Tag: medicine

Angels in the darkness

At this time of year Sweden is engulfed in darkness. We all long for light. Candles burn in every window. Candles are a part of Swedish winter, and especially at Christmas.

Today I read the following article in the journal of the Swedish Medical Association, Läkartidningen. It brought tears to my eyes. This is an English translation, but the original article can be found here.

Like angels in the darkness

Mariko Yoshinaga Galvér
General Practice registrar, Uppsala, Sweden

My name is Mariko Yoshinaga Galvér and I am a GP registrar in a health centre in Uppsala. I came to Sweden twelve years ago from Japan, where I studied medicine.

I have never written before but I feel compelled to tell the story of something special that happened yesterday.

Yesterday I received a patient, an unaccompanied refugee child.

The referral that came with her said she was tired, and she had been booked in for a 45 minute appointment, with a telephone interpreter. I saw in the medical records that the child had experienced every imaginable horror in her homeland. I realised that this was going to be a challenging meeting and as I went out to the waiting room my steps were slow and deliberate.

The girl sat alone, looking tense. I discovered that she can speak Swedish, so we dispensed with the interpreter. Seated in my office she spoke slowly and calmly; I was amazed by her calmness. I examined her. I saw the scars on her little body.

For the first time in my life I thought of God, there in my office. I am not religious, I come from a Buddhist land, though I did marry in a Swedish church. But for the first time I thought of God and I prayed: please God, help her.

And then I heard children singing, quietly and calmly. We looked at each other, my patient and I, her glance confirming that I wasn’t just hallucinating.

We went out of the room. We saw many beautiful children, dressed in white, candles in their hands. Suddenly I remembered, today was Lucia and the children before us were the Lucia train. They looked just like angels in the darkness. The staff were happy and listened as the children sang. One of the nurses fetched a chair so that a mother bearing a child in her arms could sit and listen.

The angels looked us with their beautiful, beautiful smiles.

I am convinced that this girl will be happy here. Things like this don’t happen in Japan. Maybe they don’t happen in other countries either. She will be happy in Sweden.

I cycled home. And I began to cry as I thought about the day’s Lucia.

You know God, that I have also been happy here, in Sweden.

Happy Christmas!


Swedish health care needs us foreigners

Läkartidningen (the Journal of the Swedish Medical Association) published on the web today contained an article entitled “Overseas trained doctors keep Swedish healthcare going” (Utlandsutbildade läkare håller igång svensk sjukvård, Läkartidningen, 20 August 2013). Since 2003 more than half the doctors receiving their registration in Sweden every year have been educated outside Sweden: the latest year with figures available is 2011, when 1010 Swedish educated doctors were newly registered and 1239 doctors educated outside Sweden were registered.

These doctors fall into one of three categories. First there are non-Swedish doctors who come from other countries within the EU and which is the biggest group, accounting for up to 1000 doctors per year. The reason for this growth is likely the extension of the EU to include several new member states where doctors earn significantly less than in Sweden. It is hardly surprising that such doctors move to Sweden, where the pay and the living conditions are better. Legally doctors from the EU are allowed to move freely between the member states. Their qualifications are recognized in Sweden and the only requirement for them to work here is to learn the language to a certain level and find a job.

The second group, which is also growing rapidly, is Swedes who go abroad to get their medical degree, in countries offering English language education such as Poland, Rumania and Hungary. In 2010 this accounted for 140 doctors who had gained their degree in an EU country.

The third group is doctors from non-EU countries, and this is the group to which I belong. In the last 10 years the number of these so called third country doctors has varied between 100 and 300 per year. It appears to go up and down from year to year dependent on a number of factors, one of which is the conflict situation in the world. The largest numbers appear to come from Russia and Iraq. I have yet to meet another from Australia. This group has the longest and hardest pathway to Swedish medical registration and specialist recognition.

For me the process has not been difficult but it has been long. My Australian qualification was recognized and I received Swedish registration after a provisional period under supervision for 6 months. However, to be recognized as a specialist GP, which I have been in Australia since the early 90s I was required to go through the full five year training program in general practice, a process in which I am still engaged. Training in general practice in Sweden is very enjoyable and very comprehensive. However, it has been hard psychologically to be a trainee again after so many years practicing, and it has had a very significant financial cost for me.

Swedish medical care, however, could not survive without us foreign trained doctors, and it appears to need more. In general practice there is a desperate shortage of specialists, but the reasons for that are more complicated than a lack of Swedish trainees and the length of time it takes foreigners like me to be recognized as specialists. But that will have to be the subject of another blog.