WELCOME BACK, DOCTOR

WHEN HE ARRIVED IN SAN FRANCISCO IN 2001, Dr. Eugene Karamurzin was a Russian-trained OB-GYN with five years of medical practice. With a wife and baby, limited English and limited funds, he spent the next two years working construction and driving taxis to make ends meet. Ironically, Karamurzin was living amidst an immigrant community that would have welcomed a Russian-speaking physician. Research shows that a diverse and culturally competent health care work force could help reduce the disproportionate degree of chronic and acute illness among underserved immigrant and ethnic populations.

This understanding is the driving force behind Welcome Back, a groundbreaking initiative that is "building a bridge between untapped resources and unmet needs," in the words of the program's founder, Dr. Jose Ramón Fernández-Peña. In October 2004, Welcome Back received a nearly $700,000 grant from The California Endowment to continue helping internationally trained health professionals use their hard-earned skills while helping to address critical shortages in the health work force.

OVERCOMING BARRIERS TO ENTRY
Like others, Karamurzin faced significant barriers to entering the American health care field. He struggled with the language. He had limited financial resources and time. He was unfamiliar with the U.S. health care system. And U.S. educational systems don't fully credit the credentials of his home country. Nevertheless, he was determined to find his way back into health care. "I was wasting my experience and knowledge," says Karamurzin.

Fernández-Peña had a similar experience 20 years ago. A physician in his native Mexico, Fernández-Peña realized there was a wealth of immigrant health professionals in the U.S. After finding his own way back into health care by receiving a Master's of Public Administration and ultimately joining the Health Education Department at San Francisco State University, he decided to assist others.

Today, there are three Welcome Back centers funded by The California Endowment, located in San Francisco, Los Angeles at Mt. San Antonio College and at Grossmont College in San Diego. In San Francisco, a partnership between City College of San Francisco and San Francisco State University extends health education courses to Welcome Back Center participants. The program helps immigrant health professionals develop career pathways to bring them back into the health sector, supporting them as they pursue credentialing requirements in the professions they practiced in their home country or in alternative health care careers. Since its inception, Welcome Back has met with more than 5,400 professionals in California. "Of those, more than 560 people are already working in health care who were not there four years ago," says Fernández-Peña.

EXPANDING TO POLICY
"As we've begun to see results, we've learned that there are larger structural elements that affect what we do," Fernández-Peña points out. So, the program works with educators, regulators, employers and legislators to identify opportunities to expedite licensing processes while ensuring that professional standards are maintained.

Through Welcome Back, Eugene Karamurzin first secured a job as a blood drawing technician and then moved on to become a pathologist's assistant. He also recently passed Step One of his U.S. medical licensure exam and expects to begin his medical residency in 2006, a boon for both his family and the underserved patients he will be able to see. When asked why this arduous effort is worth it, he responds, "We have to have this sort of program so immigrants can use their skills."