By Cesar E. Montelongo Hernandez

Last week a federal appeals court upheld the ruling that blocks the Trump administration from ending DACA. This means the nationwide injunction that allows DACA to remain will stay in place. Despite this, the legal battle will continue and likely head to The Supreme Court of the United States. DACA recipients have been granted a few months of respite but their long-term outlook is still very uncertain.

I am currently in my fourth year of medical school. In total the combined MD-PhD program takes eight years to complete (an MD degree alone takes four years). Students begin by completing two years of the MD, switching over to the PhD for about four years, then coming back to complete the last two years of the MD. At present I have completed two years of the MD degree and I am in the second year of the PhD degree. Ideally, I will complete the PhD degree by 2021 and the MD degree by 2023.

My current DACA permit will expire by Spring of 2020. That’s more than one year before completing my PhD degree in 2021. Logistically, I need the work permit associated with DACA so that I can be funded and pay for my tuition and living expenses. Even if I lost DACA, my conjecture is that it is likely that I will be able to continue my PhD degree. The key would be to identify the portions of my funding that require me to have a work permit, then code my funding into something less stringent like an institutional scholarship. I would live mostly off the grid and quietly complete my degree by 2021. My main concerns would be that of any PhD candidate and the additional anxiety of being deported at any time. This is the perk of being in the PhD portion of my training during this DACA uncertainty, as the situation would be more complicated during my MD training.

After completing my PhD, I would return to medical school to complete the last two years of my MD degree. The clinical portion of my MD degree would not necessarily require DACA to complete, as long as I have funding and I am not targeted for deportation. The issue is that a work permit is an absolute requirement for being admitted and completing medical residency training.  If I lost my DACA work permit, I would have roughly a year after my PhD to decide my future. Currently the most likely options would be to buy time by returning to lab research after earning my MD, though I would not be officially employed. Perhaps I could use my degrees as leverage for a Visa, though somewhat difficult as my residency training is not complete and I am not a full physician. Alternatively, I could leave the country with my degrees to seek employment elsewhere. Honestly there’s so many variables, most adverse, that it is difficult to plan concretely beyond the immediate.

But even with all of this, my mission is to persevere and progress. Advances can be made at the front of personal achievement, by adapting institutional policy, and supporting governmental decisions (e.g. legislation, executive policy, and court rulings). For allies in the biomedical community, my call to action is in being supportive at the levels that your position allows. For example, this year multiple DACA recipients were admitted to medical residency programs. Part of this accomplishment was due to the leadership that select medical residency programs took as they assessed these DACA applicants despite the uncertainty of their status. DACA supporters in the medical setting can aid us not only by supporting DACA-relief at the level of government, but by having conversations with their peers and programs about how policy at the institutional level can be adapted to allow people such as myself to continue their training.

Cesar Monelongo Hernandez is a student in the MD-PhD program at the Loyola University Chicago Stritch School of Medicine and a DACA recipient. To see how his story develops, follow him on Twitter @bacteremia