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On Immigration: Welcome to America!

American Journal of Medicine Editor Joseph Alpert

Joseph S. Alpert, MD, AJM Editor-in-Chief

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 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

To read this article in its entirety please visit our website.

-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.

3 Responses to “On Immigration: Welcome to America!”

  1. Russell leewood md May 6, 2017 at 10:37 am

    I enjoy dr Alpert’ s editorials but have to comment on this one.dr Alpert implies that the president is intending to halt all immigration. Hardly true

    Let us not confuse immigration in general with illegal immigration. Physicians here illegally should not and i am sure are not practicing medicine.thus enforcing the existing laws as the president is required to do hardly impacts us medicine

    I am a fairly recent immig/rant and went through the appropriate steps.why would this be an issue for other physicians? The pathway exists.

    I feel that blanket statements like welcome to America are naive and meaningless. The welcome has always been there-but just do it legally.

    Finally, fmg’s are frequently some of the best physicians in the us and an asset to their communities. But for many countries this is a loss of a trained professional that can be ill afforded-the term brain drain still has meaning.

  2. Shereef Hilmy May 6, 2017 at 1:20 pm

    To: Dr. Joseph S. Alpert,
    Professor of Medicine, University of Arizona
    College of Medicine, Tucson, Arizona
    Editor in Chief, The American Journal of Medicine

    Re.: On Immigration: Welcome to America
    Article in American Journal of Medicine, April 2017, Volume 130, Number 4.

    Dear Dr. Alpert:

    I read your editorial article captioned above with great interest. Like the many successful immigrants you cited, I too am an immigrant. I came to this country from Egypt and went through the appropriate credentialing and equivalency testing to be able to undergo internship, residency and fellowship training in this country. More importantly, I came to this country LEGALLY through the process of legal immigration. I too have had a long career in medicine. I also have participated in educating both American and foreign medical students and residents.

    As an immigrant to this wonderful country of opportunity, I feel that I can evaluate the immigration issue with objectivity. In reading your article, I could not help but note a degree of misrepresentation of the facts.

    I have no particular alliance with any political body. I, however, feel that facts should be presented properly. In disagreeing with President Trump, you imply that he is against all immigrants, which I think is less than factual. Even though I disagree with numerous policies proposed by Mr. Trump I have noted some of his statements on multiple occasions where he clearly stated that he welcomed LEGAL immigrants. His main concern lies with illegal aliens coming to this country without due process.

    I believe in each country’s right to control its borders by any means. Moreover, each country should be allowed to pick and choose which immigrants should be allowed into their midst. The selection should be based on merit and benefit to the society, but the process has to be lawful and legal.

    Your statement of disagreeing with President Trump is somewhat perplexing. I truly doubt that the majority of physicians you have trained were in the US illegally. I believe that the majority if not all had gone through the proper channels and procedures and were here with proper work permits and/or residency documents.

    When I applied for immigration to this wonderful country, I was almost declined a permanent residence status, which I would have accepted without question.

    Since the American Journal of Medicine is a respectable and widely circulated journal I believe it is prudent to set the facts straight by stating that President Trump’s objections pertain to illegal aliens. As opposed to numerous other policies of President Trump and his administration, I whole-heartedly support his position on LEGAL immigration.

    Shereef Hilmy, M.D., F.A.C.C.
    Associate Professor of Medicine
    University of Texas Health Science Center
    San Antonio, Texas

    • Managing Editor May 24, 2017 at 2:48 pm

      I agree completely with the expressed feelings about illegal immigrants. However, President Trump has made a number of statements where he specifically did not say he was speaking about illegal immigrants. His major problem is that he often does not think before he speaks and ends up inflaming the populace against many immigrant groups who are here legally. I can tell you that many of our trainees are from the Middle East, Pakistan, and India. They uniformly feel that President Trump’s remarks were aimed at them and made them very uncomfortable. I certainly agree that we need to keep our borders secure, but we should not disparage the many, many legal immigrants who come to the US every day. President Trump’s remarks to the Muslim family whose son was killed fighting for the US were particularly unpleasant. He appeared to have no empathy for this bereaved family. I agree with a number of the things that he said during his campaign except for his remarks on immigration. They were poorly thought out like a some of his subsequent comments. Joseph Alpert, MD