Dear President and members of BOD,
There have been reports that some APPNA member physicians are charging medical students and young graduates for the opportunity to rotate at their offices as observers.
This practice goes against our core values and mission statement. Our organization exists to facilitate Pakistani descent medical students and young graduates, not profit off them. Charging medical students and young graduates damages the trust of our newer generation and the reputation of our organization.
Most worryingly, there have also been allegations of inappropriate conduct and sexual harassment, which make the need for clear action and guidance even more urgent.
I suggest that the BOD consider the following:
1. Publicly Denounce the Practice
Issue a formal statement condemning the act of charging medical students and graduates for rotations or observerships in APPNA member offices and hospitals.
2. Code of Conduct Commitment
Require that all nominees to APPNA Board-appointed committees affirm that they do not charge students or graduates for observerships and will not in the future. This undertaking should be part of the committee code of conduct. Nominees for Council appointed committees also be asked for such disclosure and commitment as well, prior to their election by the Council.
3. Communication with Medical Schools in Pakistan
Send a letter to principals and deans of medical schools in Pakistan, making it clear that APPNA does not approve of this practice. Ask them to share the letter with their students. The letter should clarify that if any APPNA member asks them for money for observerships, they should report it to the APPNA Board or the Ethics and Grievance Committee.
4. Guidance for Students and Graduates
Develop and publish guidance for students and young graduates that outlines their rights regarding clinical observerships and training, provides clear instructions for filing complaints with state medical boards in the United States and offer resources on how to handle and report inappropriate behavior, including cases of sexual harassment.
5. Consolidated Volunteer List
Task the APPNA Young Physicians’ Committee with developing a consolidated list of volunteer members who are willing to accommodate students and young physicians for observerships, ensuring equitable and transparent access to opportunities.
6. Task the YPC and the Committee for Liaison with Professional Organizations to identify hospitals that charge, in addition to insurance, fees for rotations; and to work with other professional and ethnic organizations to persuade these hospitals and institutions to stop the practice of charging students or young graduates for rotations or observership.
By taking these steps, the BOD will reaffirm APPNA’s role as an organization that stands for the welfare of students and young physicians, while upholding its mission of service, compassion, and professional integrity.
I urge that the BOD act decisively and swiftly in this matter. APPNA’s silence risks emboldening exploitative practices, while a strong and public stand will demonstrate the organization’s unwavering commitment to its values.
Sincerely,
Nauman Ashraf,
Lifetime APPNA Member
Dear Members of the APPNA Board of Directors,
I write to bring to your urgent attention a social media post that has been circulating widely, in which a public figure displayed the photographs and names of newly matched IMG residents — including members of the inaugural IU Internal Medicine class — to advance explicitly anti-immigrant narratives and characterize their match as a “scam” at the expense of American graduates.
This pattern of conduct — weaponizing the identities of hardworking young physicians, to stoke xenophobia for social media engagement — demands a firm, coordinated institutional response. Individual reactions risk amplifying the very rhetoric we seek to counter.
I respectfully request that the Board the consider the following steps in this order of priority:
1. Activate the Advocacy, Legislative and Government Affairs Committee
The Committee should coordinate outreach to the AMA, ACGME, and AAMC, and engage Congressional allies with data documenting the indispensable role IMGs play in the physician workforce.
2. Direct the Communications Committee to Prepare Member-Facing Guidance
Chapters and individual members require unified, factual, and legally sound messaging so that responses across the organization are consistent and do not inadvertently escalate the situation. Members should collect patient stories and share those with their congressional allies and in their social media conversations.
3. Issue an Official APPNA Statement
The statement should clearly affirm the facts: that IMGs compete through the same rigorous, merit-based NRMP Match process as every other applicant; that they disproportionately serve rural and underserved communities that U.S. graduates often decline to enter; and that J-1 and H-1B visa pathways are not a scam — they are a structural lifeline for American healthcare delivery.
APPNA has already submitted two resolutions to the AMA House of Delegates this year — including one specifically advocating for expanded IMG hiring to address physician shortages and reduce burnout. We have standing, credibility, and documented institutional commitment on this issue. This is the moment to activate that platform.
I raise this matter as a concerned physician and Lifetime Member of this organization. When newly matched residents are publicly targeted by name and photograph, our silence constitutes a statement in itself. I do not believe silence reflects APPNA’s values or its mission.
I remain available to assist in drafting the official statement, coordinating with partner organizations, or supporting the advocacy effort in whatever capacity the Board finds most useful.
Thank you for your consideration and for your continued leadership on behalf of our community.
Respectfully submitted,
Nauman Ashraf, MD
Lifetime Member, APPNA