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- Anna Mykhailova and Sasha Druzhyna fled Ukraine after Russia invaded, leaving behind careers as physicians.
- Wisconsin needs more medical professionals, including physicians. But those with foreign training face hurdles that can keep them from filling that gap.
- State officials recently eased requirements for foreign-trained doctors, but Mykhailova isn’t sure what the change means for her.
- Anna works as a sonographer at a Madison hospital, while Sasha is studying for a master’s degree in medical perfusion at the Milwaukee School of Engineering.
- The family is among 100,000 Ukrainians with Temporary Protected Status, allowing them to live and work in the United States for renewable 18-month stretches.
Sasha Druzhyna knows all about transplants.
As an anesthesiologist and perfusionist in Kyiv, Ukraine, Sasha used specialized equipment to keep patients’ blood pumping during heart transplants and keep donor organs alive until they reached their recipients.
Now, after fleeing Russia’s full-scale invasion, the 52-year-old is learning his profession all over again as a student in Milwaukee School of Engineering’s medical perfusion program.
Eighty miles away, his wife Anna Mykhailova, 42, is starting over, too. In 2024, she started a job as a cardiac sonographer at a Madison hospital, using skills she refined as a cardiologist in one of Ukraine’s top heart hospitals. She’s also studying for the medical board exams in hopes of one day practicing medicine in the United States.
But as they work to rebuild their careers, they still don’t know if they’ll be allowed to stay.
“It’s so stressful because of this immigration process. I will do these really hard exams and they (might) say, ‘Oh, you have to leave this country,’” Anna said of the family’s immigration limbo.
Wisconsin needs more medical professionals, including physicians. But as the couple’s experience shows, those who arrive in the country with foreign training face hurdles that can keep them from filling that gap.
A new life begins
Had the couple fled to Europe instead, their career paths might have been simpler. Sasha might be the teacher instead of the student. Anna might still be a doctor.
But the invasion left no time to deliberate. Anna and her colleagues moved their patients to the hospital’s basement, then brought their own families to shelter there, too. Anna and Sasha brought their daughter, Varya, who was 6 years old at the time.
They listened to the news as Russian troops occupied the suburbs around Kyiv.
“When they showed civilian kids killed by Russians … I realized that nobody will protect us and (we) just have to go,” Anna said.
A friend with military connections warned that Ukrainian forces would soon blow up Ukraine’s own bridges to stop Russian troops from taking more ground.
“They told us, if you want to leave, you have to leave right now,” Anna said. Sasha drove his wife and daughter west, past sirens and explosions, toward the border with Poland.
A week later, Anna and Varya were on a plane to Boston, where Anna had a friend from medical school. Arriving with tourist visas, she thought they’d be away for just a few weeks. Sasha, who didn’t speak English, opted to stay.
“Coming here, starting from zero, no money, no nothing, no job — he didn’t want to come and wash floors in a supermarket … It’s really difficult to immigrate when you already had something in your home country,” Anna said.
He kept working in the hospital, caring for his usual patients and the war-wounded. They figured the fighting would end soon.
But about a year later, Sasha joined his family in Madison, where friends helped them get settled.
“We realized that this war is going to be forever,” Anna said. “I don’t believe that they will stop it.”
The three are among more than 100,000 Ukrainians who’ve been granted Temporary Protected Status, or TPS, because the federal government deems it unsafe to return. The status allows them to live and work in the United States for renewable 18-month stretches.
Almost four years later, they’re still here — and hoping to stay. The war rages on, and they’ve embraced their new home. Varya, 10, now speaks mostly English.
“She doesn’t want to speak Ukrainian anymore,” Anna said in an interview at her Madison apartment building in September. “So for her to go back to school in Ukraine … it’s possible, but it’s going to be really difficult.”
But staying isn’t easy either. Restarting their careers has come with significant personal and financial costs, and there’s no guarantee their efforts will pay off.
Covert cardiologist
Until recently, all foreign-trained physicians seeking to practice medicine in Wisconsin had to pass three licensing board exams — offered only in English — then compete against recent medical school graduates for a three-year residency at a U.S. hospital.
To Anna, the process seemed daunting. The tests cost around $1,000 each — not counting textbooks and study materials — and she was still taking classes to improve her English. She heard that hospitals preferred recent graduates, and she feared they’d be particularly reluctant to accept someone whose immigration status expires every 18 months.
Meanwhile, she and her husband struggled to find a place to live. The prestige they commanded back home was irrelevant to U.S. landlords running background checks.
“Could you imagine? I’m in my 40s. I don’t have any credit score … I just got my work permit. I couldn’t find a job,” Anna said. “Nobody wants me. They don’t know who I am (or) what is our culture; everybody’s afraid of us.”
She began applying for research jobs at the University of Wisconsin-Madison.
“I don’t know how many interviews I had,” Anna said. “Everybody was so nice, but (they said), ‘You are overqualified for this job.’”
Then the mom of one of her daughter’s soccer teammates mentioned that her employer, SSM Health St. Mary’s Hospital, was hiring student sonographers. She encouraged Anna to apply.
The roles are designed for people currently studying medical sonography, but Anna already had the relevant training: Ukrainian doctors regularly do their own sonography. She applied for the job with help from teachers at the Madison nonprofit Literacy Network, where she’d been taking classes to improve her English and prepare for next steps in school or work.
She started the job in 2024, running ultrasounds to aid in medical procedures and to diagnose things like heart attacks, heart murmurs, strokes and birth defects. She was promoted to a full-time position soon after.
On a typical day, she might see half a dozen patients. She doesn’t tell them she’s a doctor.
“Nobody knows,” Anna said.
Some patients get rude when they hear her accent. “I had a couple patients, they told me, ‘Don’t touch me. Call somebody else. I don’t trust you,’” she said.
Once a hospital security officer heard the way a patient spoke to her and urged her to file a report. The hospital sent a letter threatening to deny care if the patient acted that way again.
“I have a really good experience working here,” Anna said. “I really like my job right now.”
In October, Wisconsin eased requirements for foreign-trained doctors, joining several other physician-strapped states that have recently made such changes, but Anna isn’t sure what the change means for her.
Under the new rules, qualifying foreign-trained physicians can work under the supervision of another physician without repeating residency training if they’ve passed U.S. board exams and have a Wisconsin job offer.
Anna heard the news from a friend and asked about it at work.
“I showed this bill to people in the medical field here, and they were just like, ‘Oh, we don’t know,’” Anna said. “So I don’t know how does it work here, or where to go and who to ask.”
It’s also not clear she’d qualify. The new rules require applicants to have practiced medicine in their home country for at least one year in the last five years. She left her job nearly four years ago, and she figures it will likely be a couple years before she passes the board exams.
Lately, she’s been reading up on the licensing rules in other states and contemplating a move after her husband finishes school.
She wonders if things might have been easier if the family had immigrated to Poland, say, or Italy, instead of the United States. Back in Ukraine, her husband ran a perfusion school certified by the European Board of Cardiovascular Perfusion, and he received his own training in Europe. But she doesn’t think it’s worth emigrating again.
“It doesn’t matter where you go, everything is going to be different,” Anna said. “If I go to Europe, I have to start over. I have to study a new language, and then all of the education and activities for our daughter, and she also has to study a new language. So I just don’t want to do it a second time. I don’t have the energy to do it.”
From professor to pupil
Sasha, meanwhile, decided not to try to become a doctor again. His top priority was perfusion, the field to which he dedicated two doctoral dissertations and decades of work. In the United States, perfusionists don’t need to be doctors, but they do need specialized training.
“The perfusion specialty board, they do not recognize European diplomas,” Anna said. “They want them to go back to school here. But he’s happy to do it. He was so happy that they admitted him.”
Last fall, he started the two-year master’s degree program at MSOE.
“This wasn’t about choosing an easier path. Perfusion is a highly specialized and demanding field … This is where my experience is most relevant,” Sasha said, “and it’s work I genuinely value.”
Anna teases him about being so much older than the other students in the program.
“He’s like a father for all his classmates,” Anna said. “The first day, he brought actual paper, a notebook with different colored pens. His classmates brought just iPads. They were like, ‘What is that? Are you a dinosaur?’”
Paying for tuition for the first semester took most of the couple’s savings, Anna said. Their immigration status makes them ineligible for federal student loans.
She’s not sure how they’ll cover the remaining costs.
Sasha was also accepted to the perfusion school at State University of New York Upstate Medical University, which offered him a job that would have offset his tuition costs, but he didn’t want to uproot his family again.
“My daughter would need to change her school, leave her friends,” Sasha said. “You know how important it is for a girl of 10 years, your friends? It’s the most important thing in your life.”
But being in school has meant far less time with her. Since September, Sasha has spent his weekdays in Milwaukee, attending classes and shadowing other perfusionists during surgery. When he’s not in the operating room, he spends the night in a spare room he rents from a friend.
Back in Madison, Anna is “basically a single mom” five days a week. On Fridays, Sasha drives home to see his family and work on a transplant team at UW Health, where he uses perfusion techniques to keep donated organs alive and healthy until they’re transplanted.
With luck, he’ll move back to Madison after he finishes his coursework in May. He’s hoping to do his second-year rotations at Madison hospitals.
Status: Pending
Back in Kyiv, the couple’s condo stands vacant, full of the things Anna left behind when she packed hurriedly for a few weeks away.
The high-rise penthouse, located beside the many bridges on Kyiv’s east side, boasts an impressive view of the city and the river — and Russian missile strikes. The couple can’t sell it, or go back, until the war ends.
“Nobody wants to live on the 27th floor when you don’t have electricity, elevator or water, and you can see rockets and jets in front of your eyes,” Anna said.
Meanwhile, despite the time and money the two doctors have invested in their new lives, their future in the United States is uncertain.
The family’s Temporary Protected Status expired in April, and they still haven’t received an answer on the renewal application they submitted a year ago.
“The Homeland Security office said that our work permits are still valid (while) we are waiting for their decision,” Anna said. “We’re just waiting to see.”
If their application is approved, they could be on the hook for thousands of dollars. The Department of Homeland Security announced in October that Ukrainians’ applications, including those already waiting to be processed, will be subject to a new fee of $1,000 per person.
Anna has been looking into other visa options, too. Many foreign doctors practice in the United States on H1-B visas, an employer-sponsored visa for workers with specialized skills. If Sasha can eventually get one of those visas as a perfusionist, Anna will get a work permit, too. But in September, the Trump administration announced a $100,000 fee on most new H1-B visas, raising concerns that employers — including hospitals — will cut back on those visas.
Even if the family is able to renew their status, it will end in October unless the Department of Homeland Security extends Ukraine’s TPS designation. Since President Donald Trump took office last year, his administration ended TPS for immigrants from 10 countries, revoking legal status for more than 1.6 million immigrants, NPR found.
Anna worries that she and her family could become targets for deportation before they ever get a decision on their application.
“I don’t feel safe,” Anna said. “When you are waiting, you are legally in the United States, but this new administration and ICE police, they think that you are illegal here.”
Still, she said, she and Sasha try to stay positive.
“My husband says this is a good opportunity. He feels so young because he is studying as a student, and he says it’s just an adventure,” Anna said.
She looks for the bright side, too. She points to the support and kindness Americans have shown her and the fact that she’s learned she can survive “without anything.”
“I feel like a homeless person. I feel like Ukraine is not my home anymore, and the United States is not my home yet,” Anna said, “but people are trying to make it feel like home.”
This story is part of Public Square, an occasional photography series highlighting how Wisconsin residents connect with their communities. To suggest someone in your community for us to feature, email Joe Timmerman at jtimmerman@wisconsinwatch.org.
Natalie Yahr reports on pathways to success statewide for Wisconsin Watch, working in partnership with Open Campus. Email her at nyahr@wisconsinwatch.org.
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