Rosa Aramburo looks like any other medical school student, wearing a crisp white lab coat as she scrolls through charts on her laptop inside Loyola University’s suburban Maywood facility. The 26-year-old faces the routine pressures of being in medical school—this week, her cohort is submitting applications for the 30,000 residency positions available in the country each year—but lately, it’s been augmented by stress after the Trump administration announced it would end the Deferred Action for Childhood Arrivals program in six months. If Congress doesn’t act to extend the program before then, she could be deported before she can start her residency or get her medical license, much less pay off her student debt.

Aramburo is part of the Stritch School of Medicine’s first wave of students with DACA status: the Obama-era program that allows undocumented immigrants who arrived in the country as children to get work permits, driver’s licenses, and other official paperwork. More than 886,000 so-called “Dreamers” have joined the program since it began in 2012; only about 70 of them are in medical school, according to 2016 data from the Association of American Medical Colleges. This year, 32 of them enrolled at Stritch.

Now living in Forest Park, Aramburo says she was initially shocked to meet other young adults taking the same uncertain path as her. “I thought it was just me…. I felt isolated. But then, after DACA, Stritch opened the doors,” Aramburo says.

In fact, Aramburo was the inspiration for Stritch’s entire DACA program, the most robust in the nation. In 2011, the then-college senior (majoring in biology and Spanish literature) at Loyola Marymount University impressed a professor so much that he sent emails to some colleagues, asking for help. He wrote that one of the brightest students he had ever encountered was about to slip through the cracks because of her undocumented status.

One email ended up in the inbox of Mark G. Kuczewski, department chair of medical education at Stritch. A bioethicist by training, he had already been looking into the barriers undocumented students face when they apply to medical school. Prodded on by Aramburo’s story, he worked with colleagues to create specialized financial aid programs that would be available to Dreamers, as an alternative to the federal student loans that are not available to undocumented immigrants. “Once DACA was announced in 2012 and we heard the word ‘work permit,’ we knew we had the missing link,” Kuczewski says. In 2013, Stritch was the first medical school nationwide to openly accept students with DACA status.

Aramburo was born in northern Mexico and crossed the border as a small child. She and her parents took to sleeping on benches in southern California after her pregnant mother and her father lost their jobs when she was just three. That’s when the family decided to split up, with mother and daughter returning to Mexico while Aramburo’s father stayed in California, sending small remittances back to their little village in Sinaloa State.

“They said they would do whatever it takes to bring us all back together one day,” Aramburo says of the nine years she spent away from her father.

When Aramburo was 12, her family finally raised enough money and decided it was finally time to reunite. “That’s when I met my dad [again],” she says. “My sister was 9. It was weird. He was like a stranger. I knew him from pictures and I would talk to him two minutes per month, but it was kind of strange.”

In time, Aramburo developed an interest in science, and knew that one day she would work in the medical field. Medicine felt like another world: The lone female nurse providing health care to her entire village was a “mysterious” figure; the shiny instruments at the doctor’s office in California felt otherworldly and “fancy.” However as she neared the end of high school she began to realize it’d be nearly impossible to pursue her dream without a Social Security Number.

Stritch and DACA changed all that.

“Medical schools had never really dealt with undocumented students before so they didn’t really know [what to do]. … DACA came out in June, I took the MCAT in April of the next year, 2013. Then, I said OK. I am applying to schools just to see what happens,” Aramburo says.

Stritch’s DACA students reflect the diversity of America’s 11 million undocumented residents, half of whom are Mexican nationals. While the majority of students are of Mexican nationality, there are also others who are of U.K., Korean and Indian nationality. No matter their country of origin, one of the biggest challenges is paying for school; they’re not eligible for federal student loans.  

Kuczewski was instrumental in creating a loan program, through the Illinois Finance Authority, that offers interest-free loans to Stritch students in return for a promise to pay back the principal and work four years in an underserved Illinois community after graduation.

If DACA ends, paying back her $250,000 in student loans is the third in a line of major problems Aramburo and her cohort face. First, there’s getting into residency; it’s already a competitive process, but undocumented students need work permits to participate. “My adviser told me to prepare myself that I may get zero interviews just because it is so uncertain. Residencies won’t know where I stand and they can’t afford to lose a resident, so out of hesitancy they might not even give me a chance,” she says.

After that, she’ll need to fulfill the four-year work obligation attached to her IFA loan, otherwise it will garner a high interest rate—that, too, requires a work permit in addition to a medical license. DACA’s reversal will leave students with massive debt and little to do but to default— great irony, according to Kuczewski, given that doctors almost never default on student loans.

“Up to this point, I had somehow managed to get through and here is a person promising to kick out everyone,” she says, referring to Trump. “It will be a waste for all these people who put their faith in us, and for Illinois that gave us the loans. It will be a waste for everyone.”

There’s also evidence that the entire undocumented immigrant community will feel ripple effects from the lack of Dreamer doctors. Studies suggest that when stringent immigration laws are passed, people without citizenship avoid health care facilities out of fear of being asked for identifying information or confronted by authorities. This vulnerable group needs doctors who will understand their privacy and safety concerns from first-hand experience, Kuczewski says.

Estimates show that the DACA initiative alone could help introduce 5,400 previously ineligible physicians into the U.S. health care system in the coming decades to help address an ongoing American physician shortages and ensure patient access to care, according to an American Medical Association letter sent to Congress last week.

“When I was a kid, I felt abandoned, even though it wasn’t by choice,” Aramburo says of the time she spent separated from her father. Today, she faces being separated from her family again as she chooses to hold tight to the elusive dream of becoming one of America’s first Dreamer physicians.

Her parents still live in southern California, where her father works as a janitor and her mother earns a wage as a babysitter. They were already worried they would miss their daughter's graduation next May, since the cross-country trip seemed too risky, considering Trump’s promised immigration crackdowns. Now they are discussing leaving the country entirely—whether to do it voluntarily, with their possessions and dignity intact, or to face deportation and lose everything they worked for.

“If they leave, I will never be able to see them again,” Aramburo says.

While she prays that Congress will pass legislation to shield DACA-status students like herself from deportation in six months, what she really wants is an expansive overhaul of the immigration system that would include more individuals like the original “dreamers,” her parents. “My parents work really, really hard. I would say they work even harder than me, it’s just that they didn’t have the same opportunities that I did here. All I want is that my parents and other people to have the same opportunity as me,” Aramburo says.

For now, she’s not giving up hope. “I want to help people like my parents who have no insurance,” she says. “People who are lost like I was when I came 15 years ago.”