The March 2020 arrest in Minnesota of Pakistani medical doctor Muhammad Masood on terrorism charges underscores the need to reassess current security protocols in place to vet doctors, engineers, and other skilled professionals who arrive in the U.S. on H-1B visas from countries of national security interest. Hippocratic Oath takers are not immune to radical Islamism.
Undermining Critics of Trump's 'Travel Ban'
H-1B visas allow millions of non-immigrant foreigners to work temporarily in the United States, in skilled jobs for industries and big businesses that vouch for their need of the workers and are willing to sponsor them. The visas are renewable and their holders often hope to parlay them into green cards and long careers in America.
The U.S. tech industry is the most prolific employer of H-1B workers, especially Indians, over the past decade or so, but the healthcare system is right up there, claiming shortages of skilled American workers. Masood would have been among 1,871 Pakistanis who applied for H-1B visas in 2018, among a total of 419,637 that fiscal year. The medical and health sectors hired more than 185,000 H-1Bs of all nationalities between 2007 and 2017.
Medical centers like Mayo like hiring foreign medical school graduates like Masood to work high-volume hours, and they clamber for research jobs with name-brand clinics in a desperate hope to snag a rare and valuable residency spot, which almost guarantees a prosperous American life; indeed, Masood's LinkedIn site openly described himself as a "Residency Aspirant 2020!"
The Masood arrest undermines critics of President Trump's travel restrictions on Muslim-majority nations, some of which have explicitly complained that it has blocked foreign-born physicians from, initially, seven Muslim-majority countries (Pakistan not among them) on the travel-restrictions list. For example, a 2017 New York Times report quoted medical establishment figures lamenting that Trump's "travel ban" had blocked thousands of desperately needed foreign physicians (like Masood) who, if they could achieve the requirements, would work in under-served small towns and poor urban neighborhoods that American doctors eschew as not lucrative enough.
More than 15,000 doctors from the seven Muslim-majority countries were covered by Trump's restrictions, including 9,000 from Iran, 3,500 from Syria, and 1,500 from Iraq, the Times reported.
But the Times story and critics, oddly, never seem to address obvious homeland security concerns like vetting such visa applicants for security.
Those critics should finally have to address the Masood case, and many more besides.
Doctors of Terror
Maybe it's time to start adding professionals like foreign doctors applying for U.S. medical positions to risk profiles from all higher-risk countries not on Trump's travel restriction list, which would trigger deeper-dive investigations for H-1B visa applicants in countries of national security concern like Pakistan.
The idea is not far-fetched when considering research-based evidence and other anecdotal reporting that medical doctors all too often become terrorists or terrorist leaders. There's Bin Laden's successor, Dr. Ayman al-Zawahiri; George Habash, who founded the Popular Front for the Liberation of Palestine; and Fathi Shikaki, founder of Palestinian Islamic Jihad. Abdel Aziz al-Rantisi, the late leader of Hamas was a pediatrician.
Doctors are not just terrorist leaders, but operators too. Eight suspects in the 2007 foiled so-called "Physicians Plot" to bomb London and Glasgow targets were physicians and medical professionals, such as the Iraq-born Dr. Bilal Abdullah, arrested trying to blow up a jeep packed with gas cylinders at the Glasgow airport.
U.S. Army Maj. Nidal Hassan, the jihadist who massacred soldiers at Fort Hood in 2009 was a doctor. The American-educated "Lady al-Qaeda," Pakistan-born Aafia Siddiqui is now in federal prison in Texas after a 2010 conviction for grabbing an M-4 rifle after her American capture in Afghanistan and opening fire on U.S. soldiers, screaming "Allah Akbar!" She is an M.I.T.-trained neuroscientist who earned a PhD from Brandeis University and went on to plot mass-casualty attacks on several New York City landmarks.
In 2015, ISIS put out a call for foreign health workers through social media, blogs, and high-budget videos boasting of state-of-the-art facilities and equipment and medical schools in which 100 students were allowed to train for free (half of them foreigners).
Doctors and medical students responded enthusiastically and came running for the opportunity from the UK, Canada, the United States, and other countries. One of them was Kefah Basheer Hussein, a doctor of rheumatology who served ISIS and its predecessor incarnations for 15 years, according to CNN, which interviewed the captured physician in 2018. He both killed and healed as ISIS Minister of Health. But Hussein also oversaw organ and blood harvesting from captives scheduled to be executed.
A friend of mine who administers a medical school and hospital complex in the U.S. Southwest, and who did not wish to be quoted by name, told me the facilities that bring in foreign medical students on H-1B visas from the Muslim world do no security vetting on their own and rely instead on the federal government to do that work.
"We might run drug tests or something with criminal background, but the assumption is that the government has done that job," he said.
H-1B applicants go through about the same security screening as those entering on a tourist visa.
Because they are non-immigrant temporary workers, H-1B applicants go through about the same security screening as would a foreigner wanting to enter on a tourist visa, even in countries of national security concern like Pakistan, which is regarded as a "high-threat" post.
Federal officials familiar with the vetting process tell CIS that DHS and the State Department will check the application packet for obvious signs of fraud and run applicant names and dates of birth through TECS, CLASS, and IDENT databases for hits on terrorism watch lists or criminal history. Fingerprints are run through other databases. The packet is passed to an in-country U.S. consular officer, who will call the applicant in and conduct a perfunctory, pro-forma interview looking for signs of fraud or inconsistency. The same checks typically are run on anyone asking for a short-term tourist visa, even in countries like Pakistan where U.S.-designated terrorist organizations operate.
"It's the same amount of vetting as to go on vacation at Walt Disney World," one DHS veteran explained.
With no database hits, paperwork in order and checking out, and no suspicions of fraud, said one officer of the U.S. State Department familiar with the process, "the consulate officer probably said, 'oh, he's a doctor ... he's going to the Mayo Clinic ... this packet is probably ok ... um great, go save lives!'"
In 2019, the Trump administration wisely moved to toughen vetting for all foreign visa applicants by requiring five years' worth of social media profiles, email addresses, phone numbers, international travel and deportation status, as well as information on whether any family members have been involved in terrorist activities. Data like that might have opened more vistas on visa applicants' hearts and minds, maybe even deterring those who have something to hide in their social media.
But Masood seems to have secured his visa and entered the United States prior to this social media requirement, although there's a chance he may have been required to under earlier pilot programs.
To be fair, probably fewer dangerous terrorists than not end up in intelligence databases, leaving those responsible to somehow read hearts and minds.
Labor-intensive vetting of H-1B applicants is still rare and not normalized.
A labor-intensive investigation, such as checking a petitioner's online life and interviewing friends, relatives, and former employers might turn up a terrorism problem. But those kinds of investigations, while certainly helped by the social media and email address requirements now, are still rare and not normalized.
"You'd need a crazy Carrie," the State Department officer said, referring to the lead character in the television series Homeland, to uncover a prospective terrorist applying for an H-1B visa with current protocols and resources. "There's only so much you can do. You do everything you possibly can and, just, you know ... ? It sounds like this guy was the model citizen. If all of his paperwork was in order, and a consulate officer said 'he's a doctor, he's going to the Mayo Clinic,' they're just not going to do a lot of checking."
Todd Bensman is a fellow at the Middle East Forum and a senior national security fellow for the Center for Immigration Studies. He previously led counterterrorism-related intelligence efforts for the Texas Intelligence and Counterterrorism Division.