Mideast doctors seek better expertise abroad

Sunday 29/05/2016
Dr Heval Mohamed Kelli works at Emory University, in Atlanta, where he was awarded a four-year fellowship in cardiology last December. He was 17 when his family, Kurdish refugees from Syria, came to metro Atlanta in 2001.

Washington - Lack of technology, research facilities and up-to-date education are among the challenges facing medical doctors in the Middle East, prompting many to seek profes­sional fulfilment and advancement abroad.

However, for a large number, ties to their countries of origin remain strong as they share their knowl­edge and benefit their fellow citi­zens at a time when conflicts have raised an urgent need for medical expertise.

Some Arab doctors stressed the advantages of practicing in the Unit­ed States, which they say helped them fare much better than peers who stayed in their home countries.

“Practicing medicine as a profes­sion is more rewarding in the US than in any other place on the globe. If you’re trying to be a researcher or advance in your career as a scientist or a provider of a certain service, it’s fair to say it’s open and limit­less here,” said Dr Hassan Fehmi, a Lebanese nephrologist in Detroit, Michigan.

Fehmi said the educational sys­tems in the United States and Eu­rope, unlike those in Arab countries, are designed to push professionals to constantly upgrade knowledge and practice. “In medicine, for in­stance, you always have to study and keep up with most recent ad­vances,” he said. “It is about show­ing in an objective way that you’re capable of doing what you think you can.

“In the Arab world, the system is not as favourable in providing this knowledge. Many physicians end up going abroad and attend confer­ences in the EU or US to earn con­tinuous medical credit and advance their knowledge.”

Fehmi, who learned general med­icine in Baghdad at the height of Lebanon’s 1975-90 civil war, moved to the United States 30 years ago. “I’m from northern Lebanon. Dur­ing the war I was cut off from Bei­rut where universities are,” he said. “Going to Baghdad was easier than going to Beirut at the time.”

For Dr Ahmad Tarakji, a Syrian who studied medicine in Aleppo University before specialising in cardiothoracic surgery in the United States, a major handicap he faced in Syria was lack of advanced technol­ogy and resources.

“Topics are limited and the qual­ity is not so high. Physicians who go to medical conferences in the Mid­dle East from North America openly say they’re not as up-to-date as they need to be,” Tarakji said from his practice in California.

Medical schools in countries that insist on teaching medicine in Ara­bic, as is the case in Syria, often put their students at a linguistic disad­vantage when they try to update their knowledge from sources pub­lished in other languages. “Gener­ally, you have to know at least one other foreign language to stay up­dated on the latest research,” add­ed Tarakji, who heads the Syrian American Medical Society.

Medical students in the Middle East often aspire to emigrate to the West to practice. Pre-war Syria was, at times, the top exporter of doctors to the United States, according to US State Department statistics.

Many Arab doctors in the United States have kept up relations with medical circles in the Middle East. Tarakji has been providing humani­tarian and medical aid to Syrians since the outbreak of the conflict in 2011. He has often travelled to Syria to train clinicians.

Fehmi has been active with the National Arab American Medical Association (NAAMA), a group of physicians of Arab origin. “We try to continuously stay in touch with our country of origin whenever we can,” he said.

“We routinely have doctors visit­ing Arab countries to conduct semi­nars and educational advances. We have doctors who have gone to Pal­estine where we support an emer­gency room and make sure it’s well supplied always. We had several missions to the Palestinian refugee camps and unfortunately more re­cently to the Syrian refugees, rou­tinely conducting missions in clin­ics and hospitals.

“We do what we do as physicians because we like to be of help to our community and the countries we came from. That’s the other part of fulfilment a physician gets.”

One of the most contentious is­sues that physicians in the United States face, however, is the threat of malpractice lawsuits that can po­tentially end a doctor’s career.

“Many times you find yourself requesting more testing and more frequent evaluations based on the fact that there’s always a fear of po­tential liability,” Tarakji noted.

With all the advantages of practic­ing medicine in the United States, one thing stands out as a clear ad­vantage for patients and practition­ers in the Middle East and North Af­rica: a strong family and community network helps patients convalesce and acts as a low-cost, but highly ef­fective, extension to medical care.

“Each patient will have many people around them to help with recovery and making food and psy­chological support. That’s not avail­able in North America, not even with the elderly,” Tarakji said.

Arab physicians agree that pro­fessionally the West is a rewarding place where “one feels a sense of fulfilment”.

“Yet, at the end of the day, you cannot lose touch with where you come from,” Fehmi said. “That is why many of us Arab doctors con­tribute back home. It is about a sense of fulfilment to be able to pro­vide to those you grew up with and made you who you are.”