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   A Memorial University of Newfoundland Publication

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March 10, 2005


Refugee teaches valuable lesson
to medical students

For the past year, Dr. Magdi Amasaib and his wife Eman, also a physician, have lived in St. John’s as refugees from Russia. They are originally from Sudan, a country which has been embroiled in a civil war that since 1983 has seen two million deaths and over four million people displaced.

While taking refuge in Moscow allowed the Amasaibs to study and practice medicine, eventually they found themselves also unwanted there, and a year ago were accepted as refugees by Canada and placed in St. John’s.

The first task in rebuilding their lives as physicians has been to learn English. “When I came here I couldn’t speak any English,” said the soft-spoken Dr. Amasaib, who has made great progress in only 12 months. Once he passes the TOEFL (Test of English as a Foreign Language) he must then successfully take parts 1 and 2 of the Medical Council of Canada Qualifying Exam.

“It’s a very complicated system here. For me and my wife to be qualified to work as doctors in Canada we have to re-study everything we had already learned and we have to be in a training program where we can observe physicians and learn medical terms in English.”

Dr. Amasaib’s situation came to the attention of first-year medical students at Memorial this year during their clinical skills course, which focuses on patient-centered care. Students work in groups of about eight and one of the exercises involves interviewing people such as refugees, young people facing their first sexual experience, abused women and families with multiple problems.

Elizabeth Ohle is a trainer for standardized patients and an administrator for the Interprofessional Education Modules with the Centre for Collaborative Health Education. “As I was recruiting among the African population in St. John’s for people to act as standardized patients, it was quite coincidental that I was referred to Dr. Amasaib, the physician from Sudan.”

The scenario Dr. Amasaib participated in involved him visiting the “doctor” to discuss not feeling well. In the midst of the interview, details about the refugee’s history come to light. To give this scenario more authenticity, the interview took place using the services of a translator so the students could practice that form of communication as well.

David Harvey is one of the students in a first-year clinical skills group. He is especially grateful to standardized patients such as Dr. Amasaib “who gave us their advice and taught us their own personal skills.”

Mr. Harvey also had endless praise for the group coordinators who teach the students how to interact with patients and help them feel comfortable. “My coordinators, pediatrician Dr. Anne Drover and social worker Sue Pye, always offered meaningful and useful comments about our interactions with patients, whether standardized or real. They taught us to identify with the patients and really try to understand how they were feeling rather than listing off a slew of ordered questions.”

Mr. Harvey said the clinical skills course made him “a million times” better at talking with people. “The first time I did an interview with a standardized patient I was just trying to find out as much information as I could through constant questions and then just summed everything up by giving advice, which was pretty insufficient at the time. Now I realize that so much more information can come out while talking to a patient if you get a good rapport with them and try to relate to their situation.”
Standardized patients are recruited from the general population and trained to portray clinical cases to support the education and evaluation of students in all health care professions. “Some of them are very believable and the students even started the Standardized Patient Award given to the actor who goes above and beyond pretending to have medically-related problems,” said Mr. Harvey. “Some of them really brought a tear or two to some eyes.”