ACR Helping to Bring Iraqi Radiologists to United States for Intensive 'Observerships'
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Mounting war casualties strain any nation's medical establishment, but the Iraqi situation is exceptional. Hostile forces continue to target physicians. Daily work commutes are fraught with peril. Medical personnel are stretched thin, isolated from the international community, and lagging in know-how.
Amid these challenges, the American College of Radiology is helping to find solutions.
In early March, the ACR, in partnership with Agfa, the Cultural Office at the Iraqi Embassy in Washington, D.C., and several prominent U.S. medical institutions, helped launch a program that will host six Iraqi radiologists in intensive, three- to four-week "observerships" here in the United States. The goal is to expose these physicians to modern radiologic techniques, and then return them home to benefit their colleagues and patients.
On March 23, the ACR honored at its Reston, Va., headquarters a delegation led by Iraqi cultural attaché Abdul Hadi Al Khalili, M.D. Among the other honorees was radiologist Sulafa Jerew, M.D., before returning to Baghdad as the first observer.
According to ACR Executive Director Harvey Neiman, M.D., the ongoing radiology observerships are part of a broader program geared to expose dozens of Iraqi medical professionals to "some of the best training programs in the country." The ACR and its U.S. partners, he said, are uniquely positioned to render help to Iraq's radiologists — and Iraq is welcoming the program with open arms.
"There is a very massive need in Iraq," said Dr. Al Khalili. "Our senior educators and most experienced radiologists have fled Iraq. Owners of private clinics have been targeted. Radiology machines may be found all over Baghdad but often do not work because of a lack of electricity and operators, and the hardships of everyday life."
Dr. Al Khalili has felt this hardship firsthand. Conditions in his homeland forced the former chair of the department of neurosurgery at the University of Baghdad to flee for his life. Today, he devotes his waking hours to bringing Iraq's ailing health care infrastructure into the 21st century.
Dr. Jerew, 35, agreed with Dr. Al Khalili's frank assessment of Iraq. "Everything is in a bad situation," she said. "We have no one to give lectures, no one to give conferences or even to consult with. Medical personnel are under a great deal of pressure, when we see war-injured people and do not know how to treat their conditions. You see children injured or with bullet wounds, and you get upset during your work and carry it home later."
Some observers believe Iraq's medical system — once the pride of the Middle East — today lags 10 to 15 years behind the western world. Without outside help, the slide will continue. "We did a lot of interventional radiology at one time in Iraq," Dr. Al Khalili said. "We did CT-guided biopsies of the spine and other areas, but currently it is mainly emergency radiology."
He is optimistic about the future. "This very promising program will give young physicians a window onto the outside world. I'm sure they and their colleagues will gain a lot from this and be able to help their patients directly."
"Refreshing in Every Way"
In late March, Dr. Jerew completed a three-week observership at The University of Michigan Medical School. Other institutions participating in the program are the University of Pennsylvania School of Medicine, Thomas Jefferson University (Philadelphia), Henry Ford Hospital (Detroit), Massachusetts General Hospital (Boston), and the University of California at San Diego.
In Baghdad, Dr. Jerew is a general radiologist in an approximately 600-bed teaching hospital. There, she typically divides her time between ultrasound examinations and CT scans. Her exposure to the University of Michigan's leading-edge MR capabilities, she said, was an exciting opportunity.
"I enjoyed the organized, efficient, modern setting," she said. "The whole experience was very useful and refreshing in every way." Pausing, she added, "We have the same machines, but the PACs system was new for me." Because Dr. Jerew and other program participants are not credentialed in the United States, they cannot conduct actual studies but can participate as observers.
University of Michigan Radiology Department Chair N. Reed Dunnick, M.D., said he and his staff enjoyed hosting Dr. Jerew. "She is a bright, young, energetic, enthusiastic radiologist. She was clearly eager to learn and appreciative of the time she spent with us. She came in at the beginning of each morning and didn't leave until the end of the day."
Reflecting on the observerships, he said, "These are a much better experience than if [participants] just went to a conference. Dr. Jerew spent three weeks observing, learning, actually watching to see how we do patient care. It's a wonderful opportunity, in terms of the use of the equipment, protocoling, seeing the actual images, and even improving their diagnostic skills."
According to Dr. Neiman, Dr. Al Khalili not only pitched the observership idea to the ACR, but also arranged to have local Iraqi-American families host all six radiologists. This arrangement kept program costs to a minimum, while making participants feel more at home, Dr. Al Khalili said. "Dr. Jerew was invited almost every day by friends and neighbors to social gatherings, which further increased her exposure to the American community," he said.
Dr. Neiman today describes the ACR's role as a "facilitator and intermediary" that unites Iraqi radiologists, teaching hospitals, and Iraqi-Americans. Agfa generously agreed to fund all travel costs. "It's a strong partnership that really hits the nail on the head as to what the Iraqi people need," he said. "It's a win-win for everybody. It cost the ACR no out-of-pocket expense to help rebuild the health care system in Iraq and fulfill our mission of serving society."
Dr. Al Khalili was similarly pleased. "We are so grateful to the American College of Radiology. We have been working together with them for more than six months to make this happen. We have overcome so many difficulties. Now, we would really like this experience to be a model to encourage other colleges of other specialties and medical institutions to follow suit."
Fellow countryman and radiologist Anton N. Hasso, M.D., was equally buoyant. "Expatriate Iraqi radiologists like me are proud that the ACR can help in this important initiative," he said. "We can hardly wait for normal times to return, so that we can travel home to contribute our time and to teach our colleagues who have suffered and lost so much."
"Many Iraqi doctors are wishing to be in my place," added Dr. Jerew with a warm smile. I hope this program continues and expands. I give my sincere thanks to the American College of Radiology."