The Arab American Brain Drain of MDs and PhDs

The US and the Arab American Brain Drain

By: Dr. Hoda Z.M. Amer, co-founder, Treasurer of American Board Certified Doctors for Egypt (ABCDE) July 2025

My father immigrated to the US in the 1970’s. At the time, there was peak of Arab immigrants fleeing from a region devastated by numerous wars and political instability through the 60’s and 70’s. A large number of those Arab immigrants were doctors, engineers, or scientists, AKA “white collar” immigrants. They came to pursue the American Dream. The American Dream for people like them and my dad, may he rest in peace, was not about financial security, a nice house in the suburbs, a nice car. It wasn’t even about the disposable diapers that had made their debut in US markets a decade earlier. It was more than that. Their American Dream was to be able to think, explore, produce, work hard and to achieve their potential. It was a chance to delve into scientific concepts with resources they only dreamed of in their own countries. It was a chance to be rewarded for hard work, rather than reprimanded or taken down. It was a freedom of intelligent expression, debate, exploration. The American “Doctor’s” Dream for them was about scientific and medical aspirations and ambitions. The US was like no other country in that regard.

My father worked hard. Back then there were no 100-hour work day limits for residents and fellows, and he worked those hours diligently. The first medical journal article he published a few months before I was born was in an emerging field, the field of oncology. It collaborated with another emerging field, that of clinical neurophysiology. My father would go on to publish over 80 publications in the field of oncology over his lifetime. He was the 42^nd member of the American Association of Cancer Research (AACR), which now has over 50000 members worldwide.

His journey was not without challenges. My father’s immigrant background constantly made him feel that he should work harder than his non-immigrant counterparts, and he did. His colleagues would go home in the evening, he would stay long hours reviewing articles and newer treatment modalities. His colleagues would follow a 15-minute rule with patients, while he would stay up to the hour. His colleagues’ patient clinical summaries were a paragraph, my father’s would be pages on pages of clinical history and treatment recommendations. He was kind, modest, taking time to comfort and listen to his patients, something that others did not.

The fact is, my father’s story is not unique. Every year the US welcomes thousands of international and foreign medical graduates (FMGs) into residency programs nationwide. Through J-waiver programs many go on to serve rural and underserved areas that would otherwise be unfilled. FMGs enter the US medical system after an arduous long - and expensive - process of equivalency exams known as United States Medical Licensing Exam (USMLE), which by the way is the same exam administered to US medical graduates. Each exam costs over 600$. Travel costs, housing, application fees through the electronic match system known as ERAS all add to the price tag. When the non-profit I co-founded, the American Board-Certified Doctors for Egypt (ABCDE), began providing grants to Egyptian residency applicants it was for a reason; the average monthly salary of a middle-class Egyptian is not more than 300$/month - not even a quarter of the price they would need to attempt the US training pathway.

More importantly however, it was and is not about the money, though obviously that was/is a challenge. I read their applications and personal statements, and I see the other sacrifices they made and continue to make, sacrifices that cannot be measured by price tags. They leave countries, homes, families, languages… just like my father did years ago, for the American “Doctor’s” Dream.

The prospective medical training and research in the US was well worth the abovementioned sacrifices and challenges. Ivy League schools are ranked in the top 10 worldwide for medical training programs. Worldwide rankings for the best hospitals include US based institutions like Mayo Clinic and Cleveland Clinic. Medical research, again, universities like Harvard and Johns Hopkins top the list. A quick PubMed search will show the most cited articles are overwhelmingly from the US. When COVID broke out, it was the research done by Penn State University doctorates that paved the way to life saving vaccines, for which they received the Nobel Prize. This reflection of “greatness” was seen worldwide, whether through GAVI programs to vaccinate poorer countries, or collaboration between the Centers for Disease Control (CDC) and World Health Organization (WHO) to eradicate small pox, polio, etc. The number of US medical patents for diagnostic machines and ground breaking technology was/is unparalleled by any country, with the exception of China close behind, all of which is exported worldwide.

Medical research and practice are fields that have historically welcomed immigrants of all backgrounds. You didn’t need to be a certain height, skin tone, accent to join an esteemed program and succeed (obviously racism and prejudices and biases do exist, as in any other field, just not to the same degree). A list of Nobel Prize winners in Medicine and Physiology from the US, will show the majority are 1^st or 2^nd generation immigrants or of minority background. The US has always been known as the destination the world’s best and brightest. What other countries refer to as a “brain drain,” for the US has always been a “brain gain.”  

Today we begin to witness a the “reverse brain drain…”

I see young physicians questioning their plans to go to the US for residency training. I see international renown scholars declining invitations to speak at events. I see entire events being cancelled. For many researchers I see the devastation of years of hard work being frozen, their employees and lab support being turned away. I see physicians and researchers scrambling to find employment in Germany, England, or Canada. Some are even returning to their countries of origin such as China. The biotech industry, an industry I have worked in, has always been the link between researchers and biomedical or biotechnology start-ups and pharma companies. These companies now face an uncertain future and dwindling investments.

For medical researchers, the changing current environment is not just the loss of financial security after a whopping 2.7 million in funding cuts from the NIH. It’s more than that. It is medical journals receiving threatening letters from the Justice Department. It’s the ACGME, the largest body responsible for assessing and credentialing residency programs being questioned about their Diversity/Equity/Inclusion standards and policies. We see researchers and visitors and scholars being harassed at the airports or even prevented from entering the US. PhD students and scholars being intimidated, imprisoned. There is a genuine fear of intimidation. Gone is the feeling of intellectual freedom, gone is a restriction – free, politics - free science.

The practice of medicine has also changed. For years and lifetimes physicians had been respected, honored, looked up as saviors.  All of a sudden, we face in our clinics contempt, disregard for science and data, and a preference towards disinformation. This disinformation can be deadly as we recently saw with the death of children by measles, a completely preventable disease.  It can be wasteful like searching for a cause to connect autism and vaccines which has been debunked time and again. Data essential for the prevention, treatment, and management of diseases, and to challenge the basic disinformation, has been deleted. 

The loss of DEI research will also eventually have devastating and costly consequences. Minority health issues simply cannot be isolated from majority health issues. Both are intertwined, intersect and overlap and follow the natural process of disease spread and progression. A perfect example is that of the AIDs epidemic in the 80’s. What was first though of as a disease that only affects LGBTQ, was soon found to affect heterosexuals, children, mothers, transfusion receivers, etc. Without the research there would not be the treatment and management options for HIV today. When DEI restrictions include studies on women’s health you are effectively undermining the health of more than half of the population. Mental health of minorities reflects on the mental health and community health as a whole.  DEI studies are needed and essential to develop screening programs, treatment programs, and early interventions to prevent long term health issues that would otherwise be costly on an already strained medical system. Examples of these programs include maternity and birth clinics for minorities with poor perinatal outcomes. RSV clinics for Alaskan natives who are more susceptible to the virus.  Breast cancer screening for Ashkenazi Jews… We can go on and on.

The US already ranks poorly in healthcare coverage, and there are currently over 20 million Americans without coverage. And now there is the prospect of cutting Medicare and Medicaid, adding another 120 million and more Americans threatened with no health care coverage. How exactly are physicians expected to be able to treat patients with no coverage? Other than disease or death, what alternatives do the uninsured exactly have?

In 2020 the editors of the New England Journal of Medicine published an editorial titled, “Dying in a Leadership Vacuum.” In this editorial they attributed much of the 200000 deaths of Americans from COVID-19 to an administration that relied on incompetence, uninformed “opinion leaders” and weak inappropriate government policies. In 2025, we see a continuation of that same government, with an extended outreach and unprecedented capacity to impose ideology and to weaponize the medical and research fields for their own political gain. In short, the US is on a trajectory that is anything but “great,” anything but “healthy,” and will soon join other countries in experiencing its own “brain drain” as exceptional physicians and researchers choose other countries in which to practice medicine and achieve their potentials…

Dr. Hoda Z. Amer, Author, Pathologist, Treasurer of ABCDE, Hilliard OH.

Copy of a book in the Arab American Museum in Dearborn, MI, by Dr. Rashid Abdou, a Yemeni-American surgeon who immigrated to the US at the age of 15, and became one of the first of his village to receive higher education. His career spanned 50 years, including establishing the Joanie Abdu Comprehensive Breast Care Center in Youngstown, OH, named after his late wife.

Plaques in the Arab American Museum in Dearborn:Above: honoring Dr. Abdallah Najjar, a Lebanese American. He was known for his international work on eradicating malaria, and for founding the Office of International Services at the CDC. Below: honoring Dr. Ahmed Zewail, Egyptian American Physicist who received the Nobel Prize in 1999. His work influenced the medical field in numerous ways including 4D electromicroscopy, physics of medicine, and nanomedical drug development.

Excerpt from “Oncology News” in 1978, with a photo of my father, Dr. Magid Amer and his study of metastatic disease and brain scans. My father would go on to publish over 80 journal articles in the field of oncology.