Around the World….
Foreword by Dr Una Harrington
Over the past year, there has been an increasing conversation about the value of diversity in our Critical Care workplaces.
Emergency Medicine attracts a wonderfully diverse multicultural group of trainees and FACEMs. In fact, according to ACEM, just over 40 % of both ED Trainees and FACEMs identify as International Medical Graduates (IMGs).
Many years ago, as a recently qualified Intern, I came to Australia, for what I thought would be a six-month job in Fremantle ED. Thirteen years later, I’m still in Oz, now on the East Coast and happy in my more permanent ED home!!
With all this talk of diversity, at WRaP EM we got to thinking – what would you find if you asked some Ex Pat ED doctors a few questions……..
What do the Ex Pats bring to the ED melting pot?
How do diverse cultural backgrounds and medical training enrich our workplaces and our teams?
What are some of the challenges of being an Ex Pat in the ED?
What advice could be given to others who are thinking of embarking on the Ex Pat journey to our EDs down under?
Second to share her story is our FACEM colleague, Dr Nemat Alsaba. Her journey has brought her from Sauda Arabia all the way to the Gold Coast, Queensland. Over to you Nemat…….

From the Middle East to the Gold Coast
By Dr Nemat Alsaba
There have been a number of studies recently that have shown that a diverse workforce provides better team-based performance and care. What do you think you bring to your team where you work, based on your experience as an Ex-Pat?
Being a female Muslim who was born in Saudi Arabia and grew up in America then went back to the Middle East to get married and complete my MBBS then ended up in Australia, I think I bring a bag full of diverse cultural backgrounds and experiences.
I like to think that I help foster diversity and inclusion in my workplace by being the change, as I display love and respect to all my colleagues and patients.
I also bring a wealth of experience and knowledge in my clinical field. Working previously in Saudi Arabia in a heavily populated area with multiple specific diseases in that area made me gain depth of knowledge and experience in certain conditions such as hematological diseases and their emergency presentations (Sickle cell disease, Thalassemia, G6PD deficiency), along with other trauma emergencies specific to some areas that I worked in, such as fishing hook emergencies, heatstroke emergencies and scorpion bites.
I also bring cultural awareness to certain topics and issues, such as understanding the special needs of other people with different faith and culture. When I first started working in Australia, in mid-2000, most of my emergency department colleagues had very little awareness and knowledge about certain cultural needs and norms. This includes dietary requirements, specially prepared food for some patient groups, religious commitments such as fasting and prayers. Nowadays my colleagues are aware of those needs and would actively ask or organise such needs for our patients or other staff in the department.
Ex-Pat doctors bring a diverse range of experience, both culturally and clinically to the ED. How do you think the culture and/or the clinical nature of your work earlier in your training abroad has influenced how you work in the ED now?
It made me a better doctor! Working previously in Saudi Arabia in a multiculturally diverse workplace gave me the tools and skills to be culturally tolerant and more importantly socially intelligent! It also widened my horizons to learn and relate to other cultures.
What you discover is that we have more similarities than differences in our cultures. However, some people seem to focus on differences and amplify them, which unfortunately can create unpleasant and unnecessary distance between cultures.
Moving countries and changing health care systems and employers can be a big challenge for the Ex-Pats. What have been the biggest challenges working as an Ex-Pat doctor in the Emergency Department – either personally, professionally or perhaps both?
Personally, I have struggled with not having the support and the presence of a big family. I missed and I continue to miss my uncles and aunties; I also missed the food and getting the same quality of spices and herbs to cook traditional meals.
Another of my personal struggles is to keep my young kids connected to their roots and culture while juggling a busy, demanding career and fast-paced life.
I can’t recall any professional challenges. To me, medicine, disease, and professionalism have a universal basis. The challenges you might see in the Northern Hemisphere are the same challenges in Southern Hemisphere with only some minor differences.
What is one piece of advice would you give to other doctors wishing to embark on an Ex-Pat experience?
Be open-minded, and embrace the new experience and journey with balanced flexibility. Observe, reflect, and absorb at the beginning of your journey more than you would normally do.
If you are coming with your young family and kids, make that extra effort to search and plan ahead education/schooling/housing/transport issues. Happy safe family equals a happy life and happy doctor! Happy doctor equals well cared for and satisfied patients.