Leading a hospital team of foreign trained doctors

Recently, I had the opportunity to decamp from the the friendly confines of GlassHospital and trek a few miles to the north.

GlassHospital has brokered a teaching and patient-sharing agreement with a nearby religiously-affiliated community hospital I’ll call Our Lady of Blessed Proximity.

Our Lady has a residency training program, just like ours, with the major difference being that nearly all of the doctors come from foreign lands.

Something you should know about medicine in America is that there are many more residency training slots (greater than twenty thousand) than there are U.S. medical school graduates each year (fewer than seventeen thousand). International graduates compete to fill those few thousand “extra” spots. These spots typically occur in less prestigious hospitals that are often in locations less desired by U.S. graduates.

I was supervising a team consisting of two residents and two interns (residents in their first year of training after medical school). We even had a couple of “observers” show up late in the month, as they were going to soon be starting their internships and wanted to get the feel of things around the hospital.

One of the key differences between the residents at Our Lady and the residents at GlassHospital is that nearly all of the former were already full-fledged doctors in their home countries. The residents at my home place, GlassHospital, have all just graduated from U.S. medical schools and are doctoring for the first time.

Take Dipak (names and details changed to protect the innocent). He was a fully-trained surgeon back home in India; in order to land a spot here, he had to give up his dreams of surgery and become an internist. He wants to go on and subspecialize — probably in heme/onc — he likes the increased knowledge and income potential of a subfield like cancer.

Jorge mostly grew up in California. But he was born in the Philippines, and returned there to go to medical school. This limited his chances to get a more ‘prestigious’ residency slot; yet he’s the first one in his immigrant family to become a doctor, so just getting here is an accomplishment. Unlike the others, he had never practiced medicine before, so he was a touch wet behind the ears.

Samar is Jordanian; her husband is also a doctor, and has already finished his U.S. training and is working in a health manpower shortage area in a neighboring state as a hospitalist. They see each other on weekends if their schedules permit. Together they’re raising a six year-old daughter. Samar is ambivalent about whether she wants to return to Jordan to work and live; she likes it here, but feels that she’s not truly part of the culture.

Sharif is from Syria. When I found this out, I was surprised, since officially the U.S. has long considered that country a terrorist state. Sharif couldn’t love America more. He married an American woman. He has no intention of ever going back. He loves the opportunity to ply his trade here, free to make it on his own merits. Sometimes, he told me, the opportunities here feel overwhelming.

Later in the rotation, one of the observers who rounded with us for a day was named Yusuf. He was born, raised, and trained in Egypt, where he’d been an orthopaedic surgeon. The day I met him, I had a sudden urge to sit the whole group down and negotiate peace in the Middle East once and for all.

We were a team, and in spite of our differences, we were working for the common good of our patients. We all wanted to serve, to learn, and to grow as individuals and as doctors. And, I might add, to be able to think and say what we want without fear of persecution. Something that some members of my team do not take for granted.

I admired my group and the obstacles they’d overcome to land spots here. Their paths will not be easy, but with the resourcefulness they’ve all shown, they’ll likely end up successful doctors in America.