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A Bitter Pill : Foreign-Born, Foreign-Trained Latino Doctors Frustrated by Barriers to Practicing Medicine Here


What if you're Rigoberto Flores Garcia from Puebla, Mexico, and you have dreams of nice homes and new cars?

You come across the border into Southern California with $500 in your pocket and start a succession of low-paying jobs. First you scrub pots and pans at a Carl's Jr. in Los Angeles. Then you try waiting tables at a Mexican restaurant. You switch to flipping burgers for a living. Finally you lose that job.

Typical immigrant pipe dream gone sour? Well, this 34-year-old newcomer happens to be Doctor Flores, a licensed Mexican physician who once delivered 12 babies in one night.

"It was my dream and my mother's dream that I become a physician," Flores said. "I didn't know it would be this difficult, or this expensive."

Flores and hundreds of other highly educated Latinos living here--some without legal immigration status--are finding themselves in economic limbo after spending years earning medical degrees. They left Mexico or other Central American countries fed up with their governments' chaotic economies and low wages, and now they find themselves among Southern California's unemployed or underemployed because they lack the language skills and the money to take courses and exams necessary to obtain licensing here.

"My God, we keep hearing about the lack of Latino doctors in this country for our Spanish-speaking communities and here Flores was washing dishes for a living," said Enrique Zuniga, a bilingual counselor at Fullerton College.

Zuniga and counselors from other Southern California colleges are trying to create inexpensive English courses for Latino doctors that concentrate on medical terminology.

He also helped organize a group called the Consortium of Physicians from Latin American, which now includes more than 35 doctors from Los Angeles and Orange counties. The group hopes to help raise scholarship money for foreign doctors, and help with post-graduate programs.

"We need any kind of help right now," Zuniga said. "Money or leads for jobs that some of the doctors can get, such as health assistants, to keep them from abandoning their plans."

Jorge Lopez Espana, 33, graduated from the medical school at the University de San Carlos in Guatemala, where he was ranked 86th out of 500 students. At the Hospital at San Juan de Dios near Guatemala City, he performed appendectomies, removed bullets, delivered babies, and conducted autopsies.

Today, he is a health educator handing out brochures and conducting AIDS awareness seminars at a Latino community center in Santa Ana. He's one of the fortunate--he has a job in a health-related field.

Alfonso Sandoval, 33, who practiced two years after graduating from the medical school at the University of Morelia in southern Mexico, is now driving a vegetable truck for an Anaheim company.

The problem is that foreign-trained doctors must climb through a maze of state Medical Board restrictions that can take three to five years, and sometimes longer, to complete and can cost thousands of dollars.

In addition, these doctors, who must support themselves and their families, are finding the transition from Third World economy to Southern California's full-throttle materialism very tough.

For example, Sandoval earns $7.50 an hour driving a truck. His wife, Carolina, who was a third-year medical student in Morelia when they met, later became a physician and worked for a company specializing in medical examinations. She now works in an Anaheim assembly plant making aircraft parts for $6 an hour.

"Our biggest problem right now is keeping ourselves motivated and learning English so that we can fill out the applications for the medical exams and become licensed physicians here," Alfonso Sandoval said.

The couple said they took university English courses in Mexico to help prepare for the United States, "but the reality of it is, you don't learn everything from books. Our English courses were quite different from how English is spoken here," said Carolina.

"We had no idea it was going to be this tough to live here," she added.

Rolando Castillo, an assistant clinical professor of medicine at the medical school at UC Irvine, said many of the medical newcomers come unprepared.

"They arrive in Southern California with absolutely no orientation about what to expect or what they should do," he said.

Castillo charged that the medical establishment, by making the licensing procedure for foreign doctors so long and difficult and expensive (preparatory courses can cost as much as $5,000) is trying to keep newcomers out because they fear the competition.

"We have a very closed system for doctors in this country," Castillo said.

However, officials from the Medical Board of California (formerly the state Board of Medical Quality Assurance) disagreed. They contended the board does not discriminate, and noted that about one-fourth of the licenses issued last year went to foreign-trained doctors. About 25% of the state's 69,000 licensed physicians are foreign-trained, they said.

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