San Francisco, United States

Welcome Back to a Healthier Community

The Welcome Back Initiative

September 30, 2010

Training and support to link culturally diverse health care professionals to employment and healthier communities.

Dr. Maria Ait Rais, a medical doctor from Morocco, arrived in San Francisco in 2005. She had been in the US for just one week when she came to the San Francisco Welcome Back Center.  She had previously practiced medicine for two years but now, new to the Bay Area and with very limited English, medicine no longer seemed like an option. She spent the first two years studying English; then she focused her time preparing for the licensure exams – with a dictionary at hand – while being a mother to her newborn son.

Dr. Ait Rais’ story is a familiar one for internationally trained health professionals in cities across the United States.  Highly skilled talent is wasted while a critical shortage of minority representation in community health care (from nursing, pharmacology, dental hygiene, respiratory therapy, psychology and social work, to name a few) leaves many communities under-served.

A local issue, with broader implications

In 2004, Dr. Louis Sullivan, former U.S. Secretary of Health and Human Services, tabled a report which concluded that, “the lack of minority health professionals in America is compounding the nation’s persistent racial and ethnic health disparities.”

A startling example of the situation Sullivan describes is seen in the state of California where the Latino population comprises 31% of the total population, but represents only 4% of nurses and 4% of physicians throughout the state. The services and treatment that health care professionals provide are based on their skill and ability to interpret and diagnose the needs of their patients. In newcomer and diverse communities, this often means navigating linguistic and cultural barriers that can reduce effective communication and limit health literacy.

Enter the Welcome Back Initiative, a project started in San Francisco that is helping internationally trained health professionals use their skills while addressing these essential health gaps in community health care.

Welcome Back

The Welcome Back Centers offer assistance to internationally trained health professionals. Orientation services, in-depth educational case management and vocational support are among the services provided and are all designed to help these professionals navigate complicated licensure and certification systems so that their professional skills can be put to use in the job market in an appropriate and productive way.

“We see our work as building a bridge between untapped resources and unmet needs,” says the programme’s founder. Dr. José Ramón Fernández-Peña.

The services are all free, offered in multiple languages (e.g. English, Spanish, Cantonese, Mandarin, and Russian) and available to all foreign trained health professionals living in the Center’s service area.

Staff at the Welcome Back Centers offer individually tailored support to their participants. A new participant begins with an initial interview during which basic demographic information is collected. This is followed by an in-depth appointment with an educational case manager who reviews their professional and educational experience. The educational manager then provides information and guidance about licensing requirements, credential validation agencies, health-related programmes and when needed referrals to English language courses.

The Welcome Back Centers also offer workshops and other group activities such as licensing study groups which serve as peer networking and professional support opportunities. The Welcome Back Centers have test preparation lending libraries for participants to be able to borrow books and materials that would be otherwise expensive to purchase.


Success travels well. The Welcome Back Center model has been replicated in nine US cities in eight states including California, Massachusetts, Rhode Island, Maryland, Washington, Texas, New York, and Colorado. These centers currently comprise the Welcome Back Initiative.

Over 10,500 health care professionals have been served through the Welcome Back Initiative and thousands are in the process of obtaining the licenses and certificates they need to share their skills and experience with their local communities.

To date, over 2,435 participants have validated their credentials, 1,447 have passed their licensing exams and 839 obtained licenses in their original professions. Over 460 have obtained advancement in their health careers and 1,540 obtained employment in the health sector for the first time. In addition, 87 physicians have been accepted into residency training programmes.

This includes Dr. Maria Ait Rais who, with the assistance of the Welcome Back Center first began volunteering in the healthcare sector, then became a research assistant at the Children’s Hospital in Oakland, and in July of 2010, after acing her licensure exams, began her medical residency. “The Welcome Back Center is a place where an immigrant can come for support and where you can feel like you can accomplish your goals.”

To help support this replication, the Welcome Back Initiative has developed materials that will allow other jurisdictions to more easily duplicate their success.

“As we’ve begun to see results, we’ve learned that there are larger structural elements that affect what we do,” says Dr. Fernández-Peña.

To advance systematic change, the Welcome Back Initiative is now also working with policymakers and other partners to reduce the structural barriers that prevent internationally trained health professionals from practicing in the United States. This includes working with educators, regulators, employers and legislators to identify opportunities to expedite licensing processes while ensuring that professional standards are maintained.

Making it Work for You:

  • Do the due diligence! Understand the licensing processes for each profession and document the need for a multicultural/multilingual workforce
  • Identify educational partners as well as employer partners
  • Create a supportive environment for training and workshops so participants can also benefit from the networking opportunity
  • Use successful outcomes and lessons learned to create a supportive policy environment

For this Good Idea contact:

José Ramón Fernández-Peña, MD, MPA
1600 Holloway Ave., HSS 314
San Francisco, California, United States,