My outlook as a DACA medical student

My name is Cesar, I am a fourth-year student in the MD-PhD program at Loyola Stritch School of Medicine. I am a recipient of Deferred Action for Childhood Arrivals (DACA) and have been an undocumented immigrant for nearly 20 years.

I came to this country at the age of 10 and lived in southern New Mexico until, at age 25, I began my MD-PhD program in Chicago. Before that, I’d spent most of my life in a narrow geographical area due to my status. My first year of med school was an amazing introduction to medicine and the first time I felt like part of a community. I shared my academic training with supportive peers and I could openly speak about my status to the faculty and staff in my program. During my second year anti-immigrant rhetoric ramped up in politics and the media. In 2016 and early 2017 there were serious concerns regarding the DACA program, and neither DACA medical students nor their medical programs had clear answers as to what would happen.

Escalation of the situation coincided with my dedicated study time for Step 1. Multiple States announced the intention of filing a lawsuit against DACA, unless the Federal government ended the program. Then, on September 5, 2017, Attorney General Jeff Sessions announced the repeal of DACA. This was followed by a legal challenge by multiple States supporting DACA that led to a standoff. The result was that the DACA program would not allow new applications, but renewals would be possible.

Along with many DACA medical students, I was able to renew my protection for two more years during this timeframe. My initial protection was valid until September 2018 but has now been extended until early 2020. I went from not knowing if I could continue my program later this year, to being within the timeframe of finishing my PhD. But as of right now, there is no certainty of the outcome.

It is not an exaggeration to say my life now feels like a crucial match that has gone into overtime. Every second is precious, and I must balance the uncertainty of not knowing what will happen next with single-minded focus of staying in the game. I honestly do not know if I will be able to complete the clinical experience needed for my MD. I do not know if I will be able to attend residency. But I also know that my willpower must stay strong because that is what is needed to become a physician.

Currently there are DACA medical students in every year of medical school. This year our program had five DACA recipients match into residency. There are nearly 700,000 people protected by DACA with their livelihood dependent on the decisions made by those in power. The knee-jerk reaction when people learn about this topic is to ask why something is not done about it. It is true that action by congress could bring relief to all of us immediately. But immigration in the U.S. is a complicated matter, spanning decades of bureaucracy, economic opportunism, and political bidding.

One of my fears is that I will be an undocumented physician. This will severely limit where I can work and the types of patients that I can serve. It is a dystopic scenario to contemplate. I will have a quilt of protections that allow me to provide a critical service for my community, yet still fear for my livelihood in a daily basis. But despite the outlook and the uncertainty, I must have faith and move forward.