A Memorandum of Understanding signed between APPNA, AAPI and BMANA. Washington, DC: Association of Physicians of Pakistani Descent of North America (APPNA); largest expat Pakistani medical organization signed a Memorandum of understanding along with the American Association of Physicians of Indian Origin (AAPI) and Bangladesh Medical Association of North America (BMANA). On the whole, all three organizations deliver 15% of health care in the USA. This Memorandum of Understanding was signed on January 27th, 2018, where Dr. Iqbal Zafar Hamid of APPNA, Dr. Gutham Samadder of AAPI and Dr. Riaz Chaudhary of BMANA were present. Dr. Shekhani speaking at AAPI Legislative Day on the Hill on 12 April, 2018. Whole AAPI leadership is in the background standing. APPNA is thankful to Dr. Iqbal Z Hamid for his leadership role in this matter. This was a landmark event in the history of APPNA. All organizations agreed to work in a cohesive manner in dealing with health care delivery to US citizens and work towards some common goals of having fewer visa issues and to establish and be part of Healthcare organization for the betterment of minority health care issues. American Association of Physicians of Indian Origin had a Legislative Day at the Hill in Washington DC on 12 April 2018, also invited APPNA and BMANA where the delegation of APPNA was led by President-Elect APPNA, Dr. Naseem Shekhani. Dr. Shekhani as asked by Dr. Hamid, Dr. Shekhani mainly emphasizing on three main points which are common to all three organizations as follows: In rural areas, international graduates provide 60% of the primary health care. These physicians provide exceptional care and work tirelessly to make a difference in the lives of their patients. However, there continue to be difficulties in the conversion of J-1 to H-1visa, green cards and finally becoming a citizen of this great country. By combining our resources, I believe we can make a difference. We must urge Congress to help expedite the issues of physicians on getting a pathway to citizenship. Implement strategies to continuously improve the delivery of better patient care. APPNA has already established a committee to give tools to our membership to have better evidence-based practices. Additionally, steps need to be taken to minimize the pressure of insurance companies and hospital systems. I feel if we combine their resources, we can collectively address this by establishing Federally Qualified Health Care Centers and work with independent accountability care organizations. Be proactive and progressive in addressing the needs of our young physicians. We continuously hear that our kids are not coming into our organizations. One of the most challenging things we see is recruiting our children who are born and raised in the U.S. and they become physicians. We need “fresh and innovative” ideas from the young physicians to fill what they may perceive as voids to attract them towards our respective organizations. Dr. Naseem Shekhani speaking at AAPI meeting Dr. Shekhani thanked AAPI leadership for inviting APPNA to its Legislative Day. Medical diplomacy is stronger than ever, and our missions, visions and goals are in alignment. Let’s work together in a united fashion towards becoming stronger and better for our future and generations to come.