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Going Global

After 20 Years, the Office of International Medicine Programs has Extended GW’s Reach to Thousands Around the World

By Kristin Hubing

In 2004, while wrapping up her final year of college as an international student at the University of Maryland, College Park, Hawaa Almansouri, who had come to the United States from the United Arab Emirates (UAE) four years prior for her undergraduate education, sent applications to 30 medical schools across the country.

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Twenty-nine of the schools said “no,” adding only that they could not accept students without permanent residence. “They wouldn’t even look at my file,” says Almansouri. “It had nothing to do with my qualifications.” One school, however, offered her an interview — the George Washington University’s School of Medicine and Health Sciences (SMHS).

Today, nine years after SMHS’s Office of International Medicine Programs (IMP) invited her for that interview, Almansouri, M.D. ’08, RESD ’11, FEL ’13, is a proud three-time GW alumna working as an endocrinologist at Cleveland Clinic Abu Dhabi Hospital in her home country’s capital city. “IMP gave me the opportunity to get into the system,” says Almansouri, who values the flexibility to practice anywhere in the world that her SMHS education and training afford her.

This year marks IMP’s 20th anniversary, and Almansouri is just one of more than 10,000 GW and international faculty, staff, residents, fellows, and students who have benefitted from its 90 partnerships in more than 50 countries since its founding. “We’re changing lives by providing opportunities to students and professionals that they otherwise would never have,” says Huda Ayas, Ed.D. ’06, M.B.A. ’98, M.H.S.A. ’93, executive director of IMP.

In addition to the international M.D. program and the international residency and fellowship program in which Almansouri participated, IMP offers a medical research fellowship program, an international observership program, international clinical rotations for GW medical students, and continuing medical education for international faculty. Its two-fold mission, “to fly the GW flag around the world and bring the world to GW,” links helping to build capacity and improve the quality of health care abroad, with enhancing the cultural sensitivity of American medical providers.

Stanley Knoll, M.D., FACS, clinical professor of surgery at SMHS and medical director of IMP, has worked closely with Ayas since the program’s founding. He notes that the international students and residents who study and train at SMHS arrive with a great deal of medical knowledge. “We may not teach them more about a particular disease or medical procedure than they already know, but we teach them about the American medical education system and the American health care delivery system, which are both different than anywhere else in the world. And this can be just as important.”

On the other side of the equation, Ayas observes that “international experience allows physicians to become aware of their biases. While it’s difficult to measure, improved communication with patients who come from different backgrounds can improve health outcomes,” she says. “This makes them better physicians.” Knoll adds that the “faculty and student body of GW is far more diverse and internationally aware than ever before, and it’s been wonderful to participate in that process.”

FERTILE RESULTS FROM DESERT ROOTS

IMP’s roots lie in a partnership that was formed between GW and King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia in 1993. At the time, Ayas assisted with a needs assessment project that identified a shortage of qualified physicians in the Middle Eastern country. “We developed physician training programs and invited Saudi students to enroll in GW’s dual B.A./M.D. program,” recalls Ayas. “We also came up with a short-term solution that involved sending our own faculty to King Faisal Specialist Hospital to serve as practicing physicians for two years.”

The Saudi partnership has expanded over the past two decades to include affiliations with medical schools and hospitals across the kingdom, as well as with the Saudi Arabian Cultural Mission (SACM), located in Fairfax, Va., which implements national educational and training policies in an effort to meet the country’s goals of expanding health care capacity. Samar Al-Saggaf, MBBS, Ph.D., director of the department of medical and health science programs at SACM, calls the partnership “a vision of enhancement of our health care system and our health policies with well-trained alumni coming from GW.”

The long-term exchange of students and faculty, as well as the joint research efforts between GW and Saudi Arabia, have “made the impossible possible,” says Al-Saggaf, who was honored for her outstanding contribution, dedication, and leadership in medical education diplomacy at the IMP Annual Dinner in early October. Al-Saggaf remembers a time, not more than a decade ago, when just a few Saudi medical students would match with U.S. hospitals for their residency each year. By contrast, in 2013 alone, 93 Saudi students received residency matches. “This partnership has given our students the hands-on experience that makes them competitive candidates,” she says. “It gives them communication and research skills, and allows them to build relationships with U.S. doctors. IMP has done a tremendous job building this bridge.”

ENRICHING EXPERIENCES IN RESOURCE-POOR SETTINGS

Yushekia Hill, known to her friends as “Sheek,” is in her second year of the five-year M.D. program at SMHS. She is a participant in the Mentored Experience To Expand Opportunities in Research (METEOR) program, which encourages newly-admitted SMHS students from communities underrepresented in the medical profession to explore the possibility of a career in clinical or translational research by matching them with a mentor engaged in the field. While she has an interest in clinical research, especially within the African American community, Hill was undecided as to what her academic focus would be until summer of 2013 when a medical mission coordinated by IMP brought her to Haiti’s impoverished Central Plateau.

Since 2004, IMP has been organizing biannual trips to Haiti in partnership with Project Medishare, a non-profit organization dedicated to improving health care in the western hemisphere’s poorest nation. The week-long missions provide the opportunity for students from SMHS and GW’s School of Nursing and School of Public Health and Health Services to travel to the town of Thomonde to provide direct care in a resource-poor setting through Project Medishare’s mobile clinics.

“This partnership has given our students the hands-on experience that makes them competitive candidates. It gives them communication and research skills, and allows them to build relationships with U.S. doctors. IMP has done a tremendous job building this bridge.”

—Samar Al-Saggaf, MBBS, Ph.D.

The trips have historically been led by Jack Summer, M.D., FACP, RESD ’81, associate clinical professor of medicine at SMHS, and are now co-supervised by infectious disease specialist Marc Siegel, M.D., assistant professor of medicine at SMHS. In addition to providing invaluable experience diagnosing and treating diseases of poverty, students gain exposure to practicing medicine in an unfamiliar cultural setting, says Summer. “It’s important for students to see that what we think might be a goal for someone, might not be the goal they want for themselves,” he says. “It changes the way they see the world. It’s rewarding when a returned student tells me what an eye-opener the trip has been for them, but even more so when they say ‘I’d like to continue doing this kind of work overseas or at a community health clinic in D.C.’”

Hill’s experience in Haiti — her first trip to the developing world — was exactly the sort that makes Summer smile. “I came from a background where I didn’t have a lot,” she says. “But when you meet someone who has even less, you realize how much you take for granted.” Hill found herself particularly drawn to the OBGYN section of the mobile clinic, where she assessed the incoming pregnant women, taking vital signs and determining the reasons for their visit, before referring them to one of the physicians. Despite the exhausting days in Haiti — the team saw upwards of 150 patients on each of the five clinic days — Hill was energized by the experience and hopes that her future medical career will lead her abroad again. “Understanding the limited resources of my patients allows me to relate to them in a way that would be impossible otherwise,” she says. “The skill set I learned is universal.”

Summer credits IMP with the strength of the ongoing partnership with Project Medishare. “They have poured their heart and soul into making these trips successful, even though it’s just one tiny aspect of what they do,” he says.

HELP FROM ABOVE
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In addition to providing international experiences for GW students, and GW experiences for their counterparts abroad, IMP is dedicated to the growth of its continuing medical education program. In operation since 2004, the program keeps international health care professionals abreast of advances in medicine through courses that are developed, reviewed, and delivered by GW faculty who are experts in their individual clinical areas. Nearly 120 such courses, many of which are approved by the American Medical Association, have taken place throughout the Middle East, Asia, and Central America, providing continuing medical education to more than 8,000 health care professionals.

In 2006, Jeffrey S. Akman, M.D. ’81, RESD ’85, Walter A. Bloedorn Professor of Administrative Medicine, vice president for health affairs, and dean of SMHS, participated in the continuing medical education program. As then chair of SMHS’s Department of Psychiatry, Akman traveled to Kuwait, Oman, and the UAE, where he led a course that focused on diagnosing and managing depression in a primary care setting. “It presents a genuine challenge for physicians,” explains Akman, “to identify and address a problem that is so common, but which carries a great deal of stigma for patients and their families.” He recalls the experience as rewarding, and says that it “enhanced my cultural competence and my ability to relate to others.”

Janan Sarkis, M.P.H., director of international programs for IMP, remains grateful for Akman’s involvement with the department. “The support of leadership is essential to our growth,” Sarkis says. “Dr. Akman has a global vision and has always encouraged us to move forward.” This is especially important in this age of globalization, according to Sarkis. “If you’re not reaching out internationally these days, then you’re moving backwards. And we need to keep moving forwards,” she says. Knoll adds that the support of SMHS leadership has given IMP “the wherewithal to continue our growth and has really increased the dynamics of what we do.”

In the coming years, Knoll envisions IMP expanding the number of countries with which it partners, the size of its staff, and the number of opportunities for faculty to go overseas. “This will lead to more potential for international collaboration, especially in terms of research,” he says.

During a recent trip to Saudi Arabia, it was clear to Ayas that IMP has moved forward by leaps and bounds since its founding 20 years ago. “We met with 18 different medical institutions,” Ayas recalls of the week-long trip, “and at each and every one we ran into GW alumni who are now serving in leadership positions in their country.” Knoll, who accompanied Ayas on the trip, noted the resulting “tremendous goodwill that exists toward SMHS internationally.” The GW flag is indeed flying high in Saudi Arabia, and in dozens of other countries globally. “This is exactly what we were trying to do,” Ayas observes with a smile. “And we’ve done it.”


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