Fighting for Ordinary: Foreign Medical Graduates and the Need to be Exceptional

• In Event: Examining the Exceptional: Case Studies of Knowledge Production in Biomedicine and Science

Abstract

On the US House of Representatives floor, Congressman Emanuel Celler implored his fellow legislators to support his eponymous Hart-Celler Immigration and Nationality Act of 1965, a bill that established a selective migration system with a provision that prioritized the entry of “exceptionally qualified” individuals. Amongst the largest group of immigrants to enter were Foreign Medical Graduates (FMGs) from predominantly postcolonial Asian nations. These “exceptionally qualified” medical laborers were granted legal citizenship in exchange for their expertise. However, in actual clinical practice, FMGs were considered subpar and inadequate practitioners. Through oral histories and Congressional hearings, I explore this contradiction. I trace the ways that FMGs performed exceptional work or claimed exceptional status to obtain basic rights and privileges of medical practice on two levels. In everyday clinical practice, foreign practitioners reported on the need to outperform their US colleagues in all aspects of hospital life simply to receive satisfactory evaluations. And on a national level, while testifying before the US Congress, FMGs deployed their exceptional achievements as Nobel Laureates and medical thought leaders to argue for the same licensing rights and examinations available to every ordinary US medical graduate. The need to reference the most exceptional in the group in order to receive equal treatment provides important insights into the mechanisms of colorblind racism that operate in the current political moment. Furthermore, an analysis of the discursive construction of the FMG as simultaneously exceptional and underperforming reflects the complicated nature of citizenship extended to “foreigners” in the US.

Author

• Eram Alam, University of Pennsylvania