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This Doctor Can: Dr Hilal Al Saffar

Consultant cardiologist and RCP Global international adviser Dr Hilal Al Saffar shares the success of the first RCP international membership collaboration – the RCP Iraq Network.

From the beginning 

In 1981, I graduated from Baghdad University College of Medicine in Iraq, one of the earliest medical schools in the Middle East region. The college was founded in 1927 by Sir Harry Sinderson Pasha, a British physician, and it followed the British style of medical education. During my study years, we had many visitors from the UK Royal Colleges, including lecturers, examiners, and training courses on how to pass MRCP(UK).

Ever since then, I have been highly motivated to participate in the UK postgraduate system, just like many other doctors from Iraq. I aim to enhance medical education and improve healthcare services in Iraq. However, my plans were disrupted due to the onset of the first Gulf War in 1980. We had to adjust to the challenges posed by the war and continue pursuing our medical training and education. I vividly recall preparing for the internal medicine specialisation exam while serving as a doctor on the front line.

The journey into medicine and medical education 

I began my career in internal medicine, having been awarded the Certificate of Arab Board of Medicine by the Arab Board of Health Specialisations. In Iraq, cardiovascular diseases remain the number one killer. As a result, I was very motivated to follow the path of becoming a cardiologist and I had several significant role models throughout my journey. I still remember, during the second year of my postgraduate training at Al Rasheed Military Hospital doing diagnostic coronary angiography, when my teacher Omar Al Kubiasy came to the catheterisation lab and said 'This gentleman will follow me in the cardiology clinic – he will be a brilliant cardiologist in the future'.

Throughout the 1990s, during the international sanctions on Iraq, I had the privilege of being trained in several teaching hospitals, such as Al Rasheed Military, Ibn Al Bitar, and Ibn Al Nafis hospitals. Despite the shortage of medicines and equipment, my commitment to the profession remained steadfast.

After completing my postgraduate certification, I had the opportunity to work in several teaching hospitals and teach undergraduate and postgraduate students. Despite being one of the youngest among my colleagues and seniors, my teaching sessions were always well attended. At that time, no medical journals were allowed to be imported to Iraq because of the international sanctions. Visitors from outside Iraq would bring an original copy of a journal and photocopies would be distributed amongst the students and staff. Working in that environment was hard for all of us. I always like to think that tough times create hard people, and hard people create good times – which is true for us.

Developing the healthcare landscape 

Later on, I was selected by the Ministry of Health to coordinate and supervise the Iraq-UK training programme. This initiative in 2007 was a contribution by the UK government to enhance healthcare services in Iraq. The project enabled 400 Iraqi doctors to receive a two-month training in the UK, marking the first such initiative for more than 30 years.

I was responsible for coordinating the selection of Iraqi doctors to join the programme, representing a wide range of specialties. The programme required candidates to lead the development of a health project upon their return to Iraq. Dr Aram Jamal Mirza, recently appointed as RCP international adviser (IA) for Iraq, introduced primary coronary angioplasty for acute myocardial infarction in Sulaimaniyah city, Kurdistan Region of Iraq, as one of the 30 projects available in the area. This noteworthy achievement has made a positive impact in the region.

The RCP Iraq Network begins 

In 2011, I was appointed as the RCP IA for Iraq. It was a great honour and it was my dream from the start to create a network of RCP members and fellows. Together, they would work towards improving medical education and health service provision in Iraq. My dream became a reality at the end of 2020 when I sent a draft proposal to establish the RCP Iraq Network and, after approval from Dr Mumtaz Patel, who was RCP Global vice president at the time, the RCP Iraq Network was born. 

The network's vision was in alignment with RCP Global Strategy 2021–24 and focuses on the inclusion of final-year medical students, newly graduated doctors, postgraduate trainees and consultants working together for better medical education and health service provision in Iraq. This also involved building partnerships and collaboration with governmental as well as non-governmental organisations, such as the Iraqi Red Crescent Society to maintain the sustainability of the network.

We set out with a very ambitious plan and created three working subgroups: medical education, CPD/CME events, and medical research. The most significant metric of our success is the growth in our membership and RCP membership as a whole. When we formed the network, Iraq ranked 21st in overall international membership within the RCP. Today, in 2023, we rank 3rd overall. This is a testament to the commitment of my colleagues, Dr Mumtaz Patel, Aimee Protheroe (head of RCP Global) and Dr Omar Mustafa (associate global director – Middle East and North Africa and incoming global vice president), and the fantastic RCP Global team.

Our activity programme launches in January each year and continues for the following 12 months. Through delivering our scientific CPD activities, we have become number 1 in Iraq among all other medical societies providing scientific activities. Educating the medical workforce in Iraq to fulfil their potential has remained a priority for us and we have delivered around 29 teaching and training courses, attended by over 1,666 participants.

We are proud to have been able to conduct mock MRCP PACES examinations for the first time in Iraq in March 2023, which was attended by five UK-based international examiners, as well as twelve Iraq-based examiners. The mock exam was held in two Iraqi cities, Karbala (Al Kafeel hospital) and Suliamaniah (Faruk Medical City). We worked closely with the British Council and partners in Iraq to relaunch MRCP Part I and II written exams earlier this year in Baghdad. This meant that trainees wishing to take the exam did not need to leave Iraq to sit the exam, which was an excellent achievement for the network.

The future

The 'jewel in the crown' for our network is to host our first official PACES examination in Iraq. We continue to work with stakeholders within the Federation of Royal Colleges and dream of achieving this as a network.

Several universities have started to ask RCP fellows experienced in medical education for our support in reforming their curriculum, conducting faculty development training and delivering specific sessions, including ECG, blood gas analysis and interpretation of imaging. We have established collaboration with Al Ameed University Medical College and have additional universities keen to work with us on similar activities.

We are proud of our achievements in the first three years, and our future plans are just as ambitious. I recently met with the health advisor of the Iraqi prime minister to explain the positive relationship between the network and RCP, which was very well received. In the future, we would like to focus on postgraduate training and design with support from RCP.

We owe our gratitude to the RCP for the support provided since the start of our journey. We have been guided extensively and supported more recently with a new network logo and RCP Iraq Network branded content to help support our identity.

We have active and thriving online content on our website and social media platforms. We would love to hear from you and learn from your experience to continue to advance medical education, healthcare improvement and delivery in Iraq.