Refugee Medics

When they arrived with their wives and children in Sutherland, Neb., last month, neither Pham Tuong Do nor Tran Van Khang was surprised by the obvious differences between the tiny (pop. 840) corn-country community and their native Can Tho, second largest city in South Viet Nam. But they were overwhelmed by their reception. Some Vietnamese refugees have been greeted in the U.S. with open hostility. Pham, Tran and their families were welcomed warmly, and with good reason. Sutherland, which is 20 miles from the nearest hospital, has been without a doctor since the town's lone physician quit three years ago. When its citizens learned that Pham, 40, and Tran, 37, who are both physicians, were willing to settle there, they went out of their way to make them feel at home.

Easing Entry. Some townspeople reopened Sutherland's long-shuttered 20-bed hospital and fixed it up as living quarters for the two families. Others donated furniture, kitchen utensils, television sets and children's toys and bicycles. All did their best to make the Vietnamese feel at home. "We are lucky to be here," Tran's wife told her new neighbors. "No," replied Mrs. Sandy Meissner, wife of Sutherland's mayor, "we are lucky to have you."

Pham and Tran are not the only Vietnamese refugees who are likely to find their entry into U.S. society eased by their professions. Some 300 of South Viet Nam's 1,500 physicians, including the entire staff of the Saigon University School of Medicine, have turned up in California's Camp Pendleton and other refugee centers. So have at least 60 dentists and a number of pharmacists and nurses. Many are getting a head start on resettlement because of their backgrounds.

A score of doctor-short communities in Nebraska besides Sutherland have recruited Vietnamese physicians, who are unpacking their bags in rural towns with names like Ponca, Weeping Water and Loup City. The Federal Government plans to settle some Vietnamese general practitioners on Indian reservations. American physicians have begun heeding an appeal by the American Medical Association to take on refugees as assistants. One Chapel Hill, N.C., physician hired Saigon Pediatrician Nhieu Phan Van sight unseen.

The warmth of their welcome will certainly reassure Vietnamese doctors about their new homeland. But the refugees must still surmount some major obstacles before they can practice their profession. Like other foreign-trained physicians--who now constitute more than one-fifth of the 300,000 doctors practicing in the U.S.--the Vietnamese must pass the stiff requirements of the Educational Council for Foreign Medical Graduates (ECFMG), which tests both their command of English and knowledge of clinical medicine. Last winter only 7,000 of the 19,000 foreign doctors who took the exams managed to pass. Those who get by the ECFMG must then take the Federation Licensure Examination (FLEX), which is recognized by 48 states. In many cases, the doctors must also complete a 12-month hospital tour before meeting local licensing requirements.

These tests present a formidable challenge to the Vietnamese. Often fluent in French, many of the refugee physicians speak little English. Nor are they familiar with American medical practice. Vietnamese medical training, which borrows heavily from the French, is based more on books than on clinical experience. Medical problems are also different. For example, Vietnamese physicians are used to dealing with infectious diseases like malaria and tuberculosis and illnesses caused by parasites. In the U.S. they will deal with heart disease, strokes and cancer.

To learn U.S. methods, most Vietnamese refugee M.D.s are already studying for the ECFMG exam, which is held each January and July. Many have enrolled in review courses at colleges and medical schools; others are reading medical texts on their own. Some are working as assistants to military doctors at Camp Pendleton and the refugee center on Guam. Few are finding it easy to master American methods, however. Says one Vietnamese physician at Pendleton: "All of us have to learn to walk again. It will be a long time before I feel confident enough to run."

Study Support. Some refugee medics expect to do a year of studying before they even take the ECFMG test. Even the most optimistic refugees estimate that it will be a year before they are able to practice on their own. Yet their professional prognosis is good. The Vietnamese doctors have already been made more welcome than the long neglected Cuban physicians who flooded into the U.S. in the years following Fidel Castro's takeover in Havana. Many exiled Cuban physicians worked as waiters and cab drivers while they mastered English and American medicine, but most Vietnamese will be free to concentrate on their books. In return for their promise to practice in the community at least two years, Sutherland and other towns that have recruited the refugees have agreed to support them until they get their licenses.

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