Many high school graduates are about to join one of over 250 medical schools in the Arab world. Al-Fanar Media talked to two internationally successful Iraqi doctors about their advice to new medical students embarking on such a long-term step.
Osama Shukir Muhammed Amin is a former associate professor of neurology at the International Medical University, Malaysia, and a fellow of the Royal College of Physicians (London, Edinburgh, Glasgow, and Dublin).
Mohammed Mohammed is chief resident of the internal medicine residency programme at the University at Buffalo Catholic Health System, in the United States.
Both noted the anxieties new medical students may feel. They remembered similar feelings in their own early training at the University of Baghdad’s Faculty of Medicine.
Amin reminds new students that the first year of medical school is almost like the final year of high school, but in English.
“Don’t panic! Don’t be shocked in the first year,” he tells them. “Some might feel deflated, scared, and regret joining the medical school. They might consider changing to another faculty. I would say, Be patient for a year, most things will be great and beautiful soon.”
Mohammed thinks teaching hospitals need to help freshmen become familiar with the campus.
“In Baghdad, we felt lost on our first days on campus,” he said. “Earlier this month, I took our new American students on a tour to see the hospital wards and facilities, along with the cafeteria, rest spaces (on-call rooms), parking lot, library, etc. I got their emails and phone numbers to keep in touch. This is quite helpful.”
Reasons for Choosing Medicine
“Some (new students) might feel deflated, scared, and regret joining the medical school. … I would say, Be patient for a year, most things will be great and beautiful soon.”Osama Shukir Muhammed Amin A former associate professor of neurology at the International Medical University, Malaysia, and a fellow of the Royal College of Physicians (London, Edinburgh, Glasgow, and Dublin)
Arab students have many reasons for attending medical school.
“Those who love medicine see it as a prestigious degree, required in the labour market worldwide,” Amin said. “In the first year, they dream of becoming doctors to have that prestige in their inner circle and community.”
Others may choose to study medicine because they see it as a guaranteed way to get a job for life.
This idea is reflected in the skyrocketing number of medical schools in the Arab world. Sudan alone has 66 medical schools, followed by Saudi Arabia with 34, according to online resources. Egypt has 28, Iraq 23, Algeria 15, and Somalia 13.
Libya and Morocco each have 10 medical schools, followed by Syria and Yemen with nine each, and Lebanon, Palestine, and the United Arab Emirates with seven each. Jordan has six medical schools, and there are four in Tunisia, three each in Bahrain and Oman, two in Qatar, and one each in Djibouti, Kuwait, and Mauritania.
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These schools train students in general medicine and surgery for six years, five in certain countries. However, a graduate needs to spend three to seven years in a residency programme afterwards.
What to Study?
The first two to three years of medical school are a mixture of classroom and laboratory time. Students take classes in basic sciences such as anatomy, biochemistry, histology, microbiology, pathology, and pharmacology. They also learn the basics of interviewing and examining a patient.
“In Baghdad, we felt lost on our first days on campus. Earlier this month, I took our new American students on a tour to see the hospital wards and facilities. … I got their emails and phone numbers to keep in touch. This is quite helpful.”Mohammed Mohammed Chief resident of the internal medicine residency programme at the University at Buffalo Catholic Health System, in the United States
Traditionally, medical students take four or five courses in various subjects at the same time. However, some schools focus on a single subject for a shorter time—say, three or four weeks—before moving on to another. Some American-style schools take an interdisciplinary approach, in which each class focuses on a single organ or system, examining all the anatomy, pharmacology, pathology and behaviour relevant to that system.
In most schools, clinical training starts in the last three academic years, when medical students do rotations at hospitals and clinics affiliated to their schools. During these rotations, students assist resident doctors in performing basic medical procedures in specialties like surgery, pediatrics, ophthalmology, internal medicine or psychiatry.
Students are not expected to have enough expertise to practice in any specialty after finishing their clinical rotations, as that can only be partly achieved during a residency programme. One of the main advantages of rotations is that they help medical students choose their potential career paths.
Pressure from Families
While some students opt to study medicine out of passion, others are pressured to do so by their families, particularly if they obtained high grades on their high school leaving exams.
Amin was in the latter category. He joined the University of Baghdad’s Faculty of Medicine after scoring 98 percent on the high school exam, he said.
“I wanted to study computer engineering, but everyone said you need to study medicine,” said Amin, who is now a consultant neurologist in Sulaymaniyah.
“I did not like it at first. I felt alienated from the subject. But by the second and third years I started to love it. I dreamed of becoming an internal medicine specialist. One does not know what God wants for him. You must recognise what serves your goals better, and work hard. If it really hurts you psychologically or socially, you can change career.”
“I always say a physician is a health vendor; his clinic, hospital, or ward is his health shop. You provide health care in return for of money. However, this should not be your first goal.”Osama Shukir Muhammed Amin
Mohammed also advises students to remain open to changing their specialty. “Don’t limit yourself to a predetermined goal. Keep exploring all specialties,” he said. “It is normal to feel you want to change your mind.”
Both doctors say students should understand that studying medicine is a difficult path.
Mohammed encourages students to look for other resources outside the curricula to help understand their subjects in a way that suits their preferred way of learning.
Amin says students need to be ready to attend lectures and practical lessons. “A medical school requires long studying and attendance hours,” he said. “You have to be diligent and sometimes sacrifice your leisure time and hanging out with friends.”
Language and Money Issues
English is the language of instruction in almost all Arab medical schools. “English is a must for medical students,” said Amin, who has taught in Iraq, Ireland, Britain, and Malaysia.. “It is not necessary to be fluent, but you need to do your best to master English. The new generation is doing better than we did 30 years ago.”
Cost may also be a consideration for some students. While public medical schools are free in most Arab countries, studying at a private university can be expensive.
Amin said many students consider studying medicine as an investment to earn good money and have a good life. “It is a normal human right to think about one’s material prospects and family. This is neither bad nor shameful,” he said. “However, they should not have this in mind from the first year.”
“I always say a physician is a health vendor; his clinic, hospital, or ward is his health shop. You provide health care in return for money. However, this should not be your first goal.”
Amin believes introverts are not good candidates for medicine. “Medicine requires good soft skills and interpersonal relations. Fluency and social networking are the most important element for doctors. They must be sociable and open to talking to others since teamwork is the routine.”
“Don’t limit yourself to a predetermined goal. Keep exploring all specialties. It is normal to feel you want to change your mind.”Mohammed Mohammed
Amin also advises students to be open-minded and culturally sensitive when dealing with co-workers and patients from different social, ethnic, and religious backgrounds.
“Doctors should not be arrogant! You make your degree valuable, not the other way around. Your good manners grant your work value. A student should know he is there to serve others and their health.”
“Lastly, they should be diligent and show commitment to lifelong learning. A loving and collaborative environment, with positive competition, is where people flourish.”
After Med School
Medical education does not end when students get their bachelor’s degrees; they still need to pass board exams and spend three to seven years as a resident in a teaching hospital.
Some new graduates might prefer non-clinical fields, a job in research or a change of career.
“Many successful physicians chose non-clinical jobs in pharmaceutical or medical device companies,” said Amin. “Others focus on academia and research. This depends on personal preferences, one’s environment, prospects, aspirations, promotion chances, and income.”
Amin thinks most medical graduates could excel in other careers, like running an engineering company, practicing politics, or becoming lawmakers.
“Don’t limit yourself to the medical field. I know doctors who draw, sing, or even take photographs, like me. Social aspects play a big role here.”