When Ermias Melka emigrated from Ethiopia to Minnesota in 1998, it meant new opportunities for his family. But he also took a big step backward professionally: Despite working as a pharmacist for a decade in Addis Ababa, he's been able to find work in the United States only as a pharmacy tech.

Software engineer Sri Mallipudi also ran into roadblocks finding work when she immigrated to Minnesota from India three years ago. After 70 interviews and no offers, a recruiter finally told her she didn't have enough experience with American companies and lacked a master's degree from a university in the U.S. She ended up working at Starbucks.

Their experiences are common among college-educated immigrants in the United States. Lack of English proficiency, licensing and credentialing barriers, and extra educational requirements make it hard for some immigrants to find high-skilled jobs here — an issue sometimes called "brain waste."

Now a bill before the Legislature would address the barriers to higher-skilled work for immigrant physicians. Sen. Alice Mann, DFL-Edina, who co-sponsored the bill, said it would put "anywhere between 250 to 300 physicians back out into the workforce that currently cannot practice" in Minnesota.

The bill would grant a limited license to some graduates of foreign medical schools to work for two years in a rural or underserved urban community in the state. If the doctor is in good standing after two years, they would be eligible for an unrestricted license to practice in Minnesota.

The two-year period of supervised practice is important, said Mann. "There are cultural aspects to how to practice medicine, and we want our physicians to be able to learn that and incorporate that into their practice," she said.

Mann emigrated from Brazil to the U.S. with her family when she was a child. For years her mother worked three jobs to support the family while her father, a physician in Brazil, went through hurdles to practice medicine here. When she entered the Legislature in 2019, she came across several physicians who had a similar experience.

"They were saying, 'I have lived here for many years, I can't practice medicine and I was a doctor from wherever I came from,'" Mann said.

According to Mann, most states in the U.S. have significant barriers for physicians who completed their training abroad to practice medicine. At the same time, the number of residency slots isn't keeping up with demand. Her staff sought to tackle both issues in bill: Immigrant physicians wouldn't have to go through residency again, opening those slots for people who hadn't received training yet.

"I just don't see, personally, a downside to getting people to do what they've been trained to do and they're good at, especially when we have a workforce shortage in health care," Mann said.

A 2021 study by the Migration Policy Institute, a Washington, D.C.-based think tank, estimated that underuse of immigrant skills costs the U.S. economy $40 billion a year, including $10 billion in taxes to federal, state and local governments. And it's become a pressing issue in fields like health care, which faces a shortage of doctors and nurses.

Mallipudi worked as a software engineer for Broadcom in Andhra Pradesh, India, for almost four years, making $50 to $60 an hour, before moving to Minnesota to join her new husband in 2021. She expected to have a few months off while waiting for her work authorization before landing a comparable job in the U.S.

But after a series of job rejections, Mallipudi felt like she had two options: get a master's degree or work low-skilled jobs while changing her career. She started a seasonal job at a Target Starbucks in October 2022 and by the following January was promoted to full-time, with benefits such as education assistance.

Mallipudi completed a full stack development boot camp at the University of Minnesota in 2023 and is now looking for a job as a junior developer to gain experience before applying for more senior jobs.

Melka went into pharmacy because he was interested in learning about medications and how people are treated. He graduated in 1987 with a master's degree and started working in a hospital pharmacy.

"Pharmacy is more like life chemistry," he said. "You can see all the medication people are treated with and the chemistry applied on that, so I'm so interested in that."

After arriving in the U.S., Melka passed the Foreign Pharmacy Graduate Equivalency Examination in 2005. But he flunked the qualifying English exam at least a dozen times, which prevented him from working as a full-fledged pharmacist. By then, he needed to take the foreign pharmacy exam all over again.

He didn't want to return to school or retake the exams, so he continued as a pharmacy technician, a job that requires only a high school degree or GED. But it meant thousands of dollars in lost wages; the mean annual wage for pharmacy technicians in the U.S. is $40,260, while the mean annual wage for pharmacists is $129,410, according to the U.S. Bureau of Labor Statistics.

Melka and members of his family supported each other during the transition to the U.S., he said. Both he and his wife worked while raising their children, one in the morning and the other in the afternoon. They were able to buy a house, cars and other things together.

"The children are so good, they're helping us too," he said. "They're helping each other, so we grow together."

About the partnership

This story comes to you from Sahan Journal, a nonprofit newsroom dedicated to covering Minnesota's immigrants and communities of color. Sign up for a free newsletter to receive Sahan's stories in your inbox.