This interview is with a resident who is training at an Ontario medical school and will be returning to Saudi Arabia shortly, at the order of the Saudi government. The trainee’s name has been withheld.
How did you hear that you had to go back?
I was at work. It was a very stressful day, and at night, a couple of my colleagues sent me links to the news.
At first, I didn’t think it was real. I thought it would probably blow over in a couple of days. So it didn’t affect me much and I continued with my work. But then over the next few days, it started to become real. And because I was on a very busy service, it distracted me a little. Then, on the first weekend that I was off, it hit me. I was like, “This is happening! We’re being called back.”
I’ve been joking with my friends and colleagues about how I’ve passed through all the stages of grief. I was definitely in shock initially. I was denying it and thought it was going to blow over. And then I was angry. I thought, “This is going to interrupt my life. This cannot be happening to me right now!” And then I thought maybe physicians were going to be exempted from this. Maybe it’s aimed at other undergrad or postgraduate students. So that was my bargaining stage. And then it turned out that everyone was included.
I could transition to another program in the States for example, but that will probably take time. I might lose some years.
Now I think I’m at the acceptance phase. It’s not in my or anyone’s control at this point, so I might as well just start focusing on the future and where we go from here.
Everyone needed some time to deal with the situation. It’s not easy to relocate within 30 days. [The trainees were originally told they had to leave by August 31, but have now been given until September 22.] It takes a long time to figure things out, and it’s very stressful. Everyone needed some personal time, but we also met as a group multiple times to discuss what was going to happen and how we were going to deal with this.
I’ve been meeting with my mentors to discuss career plans and where we go from here. My colleagues and the staff I have worked with—everyone has been supportive. They have let me take time off to figure things out. I’ve been blessed to have everyone reaching out. Even medical students that I’ve worked with over the years. I’ve been really fortunate to be surrounded by a supportive community.
Originally, I was planning to complete my current training and specialization, and then probably do a masters degree. I’m a sponsored trainee, so I have to do my return of service back home. I was planning on going back home and maybe introducing some of the things I learned in Canada that I found very helpful. That was my original plan.
Now, I have no idea. I’ve met with a lot of my mentors in Canada about next steps. The best option would be that things blow over and I get to return. I could transition to another program in the States for example, but that will probably take time. They would require their own examinations, their own certification before applying. I might lose some years.
We could always go home, too, where there are training programs we could join. Everyone at home has been concerned. They always have been supportive about all the decisions that I have made.
I’ve passed through all the stages of grief. I was definitely in shock initially. I was denying it and thought it was going to blow over. And then I was angry. I thought, “This is going to interrupt my life. This cannot be happening to me right now!”
What about your spouse?
Yeah, I mean, it’s affecting us all. My spouse is figuring what to do in the future, and was about to be enrolled in a couple of programs and working on the side as well. It’s devastating for both of us.
When I first started my training here, the way the hospital worked and the health system operated, and the day-to-day expectations of a trainee, were slightly different from other places I had worked. It took a while before I became comfortable. It’s a very high-paced and high-volume environment here. It’s a bit slower back home. So that was something I had to adjust to.
You’re coming to a different country and culture. I think in the past, people used to have culture shock. But now, with the media and the Web, you know what to expect coming in. It was more the hassle of relocating to a different country. Finding a new place, deciding whether you want a car or not, getting your bank account setup.
Do you like Tim Hortons coffee?
Well, I don’t hate it! But I usually make my own before coming to work. I’m used to making Turkish coffee every day since high school. So I make it and take a mug to work.
I think the most impressive aspect of Canada’s health care system is the allied health system. I think that medicine is pretty much the same worldwide in terms of diagnosing and treating patients. What I found different here were things like home care, physiotherapy and occupational therapy. I think these things are crucial to patients. Speaking with a couple of my colleagues, it’s one of the things that we are planning to push for when we get back home.
On the other hand, I think the health care system here is underfunded. For the volume and acuity of patients, there is not proper funding.
Have you experienced any discrimination?
Generally people are welcoming and accepting. I mean, you find some discrimination here and there, being a visible minority. You probably would have one, two or three encounters, but I don’t think that represents the majority.
It took a while before I became comfortable. It’s a very high-paced and high-volume environment here.
Why did you continue working in the hospital until the very last day?
The schedule had been set up before knowing that we would be pulled from the program. So if I stopped working right away that would definitely have caused a lot of trouble for other residents. I’ve been in their shoes before, and I wanted to continue working until the call schedule had been fixed.
I have a lot of fun memories of my time here. I would often come home from a very long day and would feel good about the care I provided and what I did that day. That’s a very good feeling. I don’t think that’s specific to Canada, but I will always remember those days.
I think I’ll probably miss the people and the relationships that I developed the most. My friends, colleagues and mentors. I’m a social butterfly. So I’ve made a lot of friends and everyone has been great.
On August 27, the Saudi trainees were advised by the Saudi Ministry of Education that they may remain in their positions in Canada until they have arranged for alternative assignments.
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Chris Kawala, chief medical resident at Toronto General Hospital, reflects on how his Saudi colleagues have responded to the recent announcement that they would have to leave Canada imminently.
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