My journey from GP in Egypt, till a Psychiatric resident at University in USA

[zeeec2000]

If you still have hope, and believe in God, for changing your life, and get your dream true. Thinking it is NOT impossible yet. Even if all the circumstances stand against you! And if you still think that you will make it, from nothing. So; please listen to my story, hopefully you get some useful information helping you to apply for residency training in either Canada or USA.

For those who do not know me I am Ahmed Zakaria, Zeeek or Zack, whatever people called me during my journey. I came from an average Egyptian family. Graduated from Mansoura Medical School, in 2001 with lots of hope and dreams but, low scores and empty buckets! This qualified me to start in the middle of the desert! And get $ 50 dollars/month (God bless Mansoura faculty staff. Keep saying we give you low scores coz we have high expectations and outstanding standard of education!)
My class among the first, who have what I called, USA fever, and 5 already did USMLE and went during Internship to USA. Wawooo look at this achievement they made, and this fire inside you, Why not me. I have brain; I could be an American doctor, be famous and come back in my vacations, having fun of my friends who stayed in Egypt and show off with my knowledge and fancy car. But as all we know, BRAINS is not enough to give you a spot, in number 1 country in medicine, as every year doctors from all over the world, compete for this single spo,t and they are ready to hunt you down for it.
During my work in primary care unit in small village in Egy. I start to think, after 9/11 USA will never accept me for a visa to travel, especially with empty bank account. And even if I travel they will never accept an Arab. However, At this time Canadian illusion start to shine, every where people saying” Canada needs doctors” come and apply and have a part of the American dream at least!!
I went and I got the Canadian visa!! I thought this was my first step in success. But when I arrived to Canada I found some facts” please listen carefully if you applying to Canada”

1-   Although Canadian people needs doctors, Health Canada and Royal collage, do not want foreign doctors sharing them the big cake, as we did not pay anything for our education, and come and compete with Canadians who pay 200,000 Dollars for Med school. That’s what they think about as.
2-   You can NOT get residency in Canada outside University program( no med center or private health care like Mayo clinic) and the total numbers is 15 universities with total number of 200 to 300 positions for “Immigrant doctors”. we are second class keep this fact in your mind while reading all information about Canada.
3-   MCC exams has limited study resources not like USMLE( Toronto Notes is bad)
4-   They want proof of English and TOEFL exam(now TOEFL IBT become so hard)
5-   MCC exams are timed you cannot take it anytime/year as you want, not like USMLE, so you will waste 2 years in your life to finish MCC, but because they do not have well established system, Guess what!!, After you finish MCCEE and Q part 1, Each province has special rules in order to apply for residency in this province, to make it almost impossible to get this high paid position. Like each one has its own OSCE exam, MCQ after Canadian MCC, some province want you to stay at least 6month (Manitoba) before you apply or even 1 year like BC, and during this time you drive a Taxi or wash some dishes, as there is no private health care, or position in-between, Unlike USA you could NOT do medical assistant or touch a patient! (in Canada, you either be a doctor or driving Taxi)
6-   These 200 positions every year almost 120 for Family physician residency, and the rest is left over spots from specialties, Canadian graduates do not want them, and we fight for them like hungry dogs. Example, all over Canada we are competing for 5 OBGYN, 10 Peds. Please take a look in CaRMS and see how many positions for us.
7-   Canada Health solved the problem of shortage of doctors by making a deal with Saudi and Emarat health organizations. As those 2 rich countries will send their doctors to take the residency positions, fill the shortage and after that Saudi and Emirates doc. must leave back. This is a perfect plan because:a) Canada not will pay one cent for those residents. Every month salary, paid from Saudi or Emirate Gov.  b) Make sure after they finish their residency leave so they will not compete with the Canadian doc.
8-    For those 200 spots we are almost 5000 doctors applying every year, chances is 0.01% to get in, after 3-4 years you will find it is big joke. Even I was rushing and fighting, volunteer in Canadian Cancer research, or work hard to improve my score in IMG- Ontario, for 2 years applying for every single spot in Canada the only interview I got is SINGLE interview, but not for residency but as a PHYSICIAN ASSISTANT!! And I saw doctors with PhD from their countries applied for this insulting position to become less than a nurse.

After this, I said that’s enough. I will do my last shot in USA then I will come back to my country. But I learned the lesson and I do not want to commit the same mistakes I did with Canada, so I studied the cons and prons “How you could be a doctor in USA”. These are the obstacles/ I will tell you how to overcome them:
1-   Pass USMLE with score above 90, first attempt, It is easy and I will tell you how you can do it!
2-   Graduate from Med school within 3 years MUST be young. no time to waste,
3-   Have US clinical experience, NOT observership, Must externship. Hands on I will tell you how to get it.
4-    Letter of Reference from USA doctors even GP, Do NOT think doctors in USA knows Egypt or Dr.Zewel, as you think, any letter of reference from doctors inside Egypt is Not worth the ink, PLEASE do not be fool with the arrogance inside our faculty, think because they publish paper in unknown Egyptian journal, or member of any club, America will know them!! ( during all my interviews I had in all over USA, they have constant question, they said to me: we are familiar with Indian, Pakistani and Chinese Medical Education, but we do not know about Egyptian system, could you tell us more about it!! My class this year has 5 indians 2 paki and rest are Americans, and one Egy( me).
5-   Have Green Card, or good visa, Can not help in this (this was the only point of weakness in my application) you double the number of programs you could apply if you have GC. Or American Citizenship.
6-   Research is important (but less than clinical experience) this will give you advantage over American applicant” some programs told me we will welcome you in our program as you have experience in research” I will tell you how to get it also.
7-   ENGLISH, ENGLISH. Egyptians can NOT speak English; this is our reputations among the rest of Arab countries. Unless you grow up in fancy private school, or in one of Gulf countries like Dubai, you will need 2 o 3 years to learn it. Most of programs after the interview will throw your application in the garbage, plus our accent is horrible.( Indians once they enter Uni. For next 6 years never ever speak other than English. One Egy young grad. with score 95, did not get any spot after 10 interview coz he speak English like rest of us) By the way the percentage is 20 indian:1 Egyptian applicant.
8-   Have some connection with friends or doctors inside USA, Believe me even with low score but you know someone inside the program will secure at least interview. Which it is a huge favor, do not blow this chance.
9-   Finally, being from Arab or Muslim background has the least effect in your application, not like I thought while I was in Egypt. However still it has minor effect.

In my next post I will tell you how to overcome those obstacles in both Canada and USA to become Board Certified in North America.

Tell then let’s pray all to God to keep us strong and have a faith, thanking him for the blessing he provide. May Allah reward us for following his guidance.

[Mazen Hasan]

Alsam Alikom brother Ahmed,
Jazak Allah Khyra for this great topic,

Mazen

[ajhuri]

As-Salamo Alykom wa rahmato Allah wa barakato, first thank you Dr Ahmed about this marvelous, meticulous and egyptianized words.

Really it is a dream, I can not describe it more than this, but you did it by virtue of Allah. I`m a resident in psychiatry like you, but in Abbasia, Cairo.

To be a good doctor I left my beautiful and easy living hometown: Alexandria, back behind me to live in Cairo the crowdy capital so as to be learned and trained, to somewhat I fulfilled this. But I'm still feeling, as a committed Muslim, that we are all in Egypt still far .. far ....far from the word MEDICINE, we are very retarded, very restricted in our abilities.

Many obstacles:

1- MONEY ... MONEY .... MONEY .... we are a poor country undoubtedly, I'm graduated in 2002 in Alexandria, my salary & income till now cannot exceed by any mean 150 $ per month.

2- Language: ENGLISH .... there is NO REAL English in governmental Egyptian education school .... you know.

3- Time ..... you have to work almost day to just live in Egypt no time for dreams or ambition.

4- Route ... no one here know how to deal with it? but after your article this will be easy in shaa Allah.

Except for Allah who makes the INTERNET  as a cheap means of communication and learning I would have stopped practicing medicine from years fearing from Allah to ask me about my bad level in practice but I struggle to learn everything through web as I can.

Jazak Allah khayran & complete

Your Muslim brother:
Ahmad Eid Al-Ajhuri
Resident (year 3) in psychiatry, Abbasia Hospital, Cairo Egypt.
Concentrated in: Sleep Medicine.

[omar.khudruj]

Mashallah dr ahmad your topic is just brilliant as you.. Really thnx for this interesting story & advices.. We're eager to read your next posts about to pas the obstacles you mentioned..

Good luck

[adelsh]

thank you

[khaledkhaled]

thanks for your postand hope u can complete this subject for us

[Aymane]

Salam alaykoum

Jazaka allahu khayrane for this analyse , that will make our ideas more clear ... i'm a resident (first year) in general surgery in the capital of my country : Morocco ... and i began USMLE prep since 20 days throught some kaplan books and videos that i have downloaded from internet ...

i'm waiting the second part of your post before giving some questions , and trust me , you are doing by this a great job for you ummah !!

 

[Reham]

Thanks alot for these useful information, i'm looking forward to reading the way to overcome these obstacles part
gazak Allah khyran

[drfaten]

really dr ahmad i can inspire ur problem.we face alot in Egypt.

do u think hijab can stand as obstacle for a job??
also with our finance as EGYTIAN dr,we can afford for USMLE.IT is so expensive.

Q JUM TO MY MIND
what about ireland, austeralia, feland, other european country?why we as arabian not think about them?

[Mazen Hasan]

Sister faten for the Hijab, most of the time it is not a problem in US or Canada.

For the European Country, I think the best chances are in US. however I hope we can get connected with some brothers specializing in these European countries, so we can have a real picture about the situation their.

[zeeec2000]

Salam Alekom,

Thanks for the kind response everyone, it was nice surprise for me!.
I have the rest of my topic in Arabic language, I will post it here for now as I do not want waste your precious time. Later I will translate it to English as well.

[zeeec2000]

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نبدأ بالمعادله الكنديه عشان مش حتاخد وقت كتير ولان انا مش عاوز حد يفتكر انى مطنش
طبعا لو لسه معرفتش ان كندا اصعب من امريكا بمراحل يبقى اكيد انت عندك مشكله فى الاحصاء عشان نسبه الحصول على نيابه كندا لى امريكا هيا نسبه ١: ٥٠ ولكن ليه كندا :
١- مستوى المعيشه احسن فى كندا (مش فارق كتير عن امريكا) زى بالظبط لما تشتغل فى شرم الشيخ وانك تشتغل فى القاهره. حياه انظف ومناظر طبيعيه جميله ومفيش مشاكل
٢- الجنسيه الكنديه احسن من الامريكيه فى بعض النقط اهمها فى السفر واحترام الدول الثانيه للكندين عن الامريكان اللى عاملين مشاكل مع طوب الارض, وفى المطار الناس بتحترمهم و الامريكيه بتحترمهم ايضا بس بتكرهم
٣- مفيش شك ان الاقتصاد الكندى طالع وهيا فى خلال ١٠ سنين حتكون من اغنى دول العالم زى سويسرا
٤- انك تبع دول الكومنويلث يعنى تتنقل وتعيش فى انجلترا استراليا ونيوزيلندا من غير مشاكل
٥- الجامعات عشان قليله فكل الجامعات فى كندا قويه وغنيه واى بحث علمى مهما كان صغير بيروح كل امريكا وكندا
٦- طبعا الجنسيه الكنديه بتوفر حياه كريمه لاولادك وانهم يدخلو احسن جامعات العالم بالمجان وفى الاخر كل الاطباء الكندين هما الجيل
الثانى من العائلات المهاجره لان الكندين الاصلين(وحتى الامريكان) معندهمش دماغ ولا فلوس للطب وعاوزين يعيشو حياتهم وتكون النتيجه ان ابنك حيحقق اللى انت معملتوش

بس كل العوامل دى مش هى اللى حتخليك تغامر بمستقبلك وتروح كندا لكن لو حكمت الظروف وعندك اهل او هجره او زوجه كنديه فاسمع يا سيدى عن بعض النقط اللى ممكن تسهل سكتك عشان تبقى طبيب فى كندا.
١- السياسه فى كندا هيا الحصول على اطباء خلصلو فتره النيابه ومعاهم تخصص لان: معندهمش موارد بشريه: اساتذه يعلموك او اماكن.
بس يظل انك تاخد نيابه وتتعلم فى دوله محترمه هو ده الحلم
٢- مبدأيا الولايات اللى فرصتك فيها اعلى هيا
a- Alberta b- Newfoundland c- Manitoba

بالترتيب ده لان ولايه ألبرتا دخلت نظام القطاع الخاص يعنى تقدر تشتغل فى مجال الطب من الباطن وانت بتخلص فى المعادله فيه نظام مساعد الطبيب مقننه واكتر فى البرتا وبتقبض حوالى ٧٠ الف دولار فى السنه . اقل سكور فى ال تويفل ممكن تحتاجه موجود فى البرتا ومانيتوبا كلام فارغ
٣- كندا مش معترفه بالماستر بتاعنا ولا النيابه فى ٩٠% من دول العالم , بس معترفه بىالزماله البريطانيه فى اى تخصص ( واحد دكتور
عبقرى مخلص ماجستير ودكتوراه من عين شمس فى المسالك وهاجر كندا مع عيلته للاسف بعد ما نشف ريقءيه مع ال
Royal Collage
مش راضيين يعترفو بيه وشغال فى حاجه غير الطب عشان يصرف على اسرته لكن فى المقابل واحد على قده كان فى الصحه وخلص الزماله البريطانيه فى الاطفال اللى انت محتاج تبقى نايب زاير سنه فى اى مستشفى معترف بيها فى مصر, ممكن كمان تفضل فى الصحه وتضرب ورق المستشفى من دكتور معاه الزماله الاخ ده سافر كندا وبعد شهرين كان بيشتغل فى مستشفى كنديه لمده سنه تحت ملاحظه دكتور كندى الى ان يمتحن البورد الكندى فى الاطفال.)

٤- Newfoundland

عامله قانون غبى بس لو استوفيت شروطه حتاخد نيابه ال
Family Medicine
  وهو انك تكون مخلص ال الجزء الاول
MCCEE
بمجموع مش عالى قوى وليها حد ادنى فى كل تخصص فى الامتحان متقلش عنه+
ان يكون عندك شهرين
Psychiatry
 ( لاما بتاخدهم فى امتياز او دكاتره كتير بتنزل مصر وتاخد شهاده الخبره من قسم السايكترى فى عين شمس وممكن تظبطها من كليتك+ ميكونش عدا على امتحان الايفالواشن اكتر من سنه
+ TOEFL IBT سكور ٩٢ والنطق تجيب ٢٤ الكلام ده يساوى نيابه فاميلى وانت جوه النيابه دكاتره كتير بتحول على تخصصات تانيه انت وشطارتك ولو فضلت فاميلى مش وحشه لان كندا زى انجلترا الفاميلى دكتور هو اول دكتور لازم تروح ليه الاول قبل
ما يحولك على اخصاءى ودخله كويس جدا. يبقى قبل ما تيجى كندا هجره او غيره لازم تاخد تويفل الاول من مصر ولاما تاخد كورسات او تروح
اى مركز بيحضر ليه
٥- زى ما الدكاتره السعوديين واخدين النيابات دول ليهم فايده جامده انهم جوه السيستم وشاغلين جوه المستشفى وبالعكس ماحدش بيكسر ليهم كلمه لانهم جايين بفلوسهم ومعظمهم بيساعد فى الغربه لانك لو سالت الدكتور الكندى مش حيساعدك او مش حيفهم يعنى ايه تشترك فى بحث علمى فى القسم
من غير متكون جامعه باعتاك لكن الطبيب السعودى بيروح لرأيس القسم ويقول له فى طبيب مصرى ممكن يخلص البحث وهو مخلص طب مش حيكون زى الطلبه الكندين اللى فى جامعات مختلفه وبيتطوعو فى المستشفى عن طريق المعارف والسكرتاريه الكندين اللى بيعينو اقاربهم بردو.
٦- لان مفيش حاجه اسمها متخرج بقالك قد ايه والكلام بتاع امريكا ده!! ففى اطباء بعد ما اخد الجنسيه او الجرين كارد فضل فى السعوديه
او الامارات وبيقدم كل سنه من هناك ونظام كندا زى الشمعدان بتاع مصر( كل ما تقدم اكتر فرصتك فى الفوز بنيابه تكتر) طبيب سودانى
فضل يسوق تاكسى ٦ سنين فى كندا وعمل قرشين حلوين وكل سنه بيقدم الى ان قبلوه مع ان المفروض يكون نسى الطب خالص ولو طبقت عليه نظام امريكا يبقى كل سنه المفروض ان فرصته فى النيابه بتقل بس فى كندا العكس هو اللى بيحصل!!
٧- الا متحانات كلها المفروض تجيب درجه اعلى من ٤٥٠ فى الجزيين وفى تورونتو و اوتوا مراكز بفلوس بتدربك على امتحانات كندا ولان الاسءله فى الامتحانات اللى فاتت بتتكرر (مش زى ال اسءله المعادله الامريكيه) فالاطباء هنا كتير بيوزعو الاسءله وانت ومعارفك والنت فيه اسءله كتير ( متحاولش تعتمد على مصادر المعادله الامريكيه اعتماد كلى لان اسءله كندا رخمه وقصيره ومختلفه لان لسه عندهم نظام الاسءله بتاع :

كل الاجابات صح ماعدا واسءله من نوعيه what is the least effective يعنى تعكس المعلومه فى دماغك واساله مش الهدف منها الطب قد
ما الهدف هو قوه ملاحظتك واللعب بالالفاظ.)

٨- فى النهايه انت لو بتسعى انك تاخد نيابه فى كندا حتجيلك لو انت جايب طبعا مجموع سوبر من اول سنتين تقديم او بعد كذاا سنه لو انت جبت مجموع عادى لانهم مش حيقدرو يتجاهلوك على طول.

٩- تظل المعادله الامريكيه لها وزنها فى ال 
CV
بتاعك ومعظم الاطباء اللى بيقدمو فى كندا بياخدو المعادله الامريكيه لتحسين وضعهم فى التقديم ( لاثبات ذلك يوجد فى كل ولايه عند التقديم على كل نيابه مكان لوضع المعادله الامريكيه لو هيه عندك ودرجاتك فيها) طبعا ممكن تقدم على

نيابه فى امريكا فى نفس الوقت (ده حيكون اسهل لان معندكش مشكله الفيزا زى ما تكون جاى من مصر مش من كندا) وبعد النيابه ترجع كندا ... ليه مع انك خلاص بقيت طبيب فى امريكا؟ سؤال وجيه بس انا معنديش ليه اجابه بس ممكن ترجع للاسباب السته اللى زكرتهم عن امتيازات كندا من المعيشه فى دوله غنيه ومش طارده للعرب..الخ!!
١٠- انك تاخد ماجستير فى ال
Public Health
 سنتين ده سهل وبعد كده حتجيلك نيابه لانك معاك شهاده كنديه وطيعا اثناء السنتين

الحكومه الكنديه بتغطى مصاريفك ولو معرفتش تقدر تشتغل فى الحكومه ودى مرتباتها كويسه بردو

خلاصه القول يا سيدى الفاضل كندا للطبيب اللى عنده تخصص او عنده اسره مهاجر بها ويكون معاه الزماله او يروح الولايات اللى زكرتهم من
قبل كثير من الاطباء الشاطرين بيفضل فى الخليج وبيقدم من هناك ده في حاله ان عنده وظيفه كويسه جدا فى الخليج وساعت الانتر فيو بيروح كندا وفى المطار بيقول لى موظف المطار الكندى انا بقالى اسيوع كنت بزور اهلى فى حاله ان لسه مش معاك الجنسيه وعمر ابدا موظف المطار بيختم الباسبور بتاعك ( ده ردا على سؤال اذاى اعيش بره كندا وانا معايا الجرين كارد الى ان احصل على الجنسيه بالاضافه الى تفاصيل تانيه مش موضوعنا هنا )

وفى النهايه لو معاك فلوس ممكن تشترى نيابه .. ايوه اللى سمعته صح فى ولايه

Newfoundland
لو معاك ٣٥٠٠ دولار مستغنى عنهم وتكون معاك ال
MCCEE بسكور تعبان او عدى عليه اكتر من سنه بالاضافه لى ال
TOEFL

 وعلى فكره البنك حيسلفك الفلوس من الصحه الكنديه فى مقابل انك تفضل عايش فى الولايه دى.

بالنسبه لى لنكات النت عن الموضوع ده انا حعرض شويه ومتهيألى وحوش النت هنا عارفين المواقع دى بتاعت ألبرتا وغيرها

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وده فى راءئ اهم موقع فيه كل اللنكات عن كل الولايات الكنديه
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احد المراكز المعادله الكنديه اللى بيتقدمها للاخوه القاادرين
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انا مش حطول عن كده لان الموضوع مش حيخلص ويعتمد زى غيره على توفيق الله سبحانه ويظل طبعا للشباب اللى مش فارق معاهم

طب قوى ان العيشه والفلوس ممكن تكون احسن فى كندا من دول كتيرّ!! انا على العموم حركز اكتر فى طريق النيابه لامريكا وغير كده طبعا

لو افتكرت شئ اضافى حأضيفه باستمرار .للى له سؤال معين عن كندا او يعرف معلومات يا ريت يشارك بيها هنا وانا ححاول اساعد معاكم

حتى نلتقى ارجو الله ان يوفقنا جميعا ونساعد بعض على طول

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[Mazen Hasan]

Great work Dr Ahmed, about 250 visited your topic .
keep it running
Jazak Allah Khyra.

[zeeec2000]

Thanks Dr. mazen,

I am trying my best to give my fellow muslim some help.
By the way my best friend I worked with in Canada for 2 years at Urology Department, his name was mazen and he was doing clinical fellowship for 3 years and we had 3 publication in prostate cancer before I moved to USA searching for residency. So it was nice coincidance to find another MAZEN AND UROLOGIST

[Mazen Hasan]

I am very eager to know this Mazen, the urologist.