.0-MWMOONAMVSMse07 M: "AXar.MOZ.01Z1=5:4 ,MA:M7;A• PHOTO BY GLENN TRIEST ( 1Thrlds (Differenc Russian M.D.s experience health care the American way. ADRIEN CHANDLER SPECIAL TO THE JEWISH NEWS THE DET RO IT J EWIS H NEWS CT 32 he first time Dr. Eugeniya Khanukov set foot in an American hospital, she couldn't believe her eyes. It was 1979 and the internist from the former Soviet Union had recently arrived with her family to resettle in Detroit. She had taken a job as a technician in the physical therapy unit at Sinai Hospital. "It was like a fairy tale," she recalls. "Every patient had a semi-private room, with a TV and a telephone. This didn't ex- ist in Russia. I said to myself, These peo- ple are regular patients, not party bosses? That was my first impression." By contrast, the community hospital in Baku, Azerbaijan, where Dr. Khanukov had worked, was understaffed and over- crowded — 20 same-sex patients in one room, with one bathroom and no shower. Dr. Khanukov and other Russian doc- tors face the challenge of bridging gaps between the Soviet and American health- care systems. On average, a Russian doc- tor receives seven to eight years of training, compared to 11 to 12 years (in- cluding undergraduate school) for an American. Not all Russian doctors who immigrate here stay in medicine. An informal sur- vey by Detroit's Jewish Resettlement Ser- vice reports that, since 1989, about 50 doctors have come from the Soviet Union. Four have entered into private practices, a few have opted to get technical training and 14 passed through residency pro- grams, mostly at Sinai. Complicating the language barrier are financial challenges and new profession- Dr. Eugeniya Khanukov underwent rigorous retraining to pursue her American dream. al requirements. When foreign doctors, including Russians, want to practice med- icine in the United States, they must un- dergo rigorous retraining and testing. There is now a single, three-part certi- fication test all foreign medical graduates take: the U.S. Medical Licensing Exams. Emigres must complete the first two parts before they begin "house staff' or resi- dency training. The third part, for li- censing, can be taken after one year of clinical training. Depending on their specialty, the doc- tors have to re-do a residency program, which can take up to three years to com- plete. There is also an English proficien- cy exam. "You can't get back into the field with- out retraining," says Dr. Khanukov, 48. "I had no choice." Pola Friedman, president of the Sinai Health Care Foundation, says the going isn't easy. "A lot of the Russian doctors trained there don't have anywhere near the kind of sophisticated training our doctors get," she says. "The language barrier is in- credible. And there's a whole series of hoops and tests that must be passed be- fore they can even be considered for house officership." The Russian doctors know they will have to play catch-up to their American counterparts. Dr. Emerich Grinbaum calls the post-graduate training here "superb." "When you come, you don't know a lot of things. You don't know about the ma- chines. You don't know anything, really. The care, the technical level, the knowl- edge, there is no comparison. It's like a different planet," says Dr. Grinbaum, 64, a Farmington Hills internist who owns and practices at a Flint area outpatient clinic. "There is a shortage of everything (in Russia). Equipment, X-rays and film, an- tibiotics, gloves, linens. The average Russ- ian doctor can't read an X-ray," he says. Dr. Grinbaum came to Detroit from the Ukraine in 1979. At 50, he had to under- go the rigors of a residency at Sinai Hos- pital. He learned a completely new system of health-care delivery while trying to keep up with residents half his age. "I didn't have a lot of time to lose," he says. He managed to pass his licensing exam after one year of residency, then found