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Acad Med. 2014 Dec;89(12):1593-8. doi: 10.1097/ACM.0000000000000399.

Medical education for "Dreamers": Barriers and opportunities for undocumented immigrants.

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Dr. Kuczewski is Fr. Michael I. English Professor of Medical Ethics, director, Neiswanger Institute for Bioethics and Health Policy, and chair, Department of Medical Education, Loyola University Chicago Stritch School of Medicine, Chicago, Illinois. Dr. Brubaker is dean and chief diversity officer and professor of obstetrics and gynecology and of urology, Loyola University Chicago Stritch School of Medicine, Chicago, Illinois.


Medical schools should amend their admissions policies to welcome applications from qualified undocumented immigrants, often called "Dreamers." The recent creation of the Deferred Action for Childhood Arrivals (DACA) program of the U.S. Citizenship and Immigration Service removes the key obstacles to securing a license and residency eligibility for such medical school graduates. As a result, to deny application to Dreamers of DACA status represents a kind of unjustified discrimination and violates the basic ethical principle of the equality of human beings. In addition, the medical profession's duty of beneficence to patients compels medical schools to develop the talents of any and all qualified applicants so as to produce the most competent, diverse physician workforce that best represents contemporary U.S. society. Furthermore, social justice calls for medical schools to produce physicians inclined to serve populations that have traditionally been underserved, including some minority and immigrant populations. An examination of the characteristics of those granted DACA status suggests that they are a potential source of future physicians likely to be helpful in addressing these needs. The authors of this Perspective discuss the remaining challenges facing Dreamers who want to attend medical school in the United States and possible means of overcoming these hurdles. The authors' views are based on principles of social justice, their recognition of the duty to treat Dreamer applicants fairly and justly, and their belief that physicians have an obligation primarily to the patients they serve that entails developing the best health care workforce possible.

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