to RNs, LPNs and other professionals — around 700 individuals over the last 20 years as well.”

International Institute now expects to help 40 physicians over its two-year IMG grant.

“I think it’s been more successful than we anticipated,” Anttila-Escoto said about the progress so far.  “We’ve had clients get residency interviews and a couple attain residencies.”

For Tarokh, the program’s financial help has enabled her to keep studying for her final USMLE test. She was also able to land a spot in a family medicine residency in St. Cloud. She starts in mid-June.

“I never thought it would actually happen to be honest,” she said. “It was like a miracle. I was so happy. I was happy that finally I can enter a system where I’m actually wanted and I can continue my career. I can be what I love, and I can help other people as well.”

She hopes to pursue an OB-GYN fellowship after her residency.