“Palestine is known to be one of the highest intellectual countries in the world, with illiteracy rates as low as 2.2% despite the occupation policies of pushing Palestinians away from education, knowledge and training. This also implies to the medical education with seven medical schools in the West Bank and Gaza Strip; many of their graduates are enrolled regularly in the national medical residency training programme in multiple different specialities.
The training programme in general surgery provides the trainee with the knowledge and experience needed to become a competent and safe surgeon; however, it has some limitations and challenges. One of these is the absence of high-level subspeciality training in specific niche surgical sectors; one of these is endocrine surgery.
Since my first years of training, I have been fascinated with the surgical problems and management pathways of endocrine diseases affecting the thyroid, parathyroid and adrenal glands. I always dreamt of obtaining a higher level of training in this field, which unfortunately was not available in Palestine, both as training and as a service, as there are no endocrine surgery subspecialists back home. Thankfully, Juzoor and FQMS gave me an amazing opportunity to chase my dream and provided the support and assistance needed not only to find an appropriate high-level hands-on training post in one of the most prestigious hospitals in the world and financially aiding in accommodating in an expensive city like London, but also and most importantly on the personal humane level, from the time they first met me to discuss the future plan back in 2018 to the friendly meetings when I first arrived to London in 2022 and the continuous support during the whole training period. I felt being in a family and part of their community.
I had a wonderful experience during the two-year training period in endocrine surgery at King’s College Hospital, both on the personal and professional levels. Not only have I obtained the proper high-level knowledge and surgical skills to help in providing the best care for my future patients, but also it has changed me personally by exposing me to completely different cultures. This would never have happened without the help of both Juzoor and FQMS for which I feel so grateful for making the dream come true.”
“August 1st was my last day in my NY fellowship at Montefiore Medical Center/ Albert Einstein College of Medicine, where I stayed for an entire year.
I have finished two years of shoulder and upper extremity fellowship. During these two years, I have achieved a lot of goals on the personal level and professional levels. I will share some of these with you:
I have worked with 12 shoulder and upper extremity surgeons ( from Reading Shoulder Unit, Wisconsin Medical College, and Montefiore hospital. This allows me to expose to various approaches and ways of thinking which will be helpful from diagnosis to surgical treatment.
I have participated in a total of 1161 operations ( Shoulder and Upper extremity), as attached in the logbook.
I participated in 11 in-person Shoulder and elbow courses last year—two from the Mayo Clinic. from essential to master courses. I have been granted in one of these courses the Best participated Fellow. I got an offer from the Mayo Clinic to be the scientist visitor of the year. Next Sept. I have got two covered courses in San Fransisco.
I have published five peer-reviewed publications, and I am working on seven more. I applied for one research grant for a future project with Wisconsin Medical College.
Established good relationships with my mentors all over the places.
Accepted as a member of American Shoulder and Elbow Surgeons (ASES).
I am confident I can give my patients the most updated knowledge and treatment.
I got good offers to work in the USA, But I am not interested in working outside of Palestine. In the last six months, I have tried to find a Job in Palestine by contacting various hospitals, but unfortunately, I did not find any so far. I backed to Palestine 3 days ago. And I am working to establish my practice and find a job that suits my future goals. Meanwhile, I am also working to reestablish my personal life.
I want to thank everyone; you were supportive and helpful; without you (Juzoor and FQMS), I won’t be able to achieve what I have already achieved. There are no words to express your incredible work. I am really Impressed.”,
“I have applied for a 2-year Respiratory training fellowship through Juzoor and FQMS and was accepted in 2019 at university Hospital of Southampton.
It was a life-changing opportunity. I had the chance to develop in many aspects, including clinical respiratory teaching, research, and leadership and management.
I’m committed to taking my experience back home, hoping to improve the Palestinian medical system and looking forward to a Palestinian fellowship programme.
Thanks to Juzoor and FQMS for providing a sub-speciality training opportunity, and many thanks for the unlimited support.”
Islam has been completing our postgraduate subspeciality training at King’s College Hospital London in interventional radiology since July 2018.
“Throughout my training years in general radiology, I started to hear about a state-of-the-art branch of radiology called ‘interventional radiology’. In this branch, major interventional procedures are performed under image guidance.
Unfortunately, there are very few training opportunities in this field available in the Arab World. In Palestine, it’s much worse, as only a few basic procedures are performed. This motivated me to apply through Juzoor and FQMS to do my subspeciality training at King’s College Hospital in London.
During the past year, I have learnt to do many procedures. From basic ones, like biopsies, to peripheral vascular angioplasties. During the upcoming year, I will get more training in oncological procedures and perform trans-arterial chemoembolisation (TACE) and aortic procedures (EVAR and TEVAR).
My plan, after I finish training, is to set up an interventional radiology practice in one of the main Palestinian hospitals. Through this I can reduce the suffering of my patients. Before, they would’ve had to either get a more invasive procedure, like an amputation, or travel outside Palestine to get the required interventional radiology procedure.”
Eyad was part of our postgraduate training programme for 2 years at King’s College London Hospital in orthopaedic surgery. He returned to Palestine in 2016 and now works at the Arab Care Hospital in Ramallah.
“I had huge benefits from my training. King’s College is a trauma centre, so I was able to increase my experience in orthopaedic trauma, as well as my speciality training, as I did a fellowship in knee and shoulder surgery. It was a great experience. I learnt a lot!
When I went back home, I started to apply things I learnt clinically. In the past there was no shoulder and advanced knee surgery, so any case had to be transferred outside Palestine. So to some extent I have reduced the number of cases that have needed to be transferred.
In the future, I’m planning to engage myself in the general sector to continue to reduce the number of transferred cases; also, if I can, I will help in teaching. Also, I will continue to develop myself and to have new experiences so I can help our people.”
Read about Naji, who received postgraduate subspeciality training in London:
“I started a two-year training programme in the Gynaecological Oncology Department in the UK in May 2016. In the beginning, I didn’t have high expectations about the quality of training I was going to have. But when I started my new post, I found that I had a great opportunity and I needed to get the maximum benefit out of it.
My training was mainly in the surgical management of women’s cancer at University College London Hospital (UCLH). It took me a short period until I felt like a member of the gynaecological oncology team. I can’t deny some difficulties at the beginning. With the support of my team and my FQMS mentor, I managed to overcome them.
In a hospital like UCLH, I found highly skilled surgeons with a great amount of experience. They knew how to deal with trainees and transfer their experience to them. Also being in a city like London with a big population exposed me to all kinds of cases with good numbers. This helped me build up my experience and competence. In comparison, Palestine suffers from a lack of well-qualified trainers. Also due to the absence of big referral hospitals, the opportunities for good surgical gynaecological training are scarce.
Now as I’m back home, I hope that I can use this training to contribute to raising the level of our healthcare system by transferring my experience and knowledge to new doctors.”
There are two more postgraduate trainees arriving next year:
Islam (Interventional Radiology)
Mohammad (Respiratory Medicine)
Abeer has passed the final part of the Arab Board exam and will be taking the FRCPath part 2 in 2018. She plans to return to Gaza after. There she hopes to use her training to improve services available in Gaza and teach a new generation of doctors.
Here, in their own words, are updates from our postgraduate trainees Naji, Maha, and Najib on their time in the UK so far.
Najib
I came to UCLH six months ago. When I met my supervisor, he designed a schedule to integrate me into the new system.
I work in the labour ward on Mondays, where the protocols and guidelines of the Royal College are strictly followed. What impressed me most is the teamwork in the labour ward. You can sense a rhythm among consultants, registrars and midwives. For the rest of the week, I either cover clinics in urogynaecology and endometriosis or assist in theatres.
UCLH is one of the most prestigious endometriosis centres in the UK. They deal with complicated cases, especially rectovaginal disease. This is expanding my experience in both pelvic anatomy and laparoscopy. The consultants are very keen to teach me and I’m learning something new every day. UCLH is a lovely place to learn.
Naji
“I’ve been in London a year and a half. When I arrived in London, I wasn’t sure about the level of training I was going to have, but it has more than lived up to my expectations. In the beginning, I struggled adapting to this new system.
My surgical skills have improved greatly. Following up on patients and our weekly MDT, I have widened my experience in planning and executing surgery well. My main goal was to improve my laparoscopic surgery skills. After a year, I can perform this type of surgery safely, but I need more experience to be able to do it independently. My time is limited, especially as this is a big and complicated subspeciality, but the team has been friendly and helped my confidence and skill grow.
I hope I’ll be able to achieve what I wanted to when I made the decision to quit my job in Palestine and train in England.”
Maha
Starting a new life in a different country, a different continent and indeed a different culture is not an easy step, especially when you have a family with you. Settling into a new place, new home and new rules and regulations is a big source of anxiety, but over time you start to relax, which is when I was ready to begin my training.
Becoming a part of the haematology-haematopathology team was peaceful. I was welcomed by the team and introduced to working straight away. But when you open the door to so much knowledge, there can be some storms to face, but luckily I was able to overcome them. Day by day I started to become more familiar with the routine and work. I started to get involved in educational activities. What really helped is that North Bristol NHS Trust is one of the core haematopathology centres in the south of England. I am lucky to be part of their team.
Now after a year, I’m beginning to feel that I’m advancing my skills and helping myself lay the foundation for my return to Palestine. My hope is that I will be able to help create a haemato-oncology service in Palestine with up-to-date applications and diagnostic methods.
They say, “dream big, work hard, stay focused and surround yourself with good people,” and I think that is my secret. Well, it’s not a secret anymore!
Read an update from Inji Al Shaer, who was sponsored for a fellowship in renal medicine at Kent and Canterbury Hospital:
“When I was presented with the idea of completing my fellowship in renal medicine in the UK, I was overjoyed. FQMS provided me with a golden opportunity to advance my career and for that I will be forever grateful and indebted.
There are quite a few differences in medical training and practice between the UK and my homeland, Palestine. This might be partially attributed to the obvious difference between developed and developing countries. Namely, there is a lack of formal training in sub-specialities in Palestine despite the massive need and demand. Statistically, the number of patients with kidney problems, failures and transplants is on the rise. However, patients usually have no other option but to be put on a long waiting list for referral to Israeli or Jordanian hospitals. If they are really lucky, they can afford to travel abroad for their necessary medical treatment, which is rarely the case.
Palestine is not short of bright minds, but it lacks resources and training facilities. This has left it in desperate need of sub-specialist physicians.
I cannot begin to express my gratitude to FQMS. Their support has changed the course of my life. Had I stayed in Palestine, I would have been confined to the patriarchal society’s norms and would not have been able to advance my career in the same way due to the complex situation, specifically the siege on the Gaza Strip. The fellowship has provided me with a well-rounded experience. This included both theoretical and practical experience, which is much needed in Palestine. There is a wealth of experience in taking care of kidney patients and performing procedures, like dialysis, line insertion, and biopsies, as well as leadership and management skills. Combined together lead to improvements in treatment and the maintenance of good medical standards.
Developing my career as a nephrologist in the UK has been a great journey. This wouldn’t have been possible without the support of FQMS.”
