AP, New York, Mar 27: After finishing medical school in Bogota, Colombia, Maria Anjelica Montenegro did it all — obstetrics, pediatrics, emergency medicine, even surgery. By her estimate, she worked with thousands of patients.
None of that prepared her for the jobs she's had since she moved to the United States: Sales clerk. Babysitter. Medical assistant.
That last one definitely rubbed raw at times.
'I know I was working in my field,' the 34-year-old New York resident said. 'But that is medical assistant. I'm a doctor.'
Montenegro is hardly unique, given the high U.S. unemployment rate these days. Her situation reflects a trend that some researchers call 'brain waste' — a term applied to immigrants who were skilled professionals in their home countries, yet are stymied in their efforts to find work in the U.S. that makes full use of their education or training.
Most of these immigrants wind up underemployed because of barriers like language, lack of access to job networks, or credentialing requirements that are different from those in other countries. Some are held back even further because they're also in the U.S. illegally.
An analysis by researchers at the Migration Policy Institute, an immigration think tank, estimated that 1.2 million college-educated immigrants in the United States were underemployed, out of a population of 6.7 million. About another 350,000 were unemployed. The analysis, based on data from the Census Bureau's 2009 American Community Survey, did not differentiate between legal and illegal immigrants.
Brain waste has consequences for immigrants as well as American employers and the larger economy, said Jeanne Batalova, policy analyst at the institute and co-author of a study on the issue.
For immigrants, it means bringing home less money than they have the potential to earn. For employers, it means fewer skilled applicants in their hiring pools. For the country overall, it means a missed opportunity to leverage already trained professionals in areas where there may be a desperate need for them.
There's a 'loss when human talent and potential is not maximized in the fullest,' Batalova said.
Mohan Singh, 55, thought moving to the United States would be a smooth transition. Born and raised in India, he left his home country for Kuwait, where he worked in air conditioning and elevator maintenance. He lived in Kuwait for 25 years, started his own company and was successful enough to send his daughter and son to college in the United States.
At their urging, Singh came to the U.S. in 2000. He said he thought 'that I'll be getting the same job, I'll be getting into a good field, make a good life.'
It took seven years to complete the paperwork that allowed Singh to work here legally. When he applied for jobs, would-be employers focused on the fact that Singh had not worked in his field in the United States.
'They cancel all my experience,' he said.
He now spends 12 hours a day, seven days a week, behind the wheel of a taxicab. It's a far cry from the work he's done for much of his life, Singh said, and the wages are much lower than those he once brought home. The whole experience has soured him on the idea of staying in America. He plans to move back to India in a couple of years, when his son is done with his post-graduate work.
'I used to have money, I used to have good life,' Singh said. 'Over here, I'm hand to mouth.'
Nikki Cicerani, executive director of Upwardly Global, a nonprofit organization that helps legal immigrants find work in their chosen professions, said typically, immigrants come from environments where job-seeking is done differently. They may not know how to navigate the system, whether it's building a network to learn about job openings or having a resume formatted in a way that is familiar to American employers.
Interviewing can be especially tricky. 'In many other countries, the resume and the educational experience is the clincher,' Cicerani said, 'whereas in the United States, the interview is make it or break it.'
American employers can also have difficulty figuring out if an immigrant would be the kind of employee they are seeking, absent a ready way of understanding how foreign educational or professional expertise translates in the U.S. job market, Cicerani said.
'They're not really clear how to evaluate a foreign degree against a U.S.-educated candidate,' she said.
Montenegro came to the United States in 2004 to care for her mother, who had been diagnosed with breast cancer. She stayed after marrying a man she met here, and became an American citizen. She now lives in the New York borough of Queens with her husband and two children.
Language was the first barrier that Montenegro encountered. She needed to improve her English, but she also needed to work. She took a job as a sales clerk in a local mall, and even though it felt strange to be a medical professional working in retail, she said, the position at least helped her polish her language skills.
Then came larger hurdles that no amount of perfect English could surmount. There's a series of exams, the first of which cost $1,000 alone, Montenegro said. She also has to complete a residency, a requirement for all graduates of American medical schools. There are a limited number of residency slots overall which makes it a very competitive process for everyone, but even more so for foreign medical school graduates.
Montenegro has one more exam to pass before she can apply for a residency, a process that will take at least a year or two. There's no guarantee that she'll be accepted for a residency; At times, she fears she may never work as a doctor here.
'So many times I want to get my things and my passport and go back to my country,' Montenegro said. Over the years, she heard stories about the lifestyles her doctor friends in Colombia were able to afford as she worked at various low-wage jobs.
While Montenegro agrees that her credentials and her ability to provide good health care should be vetted before she's allowed to work in this country, she thinks having to train as a general practitioner all over again when she already has experience is a waste — especially for the U.S., she said, because she speaks fluent Spanish and could be an asset in any Spanish-speaking community in need of a doctor.
'I'm ready to do that and help people,' she said. 
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