EDITORIAL
On Immigration: Welcome to America!
During the recent presidential campaign in the US, the
Republican candidate, Donald Trump, had a number of
negative things to say about recent immigrants to the US.
While I typically avoid political issues in my commentaries
in The American Journal of Medicine, with this editorial, I
would like to go on record as disagreeing with President
Trump.
All of us currently living in both North and South
America are immigrants. Indeed, if we are willing to search
back tens of thousands of years, Native Americans also
immigrated to this continent, presumably seeking what has
been called “a better life.” Furthermore, if we are willing to
look back many more years into the past, our earliest ancestors were also immigrants, leaving their African homeland approximately 200,000 years ago. Thus, no one living
on any continent except Africa can claim that his or her
family originated there. Many in the US, like Mr. Trump’s
and my own grandparents, arrived on these shores in the
19th century alongside millions of others, predominantly
European in origin, who came here seeking opportunity,
education, and freedom from persecution and prejudice. I
believe that the majority, including my family as well as Mr.
Trump’s family, found what they sought here in “America.”
Both Mr. Trump and myself, and many of my colleagues on
the editorial board of The American Journal of Medicine,
are products of “the American Dream.”1 Today, the majority
of immigrants coming to the US come from Asia and Latin
America seeking the same conditions that caused my
grandparents to leave their homes in Lithuania.
The message that I heard during my childhood was work
hard, get educated, behave yourself, respect your family,
and you will certainly find success. Most of my friends
whose grandparents had also immigrated to the US in the
19th century received the same advice. To that admonition, I
would add another helpful factor: good luck. Certainly good
fortune has played a role in every successful individual’s life
here in the US. In practical terms, good luck involves having
a supportive family as well as outstanding teachers, mentors,
and the right pathway to a fulfilling job.
Funding: None.
Conflict of Interest: None.
Authorship: The author is solely responsible for the content of this
manuscript.
Requests for reprints should be addressed to Joseph S. Alpert, MD,
University of Arizona College of Medicine, Tucson, AZ.
E-mail address: [email protected]
0002-9343/$ -see front matter Ó 2016 Published by Elsevier Inc.
http://dx.doi.org/10.1016/j.amjmed.2016.11.032
Much has been written about immigration to the US
during the last 400 years. A search for books on immigration
to the US on Amazon.com gave a total of 5917 book choices
dealing with this topic!2 Much has also been written about
the negative response of previously established immigrants
toward the new arrivals. One example involves laws passed
by Congress in the 19th century that forbade Chinese
immigration to the US.3 In 1862, Congress passed a law
forbidding American ships to transport Chinese immigrants
to America. Twenty years later, in 1882, Congress passed
the Chinese Exclusion Act. The law served as the first
legislation in US history to ban a specific racial group from
entering the US. Only diplomats, merchants, and students
were allowed to come into the country, and Chinese
Americans were denied the right to apply for naturalization.
Eventually, these laws were repealed. Today, Chinese
Americans are among the most educated and economically
successful of all racial groups in the US. One example
suffices: in the undergraduate classes at the University of
California at Berkeley, nearly 20% are Chinese Americans.4
Contrast this with the fact that Chinese Americans represent
only 1.6% of the US population.5
During my long academic career, I have had the pleasure
of participating in the education of many outstanding firstgeneration US immigrants. During the 2016 residency
match process, 13.5% of successfully matched medical
students were non-US citizens who had graduated from a
medical school outside the US.6 As noted above, most of the
trainees that I have helped to educate were from Asia and
Latin America, and they followed the same dictum I was
given as a child: Work hard, study hard, stay out of trouble,
and respect your family. Almost all of my past trainees are
now hardworking community or academic physicians
bringing up their offspring with the same admonitions that I,
and my friends, heard when we were children. Today, 27%
of physicians and surgeons in the US are foreign born.7 The
US should be very proud of these industrious, tax-paying
citizens who are frequently the backbone of many successful US communities.
Over the years, the US has benefitted enormously from
immigrants, including many remarkable individuals, a
number of whom have won the Nobel Prize. Indeed, onethird of Nobel prizes in the sciences won by Americans
were awarded to individuals who had immigrated here.8 In
2016, all 6 scientific Nobel Prizes were won by US
immigrants!9
384
The American Journal of Medicine, Vol 130, No 4, April 2017
So, what is the take-home message in this editorial? It
can be very simply stated: The US has been built by, and
continues to thrive based on work done by, immigrants. We
should rejoice in the fact that so many hard-working and
talented individuals choose to come here to live: Welcome
to America!!
As always, I welcome comments and discussion on our
blog at amjmed.org.
Joseph S. Alpert, MD
Professor of Medicine
University of Arizona College of Medicine
Tucson
Editor in Chief
The American Journal of Medicine
3.
4.
5.
6.
7.
8.
References
1. Frishman WH. Triumph Over Tragedy. The Odyssey of an Academic Physician. Stamford, CT: Science International Corporation;
2016.
2. Amazon.com. Search for books on immigration to the US. Available at:
https://www.amazon.com/s/ref¼nb_sb_noss?url¼search-alias%3Dstrip
9.
books&field-keywords¼ImmigrationþtoþtheþUS. Accessed November
20, 2016.
Ourdocuments.gov. Chinese Exclusion Act (1882). Available at: https://
ourdocuments.gov/doc.php?flash¼true&doc¼47. Accessed November
22, 2016.
Berkeley Office of Planning and Analysis. UC Berkeley Fall enrollment
data. Available at: http://opa.berkeley.edu/uc-berkeley-fall-enrollmentdata. Accessed November 20, 2016.
Chinese Advertising Agencies. Chinese demographics in America.
Available at: http://chineseadvertisingagencies.com/Chinese-demograp
hics.html. Accessed November 20, 2016.
Educational Commission for Foreign Medical Graduates. IMG performance in the 2016 match. Available at: http://www.ecfmg.org/news/2016/
03/30/img-performance-2016-match/. Accessed November 22, 2016.
Migration Policy Institute. Foreign-born health care workers in the United
States. Available at: http://www.migrationpolicy.org/article/foreign-bornhealth-care-workers-united-states. Accessed November 22, 2016.
Reuters. Immigrants win one third of U.S. Nobel prizes in key fields.
Available at: http://www.reuters.com/article/us-immigration-nobelprizesidUSKBN0EG2KP20140605. Accessed November 20, 2016.
Independent Digital News & Media. All six of America’s 2016 Nobel
Prize winners are immigrants. Available at: http://www.independent.co.
uk/news/world/americas/nobel-prize-winners-immigrants-us-donald-tru
mp-brexit-immigration-racism-post-referendum-racism-a7355406.html.
Accessed November 20, 2016.