The problem of missionary physician recruitment must be the concern of all of us. Deep study, much prayer, and personal visitation is necessary to meet the call of world medical needs. May God enable us to find men dedicated wholly to the body of the work as well as to the right arm of the message.—Editors.
One of our workers at the alumni office fired the imagination of her non-Adventist brother by telling him of the opportunities for foreign medical mission service and adding that only one of every ten doctors graduating from CME was being sent out. "Who gets to go?" was his eager question. She did not have the heart to tell him there is an actual shortage of available doctors among us alumni.
In the January-February, 1958, number of the Medical Service Exchange, Dr. Theodore R. Flaiz, '38, medical secretary of the General Conference, listed twenty foreign medical calls. Most of these were more than twelve months old.
If we add to this year the time of study and deliberation in the field prior to placement of the call, the additional time consumed in processing the call, the search for a doctor, negotiations with him, physical examinations and immunizations of him and his family, liquidation of his practice, visa, travel, foreign medical board examinations and possible language study, we can readily see how another one to two years could slip by before the opening would be filled.
While most of the calls are placed well in advance of their actual openings, yet field administrators tax their ingenuity to satisfy the local needs during the waiting period. Many times the mission doctor is persuaded to stay on past his due furlough time, or else the institution is crippled for lack of replacement. As was explained, this time could easily mount to two years.
What are some of the reasons for such shortage and delay?
Someone has aptly said that "a church without foreign missions is a church without a mission." We belong to a church with an aggressive, dynamic foreign-mission program including numerous medical mission stations and hospitals. Has their number increased out of proportion to the number of students graduating annually from our CME School of Medicine? Hardly. We, the alumni, students, and faculty of the CME, cannot shrug this off as being of concern mostly to the field and the Mission Board—it is equally our concern, for it is the avowed purpose of the CME to meet the medical needs of the sponsoring church organization.
The problem is perhaps more complex than one standing on the sidelines can fully visualize. But I feel reluctant to believe that it needs to continue, long defying adequate solution. As one who has been in medical mission service on two continents and who through the years has been interested in this subject of recruitment, I shall mention some of the reasons for our failure and offer some suggestions for remedy.
Reasons for Difficulty
A. The Caller (Denomination)
- Lack of sufficient and reliable information about conditions, needs, opportunities in field originating the call
- Lack of adequate information regarding prospective candidate
- Problems in transmission of call due to lack of specificity, poor timing, random choosing
B. The Called (M.D.)
- Financial indebtedness upon graduation and other obligations and investments
- Sinking roots in medical practice
- Family ties and needs
- Personal comforts, social and medical contacts, avoidance of hardships, fear of the unknown
In the afternoon of July 1, 1931, in Los Angeles, intern A was called from the examining room of Part III of the National Board and asked by a visiting clergyman from the General Conference if he would consider a call to Africa. Intern A had on the previous day expressed his desire to Dr. Percy T. Magan to go to a certain country of the Far East where he knew one of the languages and for which field he had quietly been preparing himself. But Africa? He had only foggy ideas about that continent. And what about the C medical mission station? Well, the visitor knew nothing about it, but intern B, a fellow examinee who had once been in Africa, had a vague recollection of passing through that station, remembered particularly that there was "lots of sand, rocks, thorn bushes, and natives."
With that much information the visitor urged intern A to accept this call and to inform him so before sunrise of the following day when his train was taking him back to Washington, D.C. A three-minute, long-distance telephone call to the intern's wife sufficed to persuade her. By July 19 they had confirmation of the call, and two days later the young couple was on its way to the mission field.
In the British Isles the new missionary passed the qualifying medical examinations in record time but then found that the field was not ready for him. For many weeks there was no entry permit. When finally he reached the field, his destination had been changed successively from C medical mission to three others, for which he and his wife had no preparation whatsoever.
They made the most of things under difficult circumstances, but in a few short years they, disheartened and dejected, returned for reasons of poor health.
This brief, true account illustrates a number of points under consideration. True, there was speedy action and ready acceptance of a specific call. But what of the information regarding the field and the appointee and the latter's lack of physical and psychological preparation?
Suggested Remedy
I am sure that the secretaries of the General Conference put forth a great deal of effort to find out about the field and the prospective appointee before they make their contacts. But much more needs to be done to attract larger numbers of our CME graduates and to choose the right sort of persons for mission service. Ideally, each appointee should be tailor-made for a specific assignment. This could be partially achieved in the following manner:
Each field where the station is located could prepare a prospectus, depicting, in word and film, conditions (climatic, political, religious), needs and opportunities (economic, medical), and sundry activities,and submit it for editing to the respective Division of the General Conference, which would pass it on to the central office in Washington, D.C., for use of the Foreign Missions Committee. Such information could then be dispensed to potential candidates or to interested inquirers or study groups.
Each Division Medical Secretary knows his personnel, their furlough due dates, replacement needs, and new openings. Each field committee knows its budget capacity. Periodic lists of current and prospective openings could be announced in the CME publications or the Journal.
Among the students and faculty of the CME, groups could be formed which would study medical missions, selecting certain areas, even a specific hospital or station. They could gather all possible information from the prospectus, periodic list, visiting returned missionary, and other sources and thus in a sense become specialists on the subject. The work of Dr. Ralph F. Waddell, '36, has been an inspiration to many. While yet a student at CME he chose Thailand, studied about it, and prepared himself for service to its people. It is common knowledge how from practically nothing he led in building up an extensive medical work which is highly thought of by the Thai people, the government, and visitors from abroad. Directiveness in our thinking and endeavor is important.
CME Working on Plan
Dr. John E. Peterson, '39, assistant dean of the School of Medicine, is working on a plan to enable selected medical students to spend a portion of their summer vacation assisting with the work in some of our nearest foreign mission hospitals. No doubt their reports will spark foreign mission interest among our students.
Careful selection of students reduces failures, and CME cautiously screens entering students, starting with their premedical years. The Dean of Students from CME carefully watches and repeatedly confers with them, and the colleges render impartial reports. The percentage of error and failure is reduced to a minimum.
Information regarding an individual student is additive in the dean's and registrar's office, and could readily form the nucleus for a dossier to which further data could be added even after graduation. A special standing committee could be formed with representation from the faculty, students, and alumni, which as the Medical Recruitment Committee as a screening agency could render valuable assistance to the General Conference Missions Committee.
While an occasional unforeseen need may arise, most calls should not have to be made on an emergency basis; doing so reveals poor planning and timing. Short-term appointments can be specially arranged for, but long-term appointees should not be unsettled by aimless shifting hither and yon. Even in foreign countries it takes time to build up a following in practice. The usual policy of allowing a person only a certain number of years in a given place should not be applied to doctors. We have one alumnus, Dr. Roy B. Parsons, '29, who has never been shifted because replacement was impossible, and he has been outstandingly successful.
Sometimes an urgent call will be passed on almost simultaneously to several persons. General calls hold little appeal. A man must sense the appeal of a specific need in order to respond heartily.
Failure Is Traumatic
The fact that a man holds an M.D. degree does not necessarily qualify him to become surgeon and administrator of a hospital. Failure is a traumatic experience for him and an expensive one for the field. Also, if the man has been a social misfit in the homeland, in all probability he will not establish good rapport in a foreign setting. None of the best among us is too good to become a successful foreign medical missionary; for it takes talent, ingenuity, wisdom, endurance, and patient perseverance.
The General Conference has a deferred appointment plan which pays a chosen student his last two years' tuition on condition that he does not obligate himself otherwise. During these years a student can earn very little on the side or during an almost non-existent summer vacation, so to become eligible for the deferred appointment, a poor worthy student needs further financial assistance to meet his living costs. An Alumni Medical Missionary Bursary Plan could be evolved to provide such supplementary financial assistance, thus enabling certain students to respond to calls for foreign mission service. As the bursary fund grows, it could help a young graduate to liquidate private indebtedness on a prorated annual basis for each year of foreign service. This could equally apply to a resident who with his family has struggled through a long siege of a specialty training program.
M.D. Versus Minister
For the man already established in practice, a call poses still other difficulties. He may have succeeded in paying off his school debts, but he also has found it necessary to invest heavily in home, office, and equipment. Such investments are not always easy to liquidate without considerable loss. It is certainly more difficult to pull up roots from an established practice than to go into mission service direct after completion of internship or residency, provided the appointees in the latter category receive the necessary financial assistance.
The situation of a medical appointee to a foreign mission assignment is different from that of a ministerial appointee. For a minister, a call to foreign mission service is more in the nature of a transfer to another post within the employing organization. Upon return to the homeland he almost automatically receives another assignment, and upon retirement can expect sustentation from the denomination and social security from the government.
The doctor, on the other hand, has to liquidate a practice, perhaps dissolve a partnership. Protracted negotiation has a deleterious effect on his practice. Returning home he may not find employment in the organization. It takes time to build back his practice. There are other specific classifications which might be illustrated by the example of a physician I heard of recently. After having served eighteen years in foreign mission fields, he came home for health reasons. Unless he can resume work for the denomination within five years, he forfeits his sustentation credit. As there are few posts for physicians in the organized work in the U.S.A., and the health reasons will probably not allow him to serve overseas again, he must start at the bottom in private practice. He is not eligible for social security, nor can he take on any insurance program which will care for him when he must retire. He would be willing to pay into the sustentation fund, but that is apparently against the policy. This sort of thing could hardly happen to a minister. Generally speaking one might sum up that the minister is in it for life, while the physician only for the duration of a specific assignment.
Another reason for finding fewer medical appointees as compared to ministerial is due to the inequality in expense and duration of preparation. A physician has spent four to eight more years in costly study preparing for a foreign mission appointment. Perhaps the mission organization should take more cognizance of this in assisting medical appointees in their financial struggle.
Who Among Us?
There are many giants blocking the way. If one stops to consider the sacrifices he has to make, the hardships he has to overcome, and some of the inequalities mentioned, he will turn to the comfort and freedom of his private practice, leaving the burden of the call, perhaps to someone with less fitness and preparation. Foreign mission service is not for the fainthearted. If one considers the matchless love so well illustrated by the magnitude of Christ's sacrifice, and when one allows that love to flow through his own life, a call to service of needy mankind in a distant land becomes a challenge, a privilege, and an adventure for God. Who among us will experience the thrill and satisfaction of such service?
