In the days leading up to his 21st birthday, Simon Mendoza didn’t make plans with friends to visit the bars on Capitol Hill or to buy alcohol at midnight.
For Mendoza, turning 21 meant that he was no longer a part of his family’s green card application.
“Normally, when people turn 21, it’s the happiest day of their life,” Mendoza said. “I cried on my 21st birthday.”
Mendoza came to the United States from Mexico with his family in 1991 when he was six months old. His father submitted the green card application in 1996, but when he turned 21, Mendoza would no longer be considered a child, and he would have to apply for his own green card.
Since his early teens, Mendoza wanted to attend medical school and become a doctor. And though the major events in his life read like a dream application essay for any medical school — licensed as a certified nursing assistant (CNA) at the age of 16, founder of a nonprofit, graduated with honors, and a degree in microbiology from the UW — becoming a doctor is just out of his reach. Except Loyola University in Chicago, no other medical school in the United States accepts undocumented students. And until very recently, none did.
When Mendoza graduated from the UW, his options were unclear. He knew he wanted to attend the UW School of Medicine (SOM) to become a primary-care physician, but until he became a citizen, that would be impossible.
The UW SOM, like many other medical schools, does not accept international students and only accepts a limited number of students from outside of its service region, which includes Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI).
However, last year President Obama passed the Deferred Action for Childhood Arrivals executive order, which grants certain applicants temporary residence status in the United States, a social security number, and a work permit. Now medical schools across the country are trying to determine how students with DACA status fit into their admissions policies.
“If you were to educate a student who was protected by DACA, one of the things to think about is whether or not he or she would then be able to practice medicine, get licensure and so forth,” said Geoffrey Young, senior director for student affairs and programs at the Association of American Medical Colleges.
When Mendoza applied for DACA status, shortly after the executive order was made, he said that he felt as if he was coming out to the world after years of keeping his undocumented status secret.
“I was so nervous that Mitt Romney would be president because I knew that he would make the executive order and probably deport me,” he said. “It was a rough year for me.”
Mendoza has since been granted DACA status, and said he will continue to fight until he can fulfill his dream. Now medical schools, including the UW, are beginning discussions about the change Mendoza so badly desires.
“We are actively exploring the details of DACA as it affects all steps
in the process of becoming a practicing physician in the state of Washington,” said Leila Gray, an employee at UW Medicine’s Media Relations office. The UW had no further comment.
Young explained that while no one is necessarily trying to block change in admissions policies, the interplay between school policies, state and federal law, and medical facilities’ policies makes matriculating DACA students who can go on to practice medicine tricky.
However, he said that it may be too soon to say if policies will change to follow Loyola’s decision to admit DACA students.
“We’re thinking about globally how to make sure we have physicians who are available and capable and culturally competent to care for all populations within this country,” Young said. “It’s too early to really make some determination about where we’re going.”
From the personal to the public
Cultural competence is one of Mendoza’s big concerns with the current medical community.
When he was in the fourth grade, Mendoza and his family moved from Kent, Wash., to Royal City, Wash. His parents had been given job offers at Smith Brothers Farms newest branch.
Mendoza was suddenly exposed to a city in which more than 88 percent of the population was of Hispanic or Latino origin, according to the 2010 census. There, language and cultural barriers prevented the one-room clinic from providing optimal medical care.
“My parents and myself always depended on community clinics, and they always saw sort of the lack of quality medical care and adequate access to different resources,” Mendoza said. “I saw a huge need for quality medical care, and culturally sensitive medical care most importantly. There’s not only a language barrier but also a cultural barrier.”
Many physicians, he explained, don’t understand the traditional medicine that is integral to many immigrants’ upbringing. Growing up, his mother would crack an egg over his stomach to help with constipation. Mendoza said a departure from traditional healing practices can lead some Latino community members to be ambivalent about physicians.
“They always say, ‘Oh you’re just going to go pay a bunch of money and get Tylenol,’ basically,” Mendoza said.
When Mendoza was 13, his father’s hand was crushed in a farming accident. Because of their rural location, it took paramedics 30 minutes to arrive on the scene.
Mendoza became his father’s advocate and interpreter after the initial surgery.
“That was a life changer for me,” Mendoza said. “I took an active role in his health.”
Mendoza received a lot of encouragement from the doctors and nurses who surrounded him during his father’s care. Upon his release, the family moved back to Kent, where Mendoza attended high school. His junior year, Mendoza took a yearlong health sciences course which allowed him to obtain his CNA.
The experience he received in the medical field during that year became necessary — even lifesaving — in 2008, when he traveled to Louisiana to help with Hurricane Gustav relief efforts.
Mendoza was stationed at a shelter inside a middle school, where he was the only trained medical volunteer. At the age of 16 he became responsible for the lives of 150 people.
“These people were really sick,” Mendoza said. “They had hypertension, diabetes, some of them were bed ridden. I actually witnessed two heart attacks. We didn’t have electricity for the first couple of days, so the diabetics didn’t have insulin.”
A week later, two registered nurses arrived and were shocked to learn that Mendoza had been taking care of the shelter on his own.
After joining the Running Start program and becoming the second in his family to graduate from high school, Mendoza received an associate degree from Green River Community College and was accepted to the UW in 2010.
Last year, with personal experiences in mind, Mendoza founded a nonprofit called Rural Health Education (RHE),a free clinic that delivers basic health care to those living in rural areas of the state.
“My goal is to revolutionize medicine so that all communities can have equal access,” Mendoza said. “I want to equal the playing field for everybody.”
All in the balance
Mendoza hopes the UW School of Medicine will follow Loyola’s example, but he knows it probably won’t happen soon, if at all. Therefore, he has considered other options, such as joining the UW’s physician assistant program, which trains students to practice under the direction of a physician, so that he can begin practicing medicine in some form as soon as possible.
“I don’t want to hold my breath thinking that there could be any changes at the school of medicine,” he said. “I know that the UW has a great assistant physician program, and I’m no
t motivated by money. I always say that if physicians made minimum wage, I would still be motivated to be a physician.”
Before pursuing permanent residence status, Mendoza is waiting for Congress to pass comprehensive immigration reform. If this is the case, then after four years of DACA status he will have priority and eligibility to apply for citizenship.
In the meantime, he has the support of dedicated friends and colleagues. One of his friends recently created a Change.org petition asking for undocumented students like Mendoza to be able to apply to the UW School of Medicine. The petition received 360 signatures in the 12 hours it was open.
But not everyone supports Mendoza’s case. A recent article in The Seattle Times about his situation drew a high number of negative comments, people telling him to go back to Mexico among the most common.
“I just want people to put themselves in my shoes,” he said. “I was six months [old] when I came to this country. I grew up in this country. This is the only country that I know, that I can call home. Some of these people are expecting me to move back to Mexico — which is really a foreign country for me — and that’s just a scary thought.”
While he waits for decisions that are very much out of his hands, Mendoza
continues to volunteer at Christ Community Free Clinic in Auburn, Wash., where he completes nursing duties, teaches diabetes and nutrition classes, and acts as an interpreter. He is also working to grow RHE in order to provide service to more patients.
His advisor at the UW School of Medicine’s multicultural office, Pam Racansky, said the process of changing admissions policies and residency program rules is definitely on people’s radar but needs to be an ongoing dialogue between the school, the state, the AAMC, and the federal government.
“If we actually want to treat the diverse population that resides in Washington then that makes perfect sense,” she said.
Though he may have to wait years before becoming a family physician, Mendoza is focused on the changes he wants to make in the medical community.
“We are years behind on delivering quality medical care to all ethnicities,” he said. “I think we should focus on developing physicians from all different ethnicities, from genders, sexual orientation, everything. We really need
to focus on delivering the best care we can get to people and dealing with the long-standing barriers we’ve always had.”
Reach reporter Samantha Leeds at email@example.com. Twitter: @SamanthaJLeeds