Alison Bowen
and Alexia Elejalde-Ruiz
Chicago Tribune

CHICAGO: The first time he applied for a medical residency in the United States, Rafel AlHiali felt buoyant.

With nine years of experience as a physician, the Iraq native and recent immigrant to Chicago felt confident he’d be treating patients again soon.

He sent off the applications and waited. And waited. “First week, first month, second month. There was nothing,” AlHiali said. “I was really shocked.”

Five years later, after several failed attempts to land a residency, AlHiali, 40, works part-time as a medical interpreter while he tries to reclaim his derailed career.

Highly skilled immigrants like AlHiali often encounter a labyrinth of obstacles when they try to find jobs in the United States, frustrating not only their ambitions but also their earning potential as they settle for lower-skill positions.

President Donald Trump’s support for merit-based immigration systems, like those used in Canada and Australia, could make it easier for immigrants with advanced educations and skill sets to enter. Trump praised those systems for adhering to “a basic principle that those seeking to enter a country ought to be able to support themselves financially.”

But those already here say the expertise they brought with them to the United States often goes to waste. Lengthy recertification processes, language barriers and employers’ unfamiliarity with foreign credentials hobble immigrants’ efforts to find work in their fields. They take jobs as janitors, baby sitters and valets to get by.

The Migration Policy Institute, a nonpartisan research organization, calls it brain waste. Nearly 2 million college-educated immigrants and refugees in the United States are unemployed or working in low-skill jobs despite years of education and work experience.

Meanwhile, a growing share of immigrants are highly educated. Almost half of adults who entered the country between 2011 and 2015 were college graduates, up from a third who came from 2007 to 2009, according to the institute.

The current U.S. immigration system prioritizes family unification. Nearly two-thirds of the 1 million legal permanent residents accepted into the country in 2015 were either immediate relatives of American citizens or sponsored by family, while 14 percent were employment-based admissions, according to the Department of Homeland Security. Fifteen percent were refugees or asylum seekers, and 5 percent came through a diversity lottery for people from countries with low immigration rates to the U.S.

Some advocates for stricter immigration applaud Trump’s support of a merit-based system. Highly skilled immigrants wouldn’t compete with U.S. workers for low-skill jobs, and they could have a positive impact if they pay more taxes and use fewer services, said Steven Camarota, research director at the Center for Immigration Studies, a nonprofit group that favors reducing immigration.

Still, Camarota is skeptical that the United States needs such immigrants to plug talent shortages.

Wages haven’t increased for many jobs that employers say they have trouble filling, and many educated Americans have trouble finding work in their fields, he said.

Even if Trump emphasizes an immigration system based on skills and education, officials will need to address how easily that experience can be put to use.

Facing licensing tests that require hundreds of dollars, or having to repeat an entire course of study, many immigrants with advanced skills take lower-paying “survival jobs” to pay rent and buy groceries.

At Upwardly Global, a group that helps find job placements for immigrants here legally with at least a bachelor’s degree, clients include engineers, doctors and nurses who work as babysitters, cabdrivers and in factories.

“These are people who the United States has welcomed into our country,” said Tamar Frolichstein-Appel, a career counselor at Upwardly Global. “The people we work with are not in any way looking for handouts. But they have these skills, and they’re in areas where our country needs these skills.”

Aleksandra Dimo, 28, was a psychologist in Albania. She came to the United States in 2015. Here, she slices meat in a deli and her husband, a trained engineer, works as a valet. Upwardly Global helped connect her with English classes.

Someday, she hopes to work in something closer to her field. In the meantime, she volunteers every day at a community center, where her therapeutic skills are used to comfort homeless people and pregnant women.

“That makes my day,” she said. “Working three hours there, then I don’t care if I work at a deli.”

She is grateful that the deli provides a place to practice English — despite speaking Albanian, Spanish and Italian, she arrived knowing no English — and a paycheck. Still, she said, her friends ask, “You have a master’s degree and you’re working at a deli?”

AlHiali, the Iraqi physician, has spent years applying for medical residency and waiting to treat patients instead of translate for them.

He hoped his time with Upwardly Global, which helped him revise his resume and practice interviews, would help him.

“I applied even to Alaska,” said AlHiali, who said he came on a K-1 visa, or a visa for fiances traveling to marry a U.S. citizen, and is now a citizen. “I’m ready to take anything.”

Two weeks ago, for the fifth year in a row, he braced himself for the email that would reveal if he was accepted into a medical residency program.

This time, it read, “Congratulations.”