The day after the Trump administration said it would end a program that protects young undocumented immigrants from deportation, students at one Chicago-area medical school donned their white coats and held a rally to support their undocumented classmates. Their message? #HereToStay.
Loyola University Chicago Stritch School of Medicine has 32 undocumented students, the most of any medical program in the country—and nearly half of around 70 such students in medical schools nationwide in the United States. In addition to the routine stress of earning an M.D.—classwork, licensing exams, and applying for residencies—they are stressed about their futures in the country.
Last month, President Donald Trump announced a six-month "wind down" of Deferred Action for Childhood Arrivals, the Obama-era program offering two-year renewable permits to undocumented immigrants who came to the U.S. as children. It has allowed some 800,000 so-called "Dreamers" to get work permits, driver's licenses, loans, and other official documents; the nickname comes from the DREAM (Development, Relief, and Education for Alien Minors) Act, a failed federal legislative proposal to legalize their status.
Unless Congress acts to extend or replace the program by March 5th, DACA recipients' permits will expire at a rate of around 1,000 per day, leaving them without benefits and vulnerable to deportation.
Under the terms of the wind-down, those with permits set to expire in the next six months had until October 5th to renew them. After that, the government will no longer accept applications. In recent weeks, tens of thousands of affected DACA recipients rushed to renew, lining up at legal clinics to get help filling out the paperwork.
Loyola Stritch students Belsy Garcia Manrique and Cesar Montelongo, both Dreamers, have anxiously awaited news of DACA's fate since Trump took office. On the campaign trail, Trump pledged to end the program as part of his hard-line platform on illegal immigration. But his tone on DACA seemed to soften in the initial weeks of his presidency, even as he implemented strict immigration enforcement measures elsewhere.
Now that DACA is ending, though, the students are dealing with the uncertainty in very different ways. Manrique, 27, has found an escape through work at a hospital as part of her third-year clinical rotations.
"As a medical student, you have to focus on your studies," Manrique said. "But having this news literally everywhere [can] affect you in such a personal manner, it takes a toll on your studies and concentration."
Meanwhile, Montelongo, 28, has thrown himself into activism in hopes that Congress will pass legislation to replace DACA.
"One of the elements in our favor is all the outrage over DACA ending," said Montelongo, a joint M.D.-Ph.D. candidate. "They're getting rid of our only safety net for no reason. And that really resonates with the mainstream."
Last month, Montelongo traveled to Washington, D.C., to tell his story and ask a group of senators to pass the DREAM Act, which would give Dreamers permanent residency and a pathway to citizenship. He spoke up again when Illinois senator Dick Durbin, who introduced the bill, visited Loyola Stritch to advocate on the students' behalf.
"The timer is counting down,' he added. "And I feel like that is a good thing because it will force Congress to act."
Montelongo was born in Ciudad Juarez, Mexico, a city long plagued by drug gangs and violence. At age 10, he and his family arrived in the U.S. legally on tourist visas, which they overstayed. Though his parents recently obtained family-sponsored green cards after a 10-year wait, by then Montelongo and his sister were too old to qualify as part of the family.
DACA, introduced through executive action by President Barack Obama in 2012, was the siblings' only option for legal status in the U.S. It allowed Montelongo to apply for medical school, his lifelong dream, and to obtain a Social Security number so he could receive loans and a stipend for his Ph.D.
"Growing up undocumented, you lack access to health-care options," Montelongo said. "My dad had diabetes, and he was often in pain. It was very treatable, but there was no one to diagnose it. He was very sick and he lost an eye from diabetes."
The experience, he explained, pushed him toward the medical profession. His research aims to use bioinformatics to predict and treat infections of the bladder.
Dreamers Against the DREAM Act
Whether he'll get a chance to finish his studies, let alone stay in the country he calls home, depends on a sharply divided Congress with a poor record of passing major bills.
Congressional Democrats are preparing to negotiate a deal with Trump to ensure the Dreamers won't face deportation. But some of the biggest opposition comes from the Dreamers themselves.
Many worry that the Democrats, desperate to pass a bill, will make compromises in the DREAM Act or other legislation that will lead to an increased threat of deportation for undocumented parents, friends, and relatives. Trump and many Republicans have demanded more immigration enforcement and a wall along the U.S.-Mexico border.
Dreamers receive the most sympathy of all groups of undocumented immigrants in the U.S., with wide bipartisan support for them to stay in the country. Their parents, however, are often painted as lawbreakers because they illegally crossed borders or overstayed visas.
DACA recipients are wary of being used as bargaining chips. Montelongo said he can't support legislation that saves him but leaves others behind. He and other activists are pushing for a "clean" DREAM Act, one where, he said, "Dreamers get a path to citizenship but it leaves out negative additions that constitute other people getting arrested, detained, and deported."
Manrique echoed Montelongo's concerns. Her parents, undocumented immigrants from Guatemala who live in Georgia, have increasingly been preparing for the possibility of deportation. And each day, Manrique is more fearful that immigration agents will land on their doorstep and tear her family apart.
"The parents of Dreamers are the original Dreamers," Manrique said. "They get put in this bad position because they're not the 'special' ones, and that is what worries me. They also have rights, and they need that pathway to citizenship. And at this point, no one is fighting for them."
Still, Montelongo said, given the time pressure, they may have to settle for whatever Congress is able to push through by March 5th.
"I feel conflicted being vocal about something like the DREAM Act if there's no more action for comprehensive immigration reform in the future," he said. "We don't want to set our goal as the ideal and not pass anything at all. So even if we compromise right now, we can't let go of what the ideal is."
DACA was never meant to be a long-term solution. Obama created the program by executive action in 2012 after Congress failed to pass an earlier version of the DREAM Act. DACA's genesis also explains why it was so easy for Trump to undo.
"We Are With You"
The large portion of DACA beneficiaries at Loyola Stritch means their future has become a call to action for the entire school. After the white-coat rally, students organized mass phone calls to lawmakers.
"It was a gut-punch," said bioethics professor Mark Kuczewski, who chairs Loyola Stritch's department of medical education, of Trump's announcement. "But these are the kinds of young people who have lived their entire lives not taking no for an answer. And within 24 hours, we had our entire community saying, 'We are with you.'"
The American Medical Association, for its part, has said the end of DACA would not only leave dozens of medical students in limbo, but would exacerbate the physician shortage in the U.S. The country lacks 8,200 primary care physicians, and the figure could grow to more than 61,700 by 2025, the AMA said.
"DACA students are also more likely to be bilingual, to come from diverse cultural backgrounds, and to understand challenges in certain ethnic communities," it wrote in a September 5th letter to Democratic leaders. "Without these physicians, the AMA is concerned that the quality of care provided in these communities will be negatively impacted and that patient access to care will suffer."
As for Manrique, her DACA status expires in August of 2018. By then, she'll have finished her third-year clinical rotations. But without a post-DACA solution, she won't be able to apply for her medical residency, the prerequisite to becoming a doctor.
"It's got to be baby steps," Manrique said. "I'm thinking, 'Let me finish this week, this rotation, this year.' It's one day at a time. And hopefully I can get my M.D. degree."