State of Hawaii v. Trump

Filing 198

MEMORANDUM re 65 MOTION for Temporary Restraining Order [MUSLIM ADVOCATES, AMERICAN MUSLIM HEALTH PROFESSIONALS, MUPPIES, INC., THE NATIONAL ARAB AMERICAN MEDICAL ASSOCIATION, AND NETWORK OF ARAB-AMERICAN PROFESSIONALS' BRIEF OF AMICI CURIAE IN SUPPORT OF PLAINTIFFS' MOTION FOR A TEMPORARY RESTRAINING ORDER], filed by American Muslim Health Professionals, Muppies, Inc., Muslim Advocates, Network of Arab-American Professionals, The National Arab American Medical Association. (Attachments: # 1 Declaration of Anton A. Ware, # 2 Exhibit 1 - Shutdown Press Release, # 3 Exhibit 2 - Anderson Cooper Interview, # 4 Exhibit 3 - State Rudy Guiliani, # 5 Exhibit 4 - Miller on Fox News, # 6 Exhibit 5 - WaPo Kansas Suspect, # 7 Exhibit 6 - Seattle Kent, # 8 Exhibit 7 - Fire store owner, # 9 Exhibit 8 - WaPo pipe attack, # 10 Exhibit 9 - Spate of mosque fires stretches across the country, # 11 Exhibit 10 - Politico absolute no choice but to close down mosques, # 12 Exhibit 11 - Georgetown Bridge Initiative Trump Cites Flowed Poll, # 13 Exhibit 12 - Republican Candidates Debate in North Charleston, South Carolina, # 14 Exhibit 13 - Transcript Donald Trump's national security speech, # 15 Exhibit 14 - 60 Minutes Trranscript, # 16 Exhibit 15 - Meet the Press, # 17 Exhibit 16 - Presidential Candidates Debates, # 18 Exhibit 17 - Christian Broadcasting Network, # 19 Exhibit 18 - Donald Trump on Twitter defends Muslim ban, calls work a 'horrible mess', # 20 Exhibit 19 - Pew Reseach Center 2016 Refugees, # 21 Exhibit 20 - DJT Tweet, # 22 Exhibit 21 - So called judge tweet, # 23 Exhibit 22 - See you in court tweet, # 24 Exhibit 23 - Sean Spicer press conference, # 25 Exhibit 24 - Stephen Miller key engineer, # 26 Exhibit 25 - Stephen Miller Islamofascism, # 27 Exhibit 26 - Pew Forum, # 28 Exhibit 27 - State Dept Country Report, # 29 Exhibit 28 - DHS, # 30 Exhibit 29 - DOJ Iraqi Kentucky, # 31 Exhibit 30 - Cato, # 32 Exhibit 31 - Lawfare, # 33 Exhibit 32 - Brennan Center, # 34 Exhibit 33 - Letter Former Officials on March 6 EO, # 35 Exhibit 34 - Trump delays new travel ban after well-reviewed speech - CNN Politics, # 36 Exhibit 35 - Families hoping to make the U.S., # 37 Exhibit 36 - Trump Muslim ban is tearing apart families, # 38 Exhibit 37 - Children and Refugees Who Planned Medical Care in the US Stuck After Trump Executive Order - Health News - ABC News Radio, # 39 Exhibit 38 - Trump's Travel Ban, Aimed at Terrorists, Has Blocked Doctors - The New York Times, # 40 Certificate of Service)(Kacprowski, Nickolas) Modified on docket title text on 3/14/2017 (ecs, ).

EXHIBIT 38

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Trump’s Travel Ban, Aimed at Terrorists, Has Blocked Doctors - The New York Times

https://nyti.ms/2kFkSza

HEALTH

Trump’s Travel Ban, Aimed at Terrorists,
Has Blocked Doctors
By DONALD G. McNEIL Jr. FEB. 6, 2017

The Trump administration has mounted a vigorous defense of its ban on travel from
seven majority-Muslim nations, saying it is necessary to prevent terrorists from
entering the United States. But the ban, now blocked by a federal judge, also
ensnared travelers important to the well-being of many Americans: doctors.
Foreign-born physicians have become crucial to the delivery of medical care in
the United States. They work in small towns where there are no other doctors, in
poor urban neighborhoods and in Veterans Affairs hospitals.
Forty-two percent of office visits in rural America are with foreign-born
physicians, according to the American Academy of Family Physicians.
Foreign-born physicians “are the doctors in small towns in Maine and Iowa,”
said Dr. Patricia F. Walker, the associate director of the University of Minnesota’s
Global Health Pathway, which helps refugee doctors practice in the United States.
“They go to the places where graduates of Harvard Medical School don’t want to go,”
she said.
Across the United States, more than 15,000 doctors are from the seven Muslimmajority countries covered by the travel ban, according to The Medicus Firm, a firm

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that recruits doctors for hard-to-fill jobs. That includes almost 9,000 from Iran,
almost 3,500 from Syria and more than 1,500 from Iraq.
Dr. Hooman Parsi, an oncologist so talented that he has an O-1 visa granted to
individuals with “extraordinary ability or achievement,” was to start seeing patients
on Wednesday in San Bernardino, Calif.
A federal judge in Seattle lifted the administration’s travel ban on Friday, and a
federal appeals court has declined to restore it. Yet Dr. Parsi is still stuck in Iran,
waiting for a delayed visa amid the confusion while his American employer fumes.
“We need him desperately,” said Dr. Richy Agajanian, the managing partner of
the Oncology Institute of Hope and Innovation, which had just hired him. “We had
an office completely constructed — we spent three months on it, and it was supposed
to open Feb. 1. Now we can’t open it. This is really sad and frustrating.”
The 30-doctor practice does a lot of work in the Inland Empire, in San
Bernardino and Riverside Counties, Dr. Agajanian noted. “It’s very sparse in doctors
out there — many miles between oncologists,” he said. “The patients he would be
seeing have to travel another 25 miles now. Our doctors are already overworked, and
now they’ll have to be on call more often.”
The United States has a persistent doctor shortage, even though 31 new medical
schools have opened since 2002 and many existing ones have increased class sizes,
according to Merritt Hawkins, a Dallas-based medical recruiting firm.
It also noted that there are 22 percent more residencies available each year than
there are American graduates to take them. Graduates of foreign medical schools
now fill that gap; the largest number come from India, followed by Pakistan, China,
the Philippines, Iran and Israel.
(Iran is on Mr. Trump’s exclusion list; Pakistan, a Muslim-majority country
with a history of internal and external terror attacks, is not.)
Many foreign graduates have J-1 visas, which give them about three years to
complete their residencies. “They must pass licensing exams and they must do a

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residency to practice here, even if they’re superstars where they come from,” said
Phillip Miller, a Merritt Hawkins spokesman.
Foreign-born graduates have often worked at world-class institutions and have
published academic papers, so they have higher average scores than American
graduates on the medical knowledge portions of the licensing examinations,
according to Merritt Hawkins research — though most initially score lower on the
clinical skills portions, which include English and communication skills.
“I had to work my butt off to get here,” said Dr. Abdelghani el Rafei, a first-year
resident at the University of Minnesota. “They only take the top graduates from
schools in countries like mine.”
Such foreign-born graduates must return home when their visas expire, but they
can get extensions if they agree to work in an area that the Department of Health
and Human Services considers “medically underserved,” which is roughly defined as
having less than one primary care doctor for every 3,000 people.
Those who practice in an underserved area for several years can apply for green
cards. “After that, they can practice anywhere, but at least you’ve had three or four
years of a physician in your town, and that’s pretty significant,” Mr. Miller said.
Citing figures from the Iowa Board of Medicine, The Des Moines Register
reported last week that 172 doctors practicing in Iowa were from the seven countries
subject to Mr. Trump’s travel ban, and that 23 percent of the state’s 13,000
practicing doctors were born outside the United States.
Andrea Clement, a spokeswoman for Medicus, said that 76 percent of the
foreign doctors it placed last year had gone to areas with fewer than 25,000 people
or to small to medium-size cities of 25,000 to 500,000.
It placed more foreign doctors in Wisconsin than in any other state, she said,
followed by California, Texas, Maryland, Oregon, Missouri, Tennessee, Ohio and
Arizona.
Some urban areas are medically underserved, too. While Manhattan’s Upper
East Side has five times the number of doctors it needs to be adequately served

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under federal guidelines, parts of the Bronx and Brooklyn have acute doctor
shortages.
More than 150,000 residents of Brooklyn’s Bedford-Stuyvesant section, for
example, are rated as medically underserved under federal guidelines. One of the
doctors stranded overseas last week, according to Pro Publica, was Dr. Kamal
Fadlalla, an internal medicine specialist from Sudan who is a second-year resident at
Interfaith Medical Center, which serves Bedford-Stuyvesant and Crown Heights.
Many foreign-born doctors, experts said, go into family medicine, pediatrics,
internal medicine, general surgery and other front-line specialties where they see
thousands of patients a year, including many on Medicare and Medicaid, rather than
pursuing lucrative urban specialties like plastic surgery.
As an oncologist, Dr. Parsi was an exception. He moved to the United States in
2007 for postdoctoral work in molecular biology. Then, after passing his medical
exam, he completed his residency at the University of Cincinnati and a fellowship in
hematology and oncology at the University of Pittsburgh Medical Center.
Because he had to leave the country to get his new visa stamped into his
passport, he had flown to Dubai, in the United Arab Emirates. He cleared a security
vetting there, he said, but had to wait a few days for the visa, so he flew to Tehran to
see his father.
But the new court ruling affects only those who had current visa stamps in their
passport, so even though he is being issued a new visa, he still cannot return to the
United States, he said on Saturday.
“Everyone, including me, would like to keep the bad people out,” said Dr.
Naeem Moulki, a Syrian citizen who is finishing his medical residency in
Minneapolis and plans to begin a cardiology fellowship in Chicago in the fall. “But
this is not the best way to do it. If I have to leave, it affects my patients.”
Dr. El Rafei said that the ban, which means he cannot go home to see his family,
had depressed him.

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“I felt like I was back in Syria again,” he said. “You feel hunted there, as if you
did something wrong, even if you didn’t. Now I feel the same way here.”
He sees patients one day a week at the V.A. Hospital in Minneapolis, where he is
sometimes asked where he is from.
“One of my patients, he was a veteran in his 60s, said to me, ‘Why do you people
hate us?’ ’’ he said. “I told him about Syria. I said: ‘We don’t hate you. The bad
people you see on TV are the same people who make us suffer, too.’ ”
“I love this country,” he added. “There’s a time in our residency when we can
work in Africa or someplace. I want to work in a small American town, to show
people that we’re not all bad. The U.S. gives us a lot, so we want to give back what we
can.”
Correction: February 6, 2017
An earlier version of this article misattributed a quotation about the preparation
necessary for a foreign doctor to get work in the United States. It was said by Dr.
Abdelghani el Rafei, a first-year resident at the University of Minnesota, not Dr. Naeem
Moulki, a Syrian citizen who is finishing his medical residency in Minneapolis.
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A version of this article appears in print on February 7, 2017, on Page A12 of the New York edition with the
headline: Travel Ban, Aimed at Terrorists, Touches Doctors in Hard-to-Fill Jobs.

© 2017 The New York Times Company

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