Brain Drain to Brain Waste

Lady Liberty

“What did you do in your home country?” I asked.

I was speaking with a nursing assistant from Iraq. Nursing assistants help with patient care. They usually make beds, bring bed pans, and do general non-invasive patient care like bathing a patient.

“In my home country? In my home country I am a lawyer.”

This scenario is repeated all over the country, in every state, in every major city where there is a large immigrant population.

An immigrant’s country of origin is drained of those with degrees and skills desperately needed, only to come here and work at a job far below their educational level. Lawyers, doctors, teachers, engineers, chemists — none of them able to work within their chosen fields. So many of them are in jobs that will barely pay their bills and they are unable to complete the education that would allow them to work again in their respective fields.

I hear their stories in restaurants, in cabs, and in the patient navigator course that I teach twice a year. It’s a humble moment when you realize the gentleman from Cameroon that is taking your navigator course has two advanced degrees; or the woman from Senegal is a physician and you are teaching her about breast anatomy.

Researchers at Purdue University now have quantitative data that supports the stories I have heard for years. This team of researchers looked at census data from 1980 to 2009 and found that: ”

…the level of education of nearly half of immigrants was above the education requirements for their job, compared with one fourth of men born and living in the U.S. The prevalence of such “brain waste” exceeded 40 percent for immigrants with a bachelor’s degree, 50 percent for those with a doctoral or professional degree and 75 percent for those with a master’s degree. The overeducation prevalence for U.S. natives was 10-20 percentage points lower. Over time, immigrants find suitable jobs, but not to the extent of U.S. natives.*

The research has its weaknesses. For instance, women were not included in the study. The reason cited was their “complex labor market careers” during the period of time that was researched. Many women worked part time or did not work at all while raising families.

But overall the evidence of brain waste is irrefutable. 

The tragedy of this cannot be overestimated. There are .2 physicians per 1000 people in Afghanistan, while Afghan physicians work in kitchens in the United States. There are 2 teachers to every 1000 people in Ghana while Ghanaian teachers work in parking garages by day and struggle to learn English by night.

The hard thing about this post is that there are seemingly so few solutions. One thing we do know is that the better the language skills of the immigrant, the more likely they are to be able to find a job at their education level, so affordable English classes are critical. Another solution is to make the education and testing needed to meet the requirements of a particular field of study, for instance nursing, more reasonable and develop a mentor program so that people can be mentored in their field.

There is something else equally critical, something that we can address. Over and over I see Americans treating immigrants as though they are stupid. They ignorantly assume that limited language skills equals limited intellectual ability. I have watched interactions where someone who barely graduated from high school in the United States shouts at an immigrant and treats them poorly. This is inexcusable. I grew up outside the United States, and lived in two countries other than the U.S as an adult and I was never treated as stupid, despite my fractured and terrible language skills. Instead, I was encouraged to learn both Arabic and Urdu by both Egyptians and Pakistanis. Not only that, I was applauded for the baby steps I made in language learning.The rude behavior that is so prevalent in the United States toward non English speakers can and must change.

The first step in change is always awareness, so I offer a challenge: next time you are out to eat and you’re being served by a Latino, or Pakistani, or Ethiopian waiter, be reminded that you may be communicating with someone who has multiple degrees. Even if they don’t have multiple degrees, they are worthy as human beings. Next time you are in a cab, get into a conversation with the cab driver and find out more about their life. Next time someone with limited English skills speaks to you, whether to ask you a question or to serve you, encourage them and don’t dismiss them.  Next time someone talks about immigrants ruining the country, challenge them and make them give you facts on just how immigrants are ruining this country. 

While policy change around brain waste has to take place at an institutional and governmental level, behavior change depends on the individual. We can’t change people’s attitudes, but we can behave in ways that challenge their attitudes. 

“Whenever people talk in the abstract about the pros and cons of immigration, one should not forget that immigrants are individual human beings whose lives happen not to fit neatly within national borders – and that like all human beings, they are all different.
How different, though? Different better, or different worse? Such basic questions underlie whether people are willing to accept outsiders in their midst”
Philippe Legrain, Immigrants: Your Country Needs Them

*From “Attracting Global Talent and Then What? Overeducated Immigrants in the United States” 

Photo credit:

8 thoughts on “Brain Drain to Brain Waste

  1. When Jonathan first started working in an inner city ER, we watched the first season of the TV series ER (before it morphed into a soap opera, as apparently all good shows do, sigh). He kept telling me he’d seen this or that. Nearly everything that happened on that first season he had encountered in real life nursing practice.

    I particularly remember a scene where the docs are trying to save someone with heart trouble. There’s this janitor/tech lady from Eastern Europe who is looking on. She seems nervous, but we don’t know why yet. It isn’t looking good for the American docs. They’re having trouble deciding what to do. Suddenly this lady rushes into their midst, climbs on the patient, uses some barbaric looking tool to tear open the patient’s chest, and performs some procedure. (I know nothing about these medical things.) Whatever she did to rip open his chest ended up saving his life, but she took a big risk doing it like that. Afterwards the docs find out she was a heart surgeon in her own country, and they commit to helping her get the English help she needs. I guess that part of the show ER mirrored real life, too.

    Thank you for writing this important post, Marilyn.


  2. Marilyn, yes, yes a hundred times to this penetrating post, chock full of social commentary! I have met people who have been in exactly the sad situations you describe.

    A wonderful situation was that of a sweet, empathetic imam (from the Middle East, a minority person who fled his country of origin). I met him while in chaplaincy internship. He also worked an entry-level, part-time position for one of the big freight carriers while doing the internship . . . but after two units of internship, he was ready to enter the military chaplaincy in this country. I know for sure he is doing a wonderful job, wherever he is. Even though it has been years since I saw him, I pray for him and his wife, today.


  3. I have been volunteering to teach refugees English over the last several months, and have encountered this problem over and over and over again. I’m getting really good at helping people in my community locally manage the roadblocks to working in their chosen professions. A few of the hospitals in the area have programs to help immigrants transition into medical assisting if they have nursing or medical experience elsewhere. Unfortunately, it can take years for them to work through all the steps to become re-certified, and meantime, they have rent to pay and hungry mouths to feed. They seem to be a very hard-working, determined bunch though.

    Many, if not most, of the people I’ve been working with come from war torn countries. They come here to find safety and security. Often, it is no longer safe for them to work in their home countries. Transitioning to the US is a monumental task.


  4. I have two questions (and the answers may be obvious but seem to be good additional information to your article):
    1. Why do immigrants leave their countries for the USA if they will experience this drop in status/ability to perform their trained positions? Political? Persecution? This is probably a REALLY big question…
    2. What impacts are left on the countries and do they notice/see this as an issue?
    Ok – three questions, I guess…
    3. How does this impact overseas missions? Your Cameroonian example hit me close to home because our church’s conference has supported a theology school and a few hospitals in Cameroon. The whole point was to train Cameroonians in order that they can provide an elevated level of care to those in Cameroon. If they are leaving, will the USA be called upon to provide more assistance and actually possibly causing a bigger problem in the country in the long run?

    This seems to be a chicken/egg problem, but I really do value your thoughts. I doubt a solution is at hand, and – perhaps – the solution to better assist immigrants in the USA is the best one for us to focus our efforts…but – if leaving makes things worse in the country of origin and in the lives of immigrants, I don’t know why people do it…except in the case of persecution.

    Am I making any sense?


    1. Marilyn, You have asked questions that I think every missionary working in programs that train nationals has asked themselves. Our hospital in Pakistan served the needs of Pakistani patients with all kinds of diseases and also trained nurses. The nurses we trained found themselves recruited all over the world and probably 80% left primarily to go and earn money to send home to educate siblings or take care of parents. Most stayed in the nursing profession is my guess. But there have been questions of why did they leave and never come back. My wife, an American citizen and board certified doc got recruiting letter from American instituti0ns thinking she was a Pakistani trying to lure her to practice in the USA. (Although a recent immigrant of the same age with training from Britain has been told she must do a seven year Residency before she could practice here.}

      Stacy, For our trainees (primarily Christian Girls from rural families) money was an issue but the politics an pressures of living in a primarily poor and Muslim environment was probably a bigger one where they could get their families to a place they considered at least religiously secure.


    2. Stacy, let me give you an example of a friend of mine. She was a OB/GYN in Iraq and had a good job, good home and mostly good life until someone left a bag of body parts on her doorstep as a sign that her family was next to die because they were Shia. Her family left the country that night and fled to Turkey before making their way to America. Since she is highly trained, she worked very hard on her English and studied for several years to pass the tests necessary to become a doctor in America. She passed all her tests, but when she applied to more than 100 hospitals for residency, she was told that since she was older and got her degree overseas, she wouldn’t be accepted. She is now giving up on America and is trying to become a doctor in Australia where the requirements aren’t as strict. The thing that amazes me is that America is now being flooded by Arab immigrants and that many of these women will have babies here with a limited amount of English. They need bilingual doctors like my friend and yet, she is not allowed to use her skill. It is a sad situation.


Add to the discussion...

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s