By Evan Carter
The Detroit News
DETROIT (AP) - Nasseer Skhale once performed up to 25 surgeries a day as a physician in Iraq, but these days, he makes his living fixing autos at a Detroit used-car dealership.
Skhale, 41, of Dearborn Heights, who fled sectarian violence in his homeland, hopes to resume his medical career in the U.S. but faces the same hurdles that confront many doctors who have emigrated from Iraq and Syria, The Detroit News reported.
Some former doctors are working as nurses, medical billing reps or in unrelated fields, like Skhale, while tackling the long process to become certified in this country, which includes gaining residency status and passing multiple exams.
Skhale would rather be diagnosing diseases than engine problems, but he's thankful for his job at Metro Auto Sales on Detroit's west side, which allows him to support his wife and four children.
"I hope to return to my business (as a doctor) and my job in the U.S.," he said.
"I know the thinking of the doctors and I know how they think, the cases in the hospital, that's what I mean," Skhale said. "But I can't understand how the mechanic is thinking."
Skhale, who fled to China in 2013 and arrived in the U.S. last November, hasn't begun the process to become certified as a doctor in the U.S. - he wants to solidify his family's finances first.
In the meantime, Skhale is relieved to be away from Iraq, where he increasingly found himself in danger as violence flared between the nation's Shiite and Sunni Muslims. Since the U.S. invasion in 2003, more than 2,000 of the nation's doctors have been killed, according to reports from the Lancet.
Skhale said a Shiite militia targeted him for training new doctors and other medical workers.
"I was threatened many times, maybe four or five times, because I was working with an American agency, so I left Iraq," said Skhale, who came to Michigan with his family as a refugee. "They accused me of being a spy and doing some spying job for the United States."
Tarec Micho Ulbeh left Syria for similar reasons. Since the country spiraled into civil war starting in 2011, more than 750 doctors have been killed, according to Physicians for Human Rights.
Micho Ulbeh can testify to how hard it is to become certified to practice medicine after emigrating to the U.S.
Micho Ulbeh, 27, who arrived in Michigan in 2014 from Syria, is part way through the process of beginning his career as a physician in America. He left his homeland shortly after finishing medical school.
All foreign medical graduates have to achieve certification from the Educational Commission for Foreign Medical Graduates, pass the three-part United States Medical Licensing Examination, go through a U.S. residency program and become licensed in the state where they plan to practice.
In Michigan, physicians are licensed by the licensing division of the Office of Licensing and Regulatory Affairs.
Micho Ulbeh, who graduated from medical school in Syria in 2014, has already completed the ECFMG certification and is studying for the third part of the U.S. licensing exam. He volunteers at the Heart & Vascular Institute and works as a physician assistant at the Michigan Specialty Clinic, both in Dearborn.
Micho Ulbeh, who lives in Dearborn Heights, expects to get his results from the ECFMG by Aug. 17 and plans to take the third section of the licensing exam in September.
He also arrived with a green card through his aunt, an American citizen. Yet, even with his advantages, Micho Ulbeh is struggling to be accepted into a residency program.
"It's so competitive, man. You can't imagine how competitive it is. That's what makes the residencies hard," Micho Ulbeh said.
The Detroit Medical Center, for instance, accepts only 235 of the roughly 23,500 applicants who apply for residency every year.
Part of what makes it challenging for international medical graduates like Micho Ulbeh is that they have to compete with U.S. graduates for residency positions. At the same time, the number of international graduates applying for residency exceeds the number of residency positions available, according to the ECFMG.
According to the commission's Match Residency Program, 89 percent of American medical graduates and students and 50.5 percent of noncitizen international medical graduates within its program were matched with a residency in 2016.
Match figures also indicate the number of noncitizen international medical graduates applying for residency through the program has increased 8.5 percent to 7,460 between 2012 and 2016. In the same period, the number accepted into residency increased 9.9 percent to 3,769.
"The likelihood of a foreign-educated, foreign-trained physician receiving a license in the United States is very low," said Bing Goei, director of the Michigan Office for New Americans, an agency established in 2014 by Gov. Rick Snyder to assist immigrants with workforce skills.
According to Goei, while some who received their medical degree in another country eventually become doctors in the U.S., many others instead enter related jobs with a lower barrier of entry, such as physician assistant, registered nurses, medical billing or medical translation services.
But some do become licensed physicians: according to the ECFMG, 25 percent of the nation's doctors were educated abroad.
Skhale, who practiced medicine in Iraq for more than 10 years, questions whether the process for doctors like him to become certified to practice in the U.S. could be streamlined.
"No need to ask me what's the cell content because I spent 20 years playing with cells ... It is plasma. This is not practical," he said. "Ask me how to face the difficult things."
Despite all of the difficulties breaking into the medical field, Micho Ulbeh is happy with his decision to come to the U.S.
"If you want to be a doctor in this country, even as an American graduate, it's not easy," he said. "I mean, so eventually it's worth it. Maybe it costs like a lot of time, it costs you a lot of money, but at the end you will get it."
Published: Wed, Aug 10, 2016
