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.
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 first-generation 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, one-third 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
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.
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-Joseph S. Alpert, MD (Editor in Chief, The American Journal of Medicine)
This article originally appeared in the April 2017 issue of The American Journal of Medicine.
