With a growing shortage of cardiologists in the United States, there is a growing interest in recruiting more clinicians from overseas. But there are barriers to this approach, explained Abdel Almanfi, MD, a structural heart interventional cardiologist at Baylor St. Luke's Medical Center in Houston. He spoke with Cardiovascular Business about his journey from Libya to the United States, shedding light on the challenges foreign doctors face in realizing their dreams of practicing medicine in America.
Growing up in Libya, Almanfi harbored a desire to pursue a career as a cardiologist in the United States. However, his decision was met with skepticism from friends and acquaintances who warned him of the considerable distance from his homeland, the cultural disparities and the complex requirements for certification in the U.S. healthcare system. Despite these warnings, Almanfi remained undeterred.
"My medical school was in Libya. I did seven years there. It's different than United States. You do seven years there after high school. So you kind of choose the medical field when you're still 18 years old. And then I went to residency back home in Libya for about four or five years before I decided to switch and come to the states to be a cardiologist. When I came to the U.S., I had to do that again," he explained.
Almanfi found himself starting from scratch upon arrival in the United States. The U.S. medical system is notoriously rigorous and closed, requiring foreign-trained physicians to undergo a comprehensive evaluation and certification process. This involved passing standardized exams such as the USMLE (United States Medical Licensing Examination) steps, followed by applying for residency through the National Resident Matching Program (NRMP).
For Almanfi, this journey encompassed nearly a decade of dedicated effort, including three years of internal medicine residency and additional training in cardiology and interventional cardiology. The process demanded resilience and persistence, as foreign-trained physicians often encounter bureaucratic roadblocks and lengthy timelines in obtaining licensure and certification to practice medicine in the U.S. The requirement to meet the U.S certifications can be a significant deterrent for individuals who have already established careers in their home countries or seek expedited pathways to practice medicine in the U.S.
"I think if someone has a goal in mind and has determination to do this, maybe they can go through the process. I know it's painful, it can be long, but it can get you to your dream and get you to have a job and have a living and even become a U.S. citizen. That's probably the longest way and probably the official way," Almanfi said.
Finding cardiology educational opportunities
Almanfi suggests exploring alternative avenues for skill development, such as attending conferences, participating in hands-on training programs and leveraging online resources and simulators to enhance clinical proficiency.
Almanfi's own experiences underscore the significance of networking and utilizing social media platforms as valuable tools for professional advancement. As a social media ambassador for prestigious medical conferences, he has leveraged digital platforms to connect with colleagues worldwide, share insights, and collaborate on educational initiatives. Social media serves as a gateway for international physicians to engage with the global medical community, facilitating knowledge exchange, networking opportunities, and professional development.
"I think social media has became a central part of almost everything in our life nowadays. Not only in politics but also in medicine. I have been doing this for 10 years, which I think has impacted my career. And so I became more involved with physicians not only within the United States, but also outside the United States. Social media, it became like a window for the people there to look at the outside world. And so if you're traveling to the United States, you could see everything through social media, especially if you are connected with people or organizations that have a presence on social media," Almanfi explained.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com