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Becoming a doctor in Baghdad

Mohammed Jaafar Saeed tells of the struggle to study medicine in war torn Iraq



What is it like to study medicine in war torn Iraq?

Most medical students think about leaving Iraq—that’s why USMLE (the US medical licensing exam), PLAB (the professional and linguistic assessments board), and IELTS (the international English language testing system) have become common in our vocabulary. I arranged with two colleagues that we would study together. We bought books for USMLE, and that’s how I prepared for starting my last year in medical college.

Security at that time was deteriorating and getting to college was hard with the blocked roads. The constant danger of nearby bombs meant that sometimes we would wait for hours for the roads to open. Once I was returning from college with my father and the highway was closed, and an Iraqi soldier was telling people to get off the highway and use a small street beside it. So we did, and that’s when a bomb exploded. The car shook, the windshield broke, and debris fell on us. We were so close to the site of the explosion. We were lucky. In such situations 30 seconds can mean the difference between life and death.

I was in other dangerous situations in the last year at college. Mortar shells fell 20 m away from where my colleagues and I were sitting. A bomb exploded on a roundabout where my friends and I were heading to have breakfast near college—we ran quickly and took shelter behind a concrete wall. And shootings took place in a street as I was leaving college, so I hid in a shop till things calmed down.

A couple of times we were locked in the college because of shooting in a nearby area, and we waited for things to calm down. Because of these conditions some students left Iraq and started trying to get accepted in colleges abroad, and some went north to Iraqi Kurdistan, where security is good. Many students in the final year started doing elective courses in Jordan to stay away from the mess in Baghdad for some months, but they had to return to Baghdad to have their exams.

Some professors were killed. They were assassinated, and no one knows why. Other professors left Baghdad, so the number of professors was decreasing with time. Because of the insecurity, women had to look more conservative. Many started wearing the hejab, or head scarf, when on the road but took it off in college.

Usually medical students here study from lecture notes written by fellow students. I didn’t like this way of learning. I used books because they are more accurate; better organised; and have more illustrations, photos, and tables. At a medical bookshop when you want a book, you are asked whether you want it original or photocopied. No one cares about copyright here. If the book I want has photos then I’d prefer the original. If not then I’d rather the photocopied version, which is cheaper, of course. Studying from books paid off, and I got good marks.

Two of my best friends left Iraq in that last year of college. One had a name that identified his ethnic group, and he was afraid that he would be kidnapped or killed. He went to Jordan, where his relative works as a doctor. He tried to get in to several colleges, but couldn’t until last year, when he got accepted to a medical college in Amman, Jordan, but they made him repeat two semesters that he’d already studied in Baghdad. It’s not a bad decision. He will graduate three years later than us, but he is safe, and it’s nicer in Amman. My other friend transferred to a medical school in Iraqi Kurdistan, it’s safe there, and she didn’t have to repeat any work, but she had to learn the Kurdish language.

Last year the government passed a law that denies graduates of medical schools their certificates to prevent doctors leaving Iraq. Doctors were only able to get their certificates after the war in 2003, and now again we aren’t allowed them. This is unfair, and if doctors are needed then the government should tempt us, not force us, to stay.

Every year the senior medical students go on a trip, usually to Iraqi Kurdistan. It’s has mountains and beautiful views. I didn’t go because the road from Baghdad to Kurdistan passes through some dangerous areas known for sectarian violence, but some students went and returned safely.

As a senior student I spent all my time at the hospital. I was more in touch with the health system, and I saw the lack of drugs and equipment and the bureaucracy that is everywhere. Patients get sutured without anaesthesia. At one time all operations in the paediatric department were postponed for months because it lacked sutures.

I also saw how much our people lack proper education—for example, one woman got pregnant because she stopped taking the pill thinking that because she’d taken it for five years she was immune and no longer needed contraception. I was sad to see how some doctors behave with patients—for example, a teenage woman was in labour, and the gynaecologist shouted, “Come on. Make it quick. We don’t have all day.” There were also promising times—for example, after an explosion in Baghdad I was in the emergency room, and I saw that the doctors responded fast and were doing a good job taking care of injured people.

I’m not sure what the future has for me and whether I will get the chance to leave Iraq or not. Like people all over the world I want a better life, and I will work hard to achieve it.

Mohammed Jaafar Saeed general practitioner Al-Alwayia Hospital for Children, Baghdad
hammodi1983@yahoo.com
Student BMJ 2008;16:187 | 17
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LIFE
Becoming a doctor in Baghdad
      (Mohammed Jaafar Saeed May 2008)

Dr.HAIDER JALIL
(May 29th, 2008)
 internal medine, IRAQ/BAGHDAD tajmahel2@hotmail.com

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dear doctor
As u know am one of your previous collegues at college and we all shared the same miserable situations last year and I can tell about more stories that are similar - even more difficult than yours and some are still happining within the area of the hospital I work in now though i hope it gets better...

I wanna ask u whats the benefit of describing our misery to the world?? and if u want to leave Iraq for the sake of studying or peacful life (as u said lots of doctors want to do that EVEN ME) u can study and do the exams in the neighboring countries without exposing us as people that deserves the pitty from the others..(at least leave the remain of our injured pride)..WITH MY FULL RESPECT TO YOUR OPINION..

wish u all the best in your work my friend.
TAKE CARE




LIFE
Becoming a doctor in Baghdad
      (Mohammed Jaafar Saeed May 2008)

Ali Kubba, John Howard, Peter Sullivan
(July 7th, 2008)
 Consultant, Guy's Hospital aliakubba@aol.com

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We would like to express our admiration for the spirit of this brave article and acknowledge the challenge it delivers to those of us working in countries that have a moral stake in Iraq. We the respondents, representing various UK Royal Colleges, wish to reaffirm the commitment of UK medical/academic institutions to support the brave doctors and other health care professionals working in Iraq. We are currently engaged in a number of initiatives to support medical education and continuing professional development of Iraqi medics but would like to work further with Iraqis and others to devise and implement a comprehensive programme fit for the needs of Iraq.