Lucky But Not Recognized

I enjoy seeing the weekly newsletter from The Pathologist land in my inbox. Besides being full of helpful information and updates, it often raises philosophical questions – offering some food for thought to ponder throughout the day.

Normally, I consider myself a classic, well-mannered introvert – often confounded with extroversion – preferring to keep my opinions to myself, unless explicitly asked. But a recent newsletter titled: “Are You One in a Million?” struck such a chord in me that I had to hit reply. To my excitement, I got a response!

So, it’s with great honor and gratitude that I exploit the opportunity to share my story with all of you.

I am not sure if I am one in a million, but an answer to “What unique circumstances are affecting the area you live in?” – well, that is pretty straightforward. I am Ukrainian. Most of you are probably aware of the horrifying events that have been ongoing in my country since February 2022. Fewer are probably aware that this war actually started in 2014 with annexation of Crimea and the instigation of an internecine feud in the east of Ukraine.

But let’s talk pathology – because that’s what this whole story is really about. Like many countries, Ukraine has always experienced a lack of pathologists and an unequal distribution of the ones that do exist. This is compounded by the impressive size of the country, which is over 233,062 square miles. 

We must also acknowledge a persistent stigmatization of our profession. It’s not uncommon to hear: “What do you do? Are you even a doctor?”. Volunteering doctors (and pathologists too) have left their work and some have fled because their homes have been destroyed and their families were in danger. This is truly heartbreaking.

I was born in Ukraine’s capital, Kyiv, into a family of medical doctors. That city – where I studied, graduated, and worked – will forever remain my homeland. In 2014, I was Vice-Dean in Kyiv’s National Medical University – the same place I graduated from just a few years earlier. I personally welcomed and integrated hundreds of medical students that fled from destroyed Donetsk and Luhansk medical universities. These young students went on to complete their study in Kyiv several years later and became strong and successful healthcare professionals, but in a very particular way. I personally knew doctors – specifically pathologists – who were forced to leave their hospitals and university departments. We worked side-by-side in the pathology departments at the university and hospital. Some of them never came back to Eastern Ukraine. Some of them were forced to move further under different circumstances.

In 2015, I too moved further afield. But in my case, it wasn’t as bad as it may sound.

The war had been going on for a year, but I hadn’t fled. I had a good position in one of the biggest Ukrainian hospitals and biggest medical universities, but I started to feel stuck. So, after hearing of an international project on my subspeciality and PhD topic, renal pathology, I moved out from my home country. After that study, I received an offer to join a PhD project in translational research in kidney diseases (the topic of my second PhD), and then, I accidentally found myself married.

Today, I am still living and working in Italy. But there’s a caveat; Ukrainian medical diplomas are not recognized in Europe and the US. As a Ukrainian doctor, you have to undergo a long, expensive, and complicated recognition procedure. Some have managed to do it. Some have not – holding out in the hope they might return to their homeland. Even I haven’t managed to get recognition yet – despite my residency, an Italian PhD, and my strong desire.

But don’t get me wrong; I am happy. I’m working in a fantastic team, doing translational research in oncology at the department of pathology – and in one of the greatest research facilities in all of Italy. But I’m not letting go of my hope to complete the MD diploma legalization process and get back to my professional origin (or, better said, make the most of it).

What I’m really trying to tell with my story is that, besides the lack of healthcare professionals and pathologists, those doctors who fled across the world are now “homeless” in so many senses. Set aside the often overlooked emotional component and imagine yourself in their shoes. You find yourself in a new place, with new rules, and little to no rights. You would like to work, do your job, make a living, and simply be useful – but you can’t. For those like me in Italy there is some flexibility; in 2022, the country released a “temporary” recognition of MD degrees for Ukrainians who applied for political asylum. But there are too many nuances in the legislature.

To sum it up, there is an immense loss of resources across the world. Smart, trained, and hardworking people remain outcasts due to bureaucracy and political issues. While the planet declares a lack of certain specialists, professionals like me are prevented from helping to improve those statistics. Thousands of miles from my home, I’m told I can’t do the work I was trained to do. And me – I consider myself a lucky one.