Dr. Gulshan Harjee has dedicated the majority of her professional career to the Clarkston Community Health Center, a charity clinic she co-founded. For the past eight years, after selling her private practice, she has been passionately serving a diverse group of immigrant patients.
The internal medicine physician arrived in the United States after escaping three different countries during her childhood and teenage years. These experiences deeply impacted her and motivated her to assist individuals facing challenging circumstances. Serving as the pro bono medical director of the Clarkston charitable clinic, Harjee provides care to patients in a town where approximately half of the residents are foreign-born and nearly one in five lack insurance coverage.
“I chose to leave behind a successful practice and pursue this path because I wanted to give back,” she explained.
Unlike Harjee, who trained at Morehouse and Emory medical schools in Atlanta, many other immigrant doctors in Georgia face challenges when it comes to practicing medicine. Those who obtained their medical degrees outside the United States often find it difficult to compete with doctors who were trained in America for the limited number of residency spots available.
There is a significant demand for more doctors in Georgia, particularly in rural areas where severe physician shortages have been identified by the state government. As a result, the clinic in Clarkston relies heavily on volunteer physicians to bridge this gap, according to Harjee.
To address both issues, she believes that the state should establish a program that allows qualified doctors from other countries to undergo training at American healthcare institutions until they are prepared to practice as fully licensed physicians.
States like Tennessee and Alabama have successfully implemented programs that aim to increase the supply of doctors at little to no cost. Such initiatives could potentially be adopted to address the shortage of healthcare professionals in our state.
According to Harjee, by continuing to serve as a physician, they are able to familiarize themselves with our healthcare system, medications, and the way we interact with patients.
In addition, she recognizes the unique contribution that immigrant doctors could make to her clinic, which caters to numerous immigrant communities residing in DeKalb County. This diverse patient population often faces challenges when it comes to receiving care in their native languages. Immigrant doctors could play a vital role in bridging this language barrier and ensuring effective communication with patients.
Advocating for the creation of this type of pathway since the early 2010s is just one of the many reasons why she strongly supports it.
She expressed her belief that it appeared to be an ideal solution for their situation.
Georgia, unlike some of its neighboring states, has not yet implemented a law to facilitate the entry of this pool of physicians into the state workforce.
During the state’s 2024 regular legislative session, lawmakers presented a bill that aimed to permit foreign-credentialed doctors who have met American medical standards to undergo training at licensed health care centers. The ultimate goal was to enable these doctors to apply for work in medically underserved communities. Unfortunately, the proposal did not receive a vote and subsequent attempts to include these provisions in other bills, despite having widespread support, also failed.
As the 2025 regular legislative session approaches, Harjee emphasizes the importance of Georgia legislators directing their attention towards passing a bill that she believes will significantly enhance the well-being of individuals in her community. However, given the previous unsuccessful attempts to establish a viable solution, she expresses concerns that this year might yield similar outcomes.
“I believe there will be numerous other matters that will once again take precedence over our concerns,” she expressed.
Addressing physician shortages and language barriers
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Access to family medicine plays a crucial role in the overall well-being of Americans, as it impacts various aspects of their health. A study conducted by Harvard University in 2019 revealed that having 10 more primary care physicians per 100,000 individuals in a community was linked to an increase in life expectancy by 51.5 days. This highlights the significance of ensuring adequate access to family medicine for better health outcomes.
The demand for healthcare workers in Georgia surpasses the available supply, and this gap is projected to widen in the future. According to a commission established by Governor Brian Kemp in 2022, the healthcare industry in the state experiences an annual workforce loss of approximately 4%. By 2032, it is estimated that Georgia will require an additional 239,000 healthcare employees to meet its needs.
According to the commission’s projections, there will still be 1,800 primary care job openings in 2025, even after considering the increase in the number of doctors graduating from medical school and relocating to the state.
In Georgia, it is not just the rural counties that are experiencing a severe shortage of doctors. Even in the bustling Atlanta metro area, the problem persists. According to a study commissioned by the Clarkston clinic, DeKalb County alone has a deficit of over 100 primary care providers, unable to meet the healthcare demands of its residents. Jeremy Cole, the executive director of the clinic, highlights the pressing need for more medical professionals in these communities.
Central DeKalb, home to the Clarkston clinic, is known for having some of the biggest disparities in the county. With a significant number of resettled refugees in the area who possess medical training, Cole expresses his desire to tap into their expertise to help alleviate this shortage.
Darlene Lynch, an Atlanta lawyer and passionate advocate for refugees and immigrant communities, has been actively involved in efforts to reform state licensing requirements for international professionals across various industries. She emphasizes the significance of Georgia’s rich history in refugee resettlement, which has attracted a multitude of highly skilled individuals to the area.
Lynch believes that Georgia’s international community of qualified and willing doctors could be instrumental in addressing the state’s physician shortages. While Kemp’s commission proposed various strategies to attract and retain frontline healthcare workers, Lynch emphasizes the potential contribution of Georgia’s international doctors in filling the gaps.
“It’s too big,” she exclaimed, emphasizing the magnitude of the shortage. “Training alone won’t be enough to solve this.”
According to Belisa Urbina, the CEO of Ser Familia, a Georgia Latino social services nonprofit, foreign-credentialed doctors can play a crucial role in improving healthcare access for non-English speaking patients. Many of the individuals they serve are more comfortable discussing their health concerns in Spanish, their native language. By increasing the number of physicians who can provide care in the patients’ language of origin, Ser Familia aims to enhance the quality of healthcare services provided.
Many health centers are required by the federal government to provide interpretation services, but these services often fall short in meeting the needs of patients. According to Urbina, having a separate interpreter for doctor appointments can also lead to longer visits, which can be a burden for individuals with limited free time.
According to her, using an interpreter requires everything to be said twice.
Other states optimistic about licensing programs
As a Republican state Representative, Sabi Kumar reflected on his own experience as a doctor in Tennessee while working on a bill aimed at increasing the number of foreign-credentialed doctors in the state’s workforce.
Kumar, an Indian-born surgeon who received his medical training in the United States, expressed his awareness of numerous skilled international healthcare providers who have been left without residency spots. Recognizing the healthcare workforce shortages in Tennessee, he emphasized the significance of strengthening the state’s doctor population by accommodating as many qualified physicians as possible.
According to Kumar, the bill that was signed into Tennessee law in April 2023 has provided an easier pathway for qualified and trained physicians who have passed the same exam as graduates in the United States. He believes that this bill has opened up opportunities for these physicians, similar to the Georgia bill that did not pass earlier this year.
Kumar stated that it is currently challenging to determine the full impact of the recently passed laws on the health of Tennesseans, as they have not yet taken full effect. He also noted that there have been certain concerns regarding the availability of facilities for foreign-credentialed physicians to practice at.
He has been informed that the state Board of Medical Examiners has received numerous emails inquiring about the program. It appears that the effects of the law have extended beyond state boundaries.
Lynch shared that they had received suggestions from several doctors who proposed the idea of relocating to Tennessee to expedite their journey towards becoming a doctor.
Georgia State Senator Kim Jackson, a Democrat representing Clarkston, took the lead in sponsoring the bill to establish a similar process earlier this year. She plans to reintroduce the bill at the beginning of this session.
According to Jackson, although the bill was not passed during the previous session, she is confident that her proposal for 2025 will eventually be enacted into law.
“I am grateful for the tremendous bipartisan support that I have received,” she expressed. Senator Kay Kirkpatrick, a Republican and co-sponsor of the 2024 bill, expressed her willingness to collaborate with Jackson if the bill is reintroduced.
Harjee, the medical director of the Clarkston clinic, expressed doubt about the completion of a bill in the next few months. However, she couldn’t help but envision the potential opportunities for immigrant doctors if Georgia were to pass the law.
As she reflects on the countless hours she has dedicated to caring for individuals who have faced challenges in accessing healthcare, she desires to extend this opportunity to others who share her experiences.
Harjee believes that if more people were willing to pay it forward and show gratitude, there would be an abundance of care for patients who have nowhere else to turn. Taking care of these patients is a way of giving back and providing them with the support they need.
