When many doctors move to the U.S. from foreign countries in Central and South America, the Caribbean and elsewhere, they are forbidden from practicing medicine. In order to become certified as a doctor in the U.S., these foreign-born physicians must complete a residency and pass the medicine licensure examination. Based on their own family obligations, many are forced to take less qualified jobs as nurse’s assistants or phlebotomists, drawing blood, which are below their academic credentials.
Florida International University, a research university based in Miami, Florida, created a pro-gram, Foreign Educated Physicians to Bachelor of Science in Nursing and Master of Science in Nursing (BSN/MSN), that trains doctors to become nurse practitioners or registered nurses, drawing on their medical background and bilingual skills. The program enables them to stay in the medical field, earn a strong salary and assist patients.
Dr. Divina Grossman, a former dean at Florida International University (FIU), observed that the skills that many doctors had obtained in other countries were being wasted and lost. The program launched in 2001 and offered bachelor’s degrees for registered nurses but was expanded in 2010-11 to specialize in master’s degrees for nurse practitioners. The master’s program lasts eight semesters or three years, and the undergraduate program lasts five semesters or a year and a half.
The program attracts students with “an amazing background, including a significant knowledge base of medicine, patients and health care,” explained Maria Olenick, the chair of undergraduate nursing at FIU and its former director for three years. “Many of our students are looking for a second career option in healthcare,” she noted.
Since all students have already trained as physicians, they are older, with an average age of 40 years old. Moreover, it attracts more men into nursing; in fact, 50 percent of the students are men.
The program is full-time, though some students continue to work in part time jobs and earn money to meet family obligations. Many need to save enough money, work part-time or take out loans to afford the $41,000 a year tuition for state residents and $90,800 for non-residents.
Gaining acceptance into the program is extremely competitive. Olenick said about 400 students applied for the 50 openings in 2015-16, so 80 percent are rejected. Though Cuba and Haiti are the countries that produce the most students in the program, students hail from China, Czechoslovakia and more than 30 countries. Latinos comprise about 40 percent of all students.
To be accepted, students must present their translated transcripts from medical college, equivalent of a U.S. bachelor’s degree, and pass an English language exam or two English classes in the U.S. Their grades and academic performance are evaluated, and they are interviewed. “We’re looking for professionals who have a capacity to communicate in English, who have interest and motivation, and are ready to take the plunge into a full-time curriculum,” Olenick noted.
All 50 students are aiming for a master’s degree in nursing. The ones who stop at the bachelor’s degree level aren’t successful in the program or didn’t pass their registered nursing exam.
But don’t many students who are trained as physicians feel that becoming a nurse practitioner is below their status? Olenick acknowledged that some students can be disappointed and even angry at the outset.
“But most after a semester and a half turn around and say, ‘I didn’t want to do it, but now I love it,’’’ she said. Most are grateful at gaining a second chance at helping others in the healthcare field and expanding their knowledge into a new field.
Olenick said the first two years concentrate on undergraduate nursing and preparing students to pass the state board exam to become a registered nurse. The final year is the master’s portion where students prepare to become nurse practitioners and enhance their knowledge of advanced nursing and improve their prescriptive and diagnostic skills.
The program offers four specialties as nurse practitioners in: family, adult, pediatrics (18 years and younger) and psychiatric.
Many graduates of the program work in hospitals, clinics, school systems, wound care centers and medical specialties. Olenick said that the starting salary for nurse practitioners is $90,000, and obtaining a six-figure salary is not uncommon.
These FIU graduates are coveted by hospitals and other employers for several reasons. “These graduates are really doctors and nurses rolled into one. It’s like obtaining two specialties for the price of one,” explained Olenick, a native of Scranton, Pennsylvania.
Moreover, many graduates are bilingual, speaking Spanish and English, and some speak three to five languages. Speaking Spanish in Florida is clearly an advantage that helps graduates provide better patient care.
Erich Companioni, a Miami, Florida, resident and 44-year-old Cuban native who moved to the U.S. at age 13, gained his medical degree in the Dominican Republic. After passing the first of three medical boards, he got married and started to raise a family. He couldn’t afford to take time off for a residency program and instead opened a home health nursing company.
When he learned of the FIU program to train foreign-trained physicians, he saw it as a “great opportunity to become a nurse practitioner. It was closest to my dream,” he said. Once you immigrate to the U.S., he said, “You need to work to support a family.”
Learning to become a nurse practitioner is different from training to become a physician. Nurse practitioners “see patients in a holistic way. We take care of every single process and social issues. Physicians are more targeted in how they help people,” he said.
When he graduated in 2015 as a family nurse practitioner, he accepted a job in a radiation/oncology practice in Miami. His patients have cancer or terminal illnesses. “I’m helping patients not only from a medical point of view but giving them the support and guidance from day one of evaluation until they finish radiation,” he asserted.
Nurse practitioners who were trained as physicians are very marketable, Companioni explained. “The combination gives you more extensive knowledge than a regular nurse practitioner,” he observed.
Companioni is gratified being patient-centered and employing his medical skills. Some foreign-trained physicians could have a problem dealing with the “ego” issues of not being a doctor since in foreign countries, they’re viewed as gods. He said being a nurse practitioner is a “way of fulfilling his dream of helping people doing exactly what you’re training to do as a doctor with some limitations.”
Olenick sees the program as a win/win for graduates, the college and the healthcare system. It enhances diversity at FIU in several ways, “bringing different cultures and ethnic groups and bringing more men into nursing. It brings people with a background in medicine into nursing, and what can be better than that?