Earlier this spring, Dr. Kusuma Nio was anticipating two things in May.
The trauma surgeon hoped to deploy with his Army Reserve unit to Afghanistan, where his expertise in treating catastrophic injuries would be vital to U.S. and Afghan forces roiled by resurgent militants.
The other thing: Nio was to raise his right hand again May 5. Not just as a soldier, but as a U.S. citizen.
Instead, Indonesian-born Nio, 32, who lives in Springfield, Illinois, is watching his fellow soldiers of the 1st Forward Surgical Team based in New York leave for war. His path to citizenship has become a minefield.
His citizenship oath was postponed indefinitely April 13 by the United States Citizenship Immigration Service, who told him the Defense Department has suspended all applications from foreign-born recruits looking to serve.
The Pentagon's tangled bureaucracy is struggling to move 4,200 legal immigrants through the Military Accessions Vital to the National Interest program, which was implemented in 2009 to take advantage of medical and language skills critical to the success of military operations around the world.
Newly imposed requirements issued in a Pentagon memo Sept. 30 -- when the program was renewed -- have created a logjam of applicants. A rule that bars MAVNI recruits from receiving a security clearance until they complete their first term of service has crippled the ability of soldiers like Nio to earn a commission and prevents the military from using their talent for years. Until then, his time as a reserve specialist is spent cleaning scalpels instead of using them in life-saving surgery.
Nio and others are left asking a simple question: If the military wanted their talents, why are they sitting around not using them?
"I'm a fully qualified and American-trained surgeon. It doesn't make sense to me," Nio said.
Margaret Stock, a retired Army officer central in creating the MAVNI program, said May 8 that the reforms are so severely counter to the original intent of the program that it is now imploding, sending ripples throughout the military that will hurt recruiting, undermine its security missions and send personnel spending into a frenzy as the force pays bills for native troops to receive top medical and language training.
"This isn't extending the program," Stock said of the new measures. "This is destroying the program."
Stalled by new rules
The MAVNI program has attracted thousands of legal immigrants, offering a fast track to citizenship in exchange for vital medical expertise and cultural and language skills. The military identifies skills in "critical shortfall" and sets goals to bring qualified candidates into the service, according to the Sept. 30 Pentagon memo extending the program until September. About 10,400 soldiers have entered the Army through the program since 2009, Army spokesman Hank Minitrez said May 9 in an email.
The decision to bar MAVNI recruits from receiving security clearances during their first enlistment term severely limits the contributions that soldiers like Nio can make, Stock said. Doctors cannot receive a commission without the clearance. Enlisted troops cannot enter special operations, civil affairs or intelligence fields, while troops with deep skills in languages such as Russian, Arabic and Pashto are restricted for years from doing the job the Pentagon said they desperately need to be done now.
Another big change: Applicants were required to have a legal immigration status for two years and complete background checks in order to enlist. They could start the Tier-5 investigation before shipping off to training while the long process unfolded, Minitrez said.
Now, recruits must complete a Tier-5 investigation before they get orders for training. The process takes months and involves investigations from the Justice and Defense departments and intelligence agencies, Minitrez said.
Stock said the Army was unprepared for the flood of additional requirements, leaving personnel soldiers scrambling to complete case files without proper training while soldiers piled up in the system. Soldiers like Nio are trapped in a classic military Catch-22 as he continues as a reservist, still unable to attend the basic officer leaders course.
"We haven't been naturalized, so we can't go to basic. But we can't go to basic because we haven't been naturalized," he said.
Pentagon spokesman Army Lt. Col. Myles Caggins declined to answer questions about MAVNI, citing ongoing reviews of the program.
Applicants are screened by the State and Homeland Security departments and other agencies when they get visas, which makes them the most vetted recruits in the military, Stock said. Green-card holders, who are permanent residents but not citizens, are not subject to the rules, she said.
"The new rule is especially pernicious because the requirements for passing [additional screenings] are completely different from the 'good moral character' required for citizenship," Stock said.
"That's not the legal standard for naturalization," and the new requirements have not been imposed on immigrants naturalized in the past few years, Stock said.
The Army, which according to service data is the biggest user of the MAVNI program, has defended the new security measures.
"The background checks are time-consuming and extensive, but we owe it to our soldiers in the ranks and the American people to ensure everyone joining has been properly vetted," Minitrez said.
A former senior Pentagon official familiar with the program told Stars and Stripes on May 9 that the background investigation process was changed after specific threats were identified.
The threats were "serious enough that there was no way we could continue the program without addressing them," the official said on background, adding there were ongoing investigations of MAVNI recruits when he left his post after the Sept. 30 memo was issued. He declined to identify how many investigations or how many people, if any, were found to be legitimate threats.
"The number [of potential threats] was enough to get attention of senior officials," he said.
Stock waved off concerns the MAVNI program could be used by dangerous infiltrators, saying the Pentagon has succumbed to paranoia over the perceived danger of immigrants. Since the recruits are highly vetted, they are often high-quality troops once they reach their units, she said.
MAVNI recruits have been highly sought in Special Operations Command, for instance, due to their reliability and cultural skills vital to training and fighting with foreign troops.
"If you're going to sneak into the military, this is the last program you'd go through," she said.
The Army has acknowledged the new Pentagon requirements have severely bottlenecked the process since September.
About 1,000 Army recruits -- nearly a quarter of the 4,200 waiting for background check approvals -- have been in limbo so long that they no longer have legal immigration status and need extensions or exemptions from USCIS, according to an internal Army document marked "for official use only" but posted online in April. Minitrez and others were listed as the point of contact for information. The document is no longer online.
Minitrez declined to confirm that number, referring the query to DHS and USCIS. The New York Times reported that the number could be as high as 1,500.
"Competing priorities and resource allocations among the agencies due to increased volume have resulted in delays with the process," Minitrez said.
While those delay occur, recruits without legal status can't obtain a job if they are reservists and are subject to deportation, Stock said.
The Army's execution of new regulations has frustrated Nio.
Before recent changes, MAVNI could churn out minted troops with citizenship in hand in one to four months, Stock said. But the new restrictions have jolted the program enough to turn off future applicants, Stock said. While recruits with language skills await security clearances to begin training, they must enlist in other specialties that do not correspond with their skills.
"There's no point to the program if all it does is produce extremely well-vetted truck drivers," she said.
Nio said his motivations were different than some others. He holds a visa reserved for immigrants with special skills, and the hospital where he works can easily sponsor his legal status.
"This is a perfect way to give back and to serve and to learn," Nio said about his path to becoming an Army doctor. "There is nothing like combat surgery."
After earning his doctorate at the University of Minnesota in Minneapolis, Nio enlisted as a specialist in 2015 with the agreement that he would earn his commission as a captain. His contract required him to serve six years in the Army Reserve and two in the inactive Reserve, he said. He finished his background investigation in April 2016, with his oath of citizenship and commissioning on track for this month, he said. But the restrictions have stopped all progress, he said.
Nio works at a Level 1 trauma center in his civilian job, where he treats patients with gunshot wounds, severe burns and injuries sustained from car wrecks, along with surgeries for conditions like appendicitis and hernias, he said.
Contrast that with his placeholder Army reservist occupation: operating room specialist. The job involves sterilizing equipment and cleaning rooms between patients. The experience disparity equates to a pilot grounded to scrape bug splatter off an F-16.
"I'm almost through a third of my service time already," he said. "You have someone ready to go, and sitting as a specialist?"
Luckily, Nio said, his unit sympathizes with the disconnect between his skill and his rank.
Surgical teams in his unit conduct realistic training during their drill weekends, he said. Patients eviscerated by imaginary IEDs and gunfire flood medical tents. Nurses and medics buzz around Nio, who plays the role of trauma surgeon.
The training is realistic, but his authority is a facade. Once Nio removes his scrubs and stores his instruments, he steps out of the tent as a junior enlisted soldier.
Nio's unit will arrive in Afghanistan this month as the country braces for another Taliban offensive and Islamic State militants seek to regain footholds. Sharp violence has recently struck U.S. troops there. Two Army Rangers were killed April 26 during a fierce battle with Islamic State militants, and three soldiers were wounded in a suicide car bomb explosion May 3 in Kabul.
"My unit is desperate for surgeons to go on this deployment," he said. "And I'm just saying goodbye to everyone."
This article is written by Alex Horton from Stars and Stripes and was legally licensed via the Tribune Content Agency through the NewsCred publisher network. Please direct all licensing questions to firstname.lastname@example.org.