Health Beyond the Blog: Eram Alam, PhD and “The Care of Foreigners”

Alam’s new book examines the history and consequences of the immigration of physicians from post-colonial Asia to the US.

by Clara Silvestri

While growing up, Eram Alam, PhD, born in the United States to Indian immigrant parents, noticed that those around her would often assume that she was the child of physicians due to her first-generation South Asian status. Now an associate professor of the history of science at Harvard University, Alam decided to dive deeper into those everyday associations she saw made between Asian immigrants and the healthcare professions. Her resulting book, The Care of Foreigners: How Immigrant Physicians Changed US Healthcare, examines the history and consequences of the immigration of physicians from post-colonial SOuth Asia to the US.

Alam provides context for the presence and impact of South Asian immigrant physicians in the US with her interview with author and journalist Maryn McKenna on Nov. 19, 2025, for the Health Storytelling live Q&A from the Center for the Study of Human Health. She explains how the US exerted its soft power, post World War II, by advertising medical positions in the US at hospitals in South Asia. Many of these positions were based around visas that required immigrant physicians to work in an underserved area for a period of time upon arrival. This created a labor stratification in which US-trained physicians were more concentrated in well-resourced big cities, while internationally-trained physicians were more concentrated in rural areas with medical shortages.

It is often stated that the US is facing a doctor shortage, however, Alam finds that it is not a shortage issue but instead a distribution issue. After immigrant physicians finished their required time in rural areas, they would often leave to pursue their careers in more lucrative suburbs and cities. This created a low retention rate for physicians in rural areas, but this gap was constantly filled by new physicians coming from South Asia to pursue careers in the US.

Immigrant physicians had to put in extra effort to develop trusting relationships with their patients as those spaces were primarily occupied by white and male American physicians. The American Medical Association offered no support, inconsistent with their advocacy for other marginalized groups in medicine such as women. With little help from the outside, immigrant physicians had to turn to each other to build a strong and respected community.

Immigrant physicians were trained in government subsidized elite medical schools in South Asia and carried little to no debt when they moved to the US. Without debt, they were able to accumulate financial capital early in their careers. This capital, along with a strong community, empowered immigrant physicians to mobilize the government to see them as equals to their US-trained counterparts. Today, South Asian physicians have become a symbol of authority in our culture, with their children often carrying on this legacy if they too choose to pursue a medical career.

South Asian physicians are now so common in our culture that the first ever South Asian lead on a television show, The Mindy Project, was a physician. With the current administration attempting to make it more difficult for hospitals to hire international medical graduates, the impact of immigrant physicians may become more apparent now more than ever. Alam’s book reminds us not to take for granted the roles that these physicians play in providing healthcare to the most vulnerable of Americans.

The Care of Foreigners: How Immigrant Physicians Changed US Healthcare is available on Bookshop.org and you can watch the interview with Alam on Emory University’s Center for the Study of Human Health YouTube Channel.