Can Terrorists Trained as Doctors Slip into the United States?

July 4, 2007— -- Despite a shortage of doctors in this country and a growing reliance on foreign-trained physicians, medical professionals looking to immigrate to the United States must undergo the same "vigorous screening process" as all other foreign nationals, a State Department official told ABC News.com.

News that the eight suspects, recently arrested in connection with last weekend's foiled terror attacks in Scotland and England, were all foreign-born doctors or medical students has altered British perceptions that the professional class is an unlikely place to find terrorists and has raised new questions in America about immigration procedures.

In the aftermath of the June 7, 2005, attacks on London's subways and buses, British authorities assumed the next attack would similarly come from home-grown, disaffected, poor Muslim youths, but doctors, experts say, have never been strangers to terrorism.

Ayman al-Zawahri, spokesman for al Qaeda and the organization's second-in-command behind Osama bin Laden trained as a doctor in Egypt.

Three different militant groups in Gaza -- Hamas, Palestinian Islamic Jihad and the PLO -- all have had physicians in their senior ranks.

"People often assume that terrorists are poor, disadvantaged people who are brainwashed or need the money. But the ones who actually perpetrate violence without handlers and manipulation are highly intelligent by necessity," Magnus Ranstorp, a terrorism expert at the Swedish National Defense College in Stockholm told The Associated Press.

"It's only the smart ones who will survive security pressures in a subversive existence. Sometimes they are doctors, a profession that provides a brilliant cover and allows entry to countries like Britain," he said.

Regardless of the outcome of the British investigation, a debate is already under way in that country regarding its reliance on foreign doctors. As the United Kingdom requires fewer foreign physicians to meet demand, the United States is becoming increasingly reliant on them.

Some 37 percent of Britain's 238,739 doctors were trained overseas, according to the General Medical Council. As the supply of doctors meets demand, Britain last year enacted stricter requirements for foreign doctors seeking work there.

The United States, on the other hand, is facing a shortage of physicians and looking to hire more professionals trained overseas.

"The AAMC has been very concerned about the likelihood of a future shortage of doctors," said Edward Salsberg, director of the Center for Workforce Studies at the American Association of Medical Colleges.

Salsberg said the use of foreign-trained doctors "is a longstanding practice" and that "international medical school graduates have historically played an important role in the health care delivery system."

About a quarter, or between 185,234 and 190,640, of all physicians working in the United States are considered "international medical graduates," according to the American Medical Association. About 2,000 of those doctors, however, are U.S. citizens who trained overseas.

Most international doctors working both in the United Kingdom and the United States graduated from Indian medical school, about 27,558 in Britain and some 44,585 in the United States.

Salsberg said doctors should undergo the same screening as other visa applicants looking to work in the U.S.

"One would hope the State Department and Homeland Security are screening all immigrants appropriately. We don't see any reason why doctors should be treated differently."

The State Department agrees. "Everyone goes through the same vigorous screening process," a department official said.

Foreign doctors applying for visas must first be vetted by consular officials in U.S. embassies abroad, background checks are then conducted by the Department of Homeland Security, he said.

Dr. Shahid Athar, an Indian-born and Indiana-based endocrinologist and a former president of the Islamic Medical Association of North America, said Muslim doctors are on the whole dedicated to saving life not destroying it like those suspected in the British plots.

"Physicians know about the sanctity of human life and are programmed to save life, not destroy it. This is true of all physicians in general and Muslim physicians in particular," Athar said.

In a survey he conducted after 9/11 for a published paper, Athar said, he found no indication that American patients were any more fearful or less trusting of their Muslim doctors and he did not expect a backlash in light of the events unfolding in the U.K.

"There was never a backlash after 9/11. I have taken care of over 30,000 American patients in 33 years of practice… I doubt this [the UK attacks] will change things."

Kirk Fernandes contributed to this report from Boston.