A long way from Kosovo

CMAJ 2000;163(2):248

Dr. Selajdin Boshnjaku and his family: Go or stay? (Photo courtesy of Wayne Hiebert, Ottawa Citizen)

Boshnjaku, a 41-year-old orthopedic surgeon, his wife and 3 children were among the 7000 Kosovar refugees who arrived in Canada last year in the wake of the war between Serbia and NATO (see CMAJ 1999;160[13]:1860-2).

With 5 years of medical training at the University of Pristina, 4 years of specialty training and 8 years' experience, Boshnjaku didn't anticipate any problems practising in a new country. He was wrong.

The Royal College told the former chief of orthopedics at a Kosovar hospital that his medical degree would not be recognized in Canada. To work as a surgeon here, he would have to complete a residency. Boshnjaku resents the time and money it would take to repeat his medical education and is looking for another way.

Meanwhile, for nearly a year he has been a clinical observer at Ottawa's 3 teaching hospitals. As a temporary situation, he says observing doesn't seem so bad. "I was able to see new operating techniques and equipment, [which were a surprise for someone] coming from such a poor city." Still, Boshnjaku is concerned about waiting too long to return to surgery — he worries about losing his manual skills.

"I came to Canada with former patients and they see me and don't understand why I can't practise medicine. Observing [an operation] has its limits, because your hands are in your pockets, not on the operating table."

Boshnjaku says that if his struggles here persist, he will inevitably be drawn back to his war-ravaged country. In October, he visited Kosovo for 6 weeks to determine if it was safe for his family to return. He decided it wasn't.

Many other Kosovar professionals are having the same problem gaining recognition in Canada, he says. "We would like to stay in Canada, but if we have to change our professions and go lower than we already are, than we must return home."

Boshnjaku can't understand why his degree is not being recognized. He points proudly to the success of his children, who spoke little to no English before leaving their country and are now top students in their classes. "It verifies our school system," he says.

Recently, he discovered that there may be an alternative path for him to take to qualify as a Canadian surgeon. At the University of Ottawa's Faculty of Medicine, where he works 2 days a month as a prosector and demonstrator in anatomy classes, Boshnjaku was informed that he could apply for an education licence and then work as a clinical fellow.

He has already been offered a fellowship in orthopedic surgery at the Ottawa Hospital on condition that he obtain an education licence. But this process wasn't as easy as it sounded. The College of Physicians and Surgeons of Ontario required a letter from the dean of Boshnjaku's medical school before it could grant the licence, but in Kosovo the war's aftermath made even simple tasks like this nearly impossible, because phone lines are dead and a mail service no longer exists.

In desperation, Boshnjaku's wife — a former lab technician who has been unsuccessful trying to find a job due to her lack of English skills — went to Kosovo to get the letter. The college then granted an education licence, on condition that he pass 2 English-as-a-second-language exams. Boshnjaku has decided that these exams will be his final attempt to remain here. If he is not granted the education licence, he will return with his family to Kosovo.

For now, his family, along with other Canadian Kosovar refugees, is being supported by a special federal government program that is in place for 2 years. As he waits, Boshnjaku says it is painful to watch his profession from the outside. "I can't practise here," he says. "This is Canada, and I'm from Kosovo." — Caryn Hirshhorn

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