Dr. Mohammed Al-Mansob arrived in Halifax in 2018 for a two-year scholarship for heart surgery with a sense of optimism. After years of working in Saudi Arabia while his family lived in Montreal, he wanted to be in Canada full time.
Al-Mansob, who is originally from Yemen and has permanent residency in Canada, hoped the Halifax scholarship would lead to a permanent job.
Instead, he received what he described in a written complaint as a “very painful experience with racism, discrimination, double standards, disrespect and division” from some doctors, apprentices and staff connected to the division of Nova Scotia Health heart surgery and, in some cases, the medical school at Dalhousie University.
Al-Mansob, 43, is one of three internationally trained doctors who spoke to CBC about the problems they experienced during their stay in Halifax, concerns that have prompted the health authority to recently begin an independent assessment. job of the cardiac surgery division.
Over the course of multiple interviews via video, phone, and email chat in the past two months, doctors described having fewer opportunities in the operating room than white colleagues, being subject to different standards than white colleagues, facing on charges of misconduct without evidence. and management’s inaction to address their complaints. CBC reviewed the complaints, which went to some of the highest medical officials in the province.
“I’m done [saying]”Mohammed, finish your training and get out of here as soon as possible,” Al-Mansob said in a telephone interview from Toronto, where he has been a cardiac surgery fellow at the University of Toronto since 2020 at the Hospital. General of Toronto and now Sunnybrook Health Sciences Center.
Dr. Mohamed Othman says cardiac surgery residents and internationally trained fellows do not have the same opportunities in Halifax as their white colleagues. (Submitted by Dr. Mohamed Othman)
Dr. Mohamed Othman also came to Halifax thinking that it could lead to a permanent job.
In 2021, Othman moved his family from Toronto, where he completed scholarships to Toronto General and Sunnybrook for four years. He had previously trained and worked for years at universities and hospitals in his native Egypt and Saudi Arabia. If he was doing a one-year scholarship in Halifax and things were going well, he was told there could be a job.
But Othman, 49, said the job he found in the Halifax infirmary when he arrived was so toxic, “It was like a circus.”
“Everyone was complaining about each other,” he said, describing the heart surgery division as a rift between a group of surgeons seeking to promote diversity and a group more interested in Canadian and educated doctors in Canada who look like they do.
“[The public] I should know that there are, I’m sorry, some racist people in this department, “said Othman, who has Canadian citizenship, during several video interviews from Egypt, where he works as a heart surgeon and professor at Benha University. .
“They are abusing doctors who graduate abroad or internationally giving them hard times.”
Othman said he had to fight the feeling among some doctors that, as someone with international training, he was there to serve the unit instead of spending time in the operating room.
Nova Scotia Health Acting CEO Karen Oldfield said in an interview that she was aware of these complaints and that she began to feel concerns about the heart surgery division in February. After gathering information, Oldfield said he decided to order the external evaluation.
“There is no room for racism”
There have been at least three previous reviews of the division since 2010. The health authority would not provide CBC with these reviews. CBC has requested them through the information access process. Oldfield, who was appointed interim CEO last September, said he could not talk about the work that happened before he arrived.
“What I can tell you is that, you know, there is no room for racism, intimidation, harassment. [or] bullying at Nova Scotia Health. I don’t realize it and we as an organization don’t realize it. “
The evaluation is led by Dr. Jack Kitts, former president and CEO of Ottawa Hospital, and Joy Noonan, a lawyer whose practice focuses on mediation, arbitration, workplace assessments, and conflict training.
In an internal note sent to members of the division, obtained by CBC, the head of surgery, Dr. Gail Darling, states “[t]There are still ongoing concerns about interpersonal conflicts and the overall organization and staffing of the Division and Heart Health Program. “
Karen Oldfield is Acting President and CEO of Nova Scotia Health. (Dave Laughlin / CBC)
A health authority spokesman said 10 complaints of labor respect had been filed in the past five years. Of these, it was determined that six were unfounded and four violated the policy. The spokesman said the cases were dealt with “in accordance with best practice”.
Oldfield said he expects the assessment to be complete by the fall and said appropriate action would be taken based on the recommendations.
The latest assessment comes when the Nova Scotia College of Physicians and Surgeons recently accepted an external review that found a lack of understanding and action to address anti-black racism.
Even before this review was published, Dr. Gus Grant, who applied for the work, said that racism exists within the regulatory body and in the field of medicine.
Al-Mansob’s allegations, Othman and another doctor who spoke to CBC, have the support of several people related to the medical school and the health authority. CBC does not identify these individuals because they are concerned about professional retaliation for public speaking.
“This is modern colonialism”
One source said racism is insidious within the heart surgery division and that there is a mindset among some doctors and staff that “we should teach our own”. This attitude is perpetuated with examples that some medical supervisors give to their white apprentices, they said.
“The way residents see how surgeons treat everyone, they’re learning that and they’re taking it too, and they say,‘ Oh, that’s allowed, they don’t have a problem. They can treat people like shit. I can do the same with visa learners. “
Another source said that Canadian and educated students are more likely to spend quality time in the operating room, while their counterparts in other countries are often left to observe or direct the ICU and manage patients on the ground. That means they have fewer opportunities to practice their surgical skills, the source said.
“This is modern colonialism,” they said.
Sources confirmed to CBC that senior officials in the heart surgery division and Dalhousie Medical School are aware of the problems, that the problems have been raised several times by several people and yet they persist.
Dr. Ahmed Al Lawati came from Oman to do a cardiac surgery residency at Dalhousie University. He says discrimination and harassment contributed to his inability to complete his program. (Submitted by Dr. Ahmed Al Lawati)
Othman and Al-Mansob were considered hospital fellows and, as such, were paid for their work. Othman was paid $ 65,000 for the year he worked in Halifax, while Al-Mansob was paid $ 60,000 a year during his two-year fellowship.
Dalhousie University, meanwhile, incorporates fellows and residents through visa training agreements with Saudi Arabia, Kuwait, Oman, the United Arab Emirates and Qatar. The sponsoring country or health care institution pays the university $ 100,000 a year for people from those countries to do residencies or scholarships and must sign a contract stating that it will support the student with a return service contract.
In 2019, Dr. Ahmed Al Lawati was a visa apprentice who went to Halifax from Oman to do a cardiac surgery residency in Dalhousie after a successful application and a short-term trial.
Like Al-Mansob and Othman, Al Lawati says he was discriminated against while in Halifax. He said he did not feel supported in trying to solve the problem with medical school officials.
Now in his 30s, Al Lawati said he soon realized the great pressure he had to act after arriving in Dalhousie as his country-funded representative.
“These are smart people”
Looking back, however, Al Lawati said it was more than being pushed by instructors and doctors tasked with helping him become a heart surgeon.
“In the beginning, it was a lot of passive aggression and a lot of micro-aggression,” he said.
“These are smart people. They would never mistreat you in front of other people.”
During several video interviews from Oman, Al Lawati said that at the beginning of his training, his seriousness was questioned because when he left the hospital to attend the afternoon lectures on the Dalhousie campus as part of his program, he did not inform people that he would. he will not return to the hospital. It was an expectation that Al Lawati did not see put in other residents who simply followed the scheme of his program.
He found that some staff members were distant and difficult to interact with, despite having to deal with them almost daily to ensure evaluations as part of their program. At one point, he said, he was told that his communication problems were because he was “far away” and that he would have to do several years of medical school in Canada in order to learn as a Canadian.
“I cried. It was the only thing I could do,” Al Lawati said.
“I must leave this site”
Finally, the feeling of not receiving support, along with the death of his brother, pushed Al Lawati into a downward psychological spiral. He documented what was happening, took some free time, but when he returned, he said the work environment in the heart surgery division continued to cause him anxiety and affected his performance.
Al Lawati was placed in a …