When Emiliana Gonzalez, a U.S. citizen born to Mexican parents, applied to the Faculty of Odontology at Mexico’s National Autonomous University (UNAM)—the top dentistry school in Mexico—only 100 students were accepted out of 4,000 applications. Fortunately, Emiliana was one of them, but even the honor of getting accepted into one of the most competitive programs in Mexico has not translated into a job in the United States.
Since 1995, more than 3 million Mexicans and their families have migrated from the U.S. to Mexico. That includes approximately 310,000 U.S.-born children under the age of five. Like Emiliana, these children hold dual citizenship, enjoying the perks of both worlds without having to worry about getting a visa to either visit or study in the United States.
Emiliana now proudly holds a doctor of dental surgery (DDS) degree from UNAM. Since earning her degree she has worked for a number of years, gaining experience, and is now ready for the next step: to study forensics odontology to become a licensed practitioner.
Unfortunately for Emiliana, and thousands of other skilled professionals, the Mexican institutions that teach her choice of specialization are limited both in number and in quality. So she plans to return to her birthplace, the U.S., to enroll in a program. And that’s where it gets tough. While for a U.S. native it would be no problem to roll over the credits from a DDS degree for a specialized course of study, for a graduate from Mexico—even from the best school in the country—it isn’t that easy.
Since the North American Free Trade Agreement (NAFTA) took effect in 1994 (the year Emiliana was born), Mexico has transitioned from a closed state-dominated economy to become a leader of free trade globally. The North American agreement was key in this process. Considered NAFTA’s biggest winner, Mexico is now the 14th largest economy in the world, a leading exporter of advanced high-technology manufacturing and, according to the United Nations Conference on Trade and Development’s “World Investment Report 2015,” the 13th most attractive country to invest in.
But although NAFTA has propelled unparalleled economic achievements and knitted the U.S. and Mexican economies together in ways unimaginable 20 years ago, in education the exchange is far from free… or fair.
The NAFTA contains two entire chapters (chapters 12 and 16) relating to cross-border trade in services—which includes both professional education and licensing standards—and temporary entry for business persons. Annex 1210.5 includes a statement specifically establishing that NAFTA members “shall encourage the relevant bodies in their respective territories to develop mutually acceptable standards and criteria for licensing and certification of professional service providers.” The point? To recognize professional education and degrees obtained in all three countries of NAFTA across member borders.
Even though poor investment in education infrastructure is much to blame on the Mexican side (among OECD countries, Mexico spends the least on education as a percentage of GDP, investing only $8,100 per student, compared with the OECD average of $15,000), the asymmetry in the recognition of degrees and licenses granted by U.S. and Mexico’s higher education systems is grossly distorted. Since the creation of the Higher Education Accreditation Council by Mexican President Ernesto Zedillo in 2000 to coordinate the accreditation processes for approved disciplines, only actuaries, accountants and architects have been able to reach agreements with their U.S. and Canadian counterparts, establishing the first schemes of mutual recognition agreements.
According to the U.S. Department of Education’s International Affairs Office, there are over 50 professional fields that are licensed in all U.S. states and territories, of which a majority require some formal post-secondary education or training as a prerequisite for entry. And although not all of these professions have specialized credential evaluation services, nor do all of them have procedures for recognizing non-U.S. qualifications, it is often the case that foreign trained professionals must engage in extra years of study in the U.S. before qualifying to obtain a license to practice. This is common for all health professions, including chiropractic medicine, dentistry, dental hygiene, pharmacy and psychology, and others such as cosmetology, law, social work, teaching and veterinary science, to mention just a few.
In Mexico, professions are regulated by the Ministry of Education, which issues a professional license (cédula professional) after successful completion of a recognized undergraduate degree. It is worth mentioning that not all professions demand a professional license to practice, but there are around 25 professions that do, including architecture, biology, law, medicine, nursing, chemistry, veterinary and notaries. Although it can be a time consuming and bureaucratic procedure, foreign trained professionals can obtain a professional license to practice in Mexico in a more accessible and affordable way than in the U.S., as they do not need to re-enroll in a program to qualify for a license, but rather can validate their degree before the Ministry of Education’s General Professions Directorate. With a few state exceptions, like Jalisco, after obtaining a professional license in Mexico, a person can practice their accredited profession in the entire country.
Resistance to harmonized qualifications has impeded the free mobility of professionals between the North American countries, thereby creating bottlenecks and distortions in the labor market.
Originally, NAFTA opponents in the U.S. feared that the harmonization of the free trade process would result in a decrease in funding for education in home countries and lead to a flood of exchange students seeking entry into U.S. system. 22 years after the signing of the treaty, the effect is quite the opposite. The number of Canadian students attending higher education in the U.S. has decreased and Mexico has become the fifth most popular destination for U.S. students studying abroad. The problem is, though, the degrees and licenses they may obtain across the border aren’t valid in their native labor markets.
While Emiliana holds a valid U.S. passport and a Social Security number that enables her to work, since she is a foreign-educated dentist, enrolling in a specialization and obtaining a license to practice is not an automatic process. First, she must obtain a degree from a dental education program accredited by the American Dental Association Commission on Dental Accreditation (CODA), which implies studying for at least two or three more years to obtain the DDS degree she already earned at UNAM. (This, by the way, is not required of dentists trained in Canada; CODA identifies foreign-educated dentists as individuals who have attended, graduated and earned a dental degree from a dental school in a country other than the U.S. or Canada.)
In the U.S. alone, between 2010 and 2020 an estimated 5.6. million vacancies for health care professionals at all skills levels will open. But blocks to the free flow of professionally qualified labor have made getting to practice dentistry an even more difficult task than qualifying for a visa. The same is true for other highly specialized occupations like medicine and law, where licenses to practice are subject to national and in some cases, state approval. Canadian doctors and lawyers do need to get state licenses but they typically don’t have to engage in extra years of study prior to qualifying for it. They are subject to the same requsites as domestic students.
The harmonization of qualifications between U.S. and Mexico represents an important source to fill in the need for high skilled health care professionals (and other specialists) in North America. The disjuncture between the standards across the border remains a significant gap in the full implementation of NAFTA and more efficient cross labor markets. In the meantime, though, well-qualified professionals like Emiliana, and the other sons and daughters of NAFTA, will have to pile up additional years of study just to meet a legitimate need on the other side of the border.