work as a general practitioner.
Through private donations,
the Sinai Health Care Founda-
tion funds a program designed
to bring Russian Jewish doctors
up to speed and make them more
competitive. The three-year-old
program lasts three to six
months and gives the doctors
some clinical experience at Sinai
before their residency.
Dr. Khanukov had a difficult
time finding a residency spot af-
ter she passed her foreign med-
ical exams. There weren't a lot of
spaces available, and she ended
up having to complete a one-year,
unpaid externship program
through Wayne State Universi-
ty.
Even "dues-paying" stints like
that provide no guarantee a doc- abundant resources are rela-
tor will be accepted into a resi- tively easy to adjust to, however.
dency program. Wayne State A more daunting hurdle is deal-
eventually accepted Dr. ing with patients.
Khanukov into a three-year res-
"It's both technical and philo-
idency rotation. She is now an in- sophical differences," says Dr.
ternist working for DEMAC
Corporation, the HMO run by
the Detroit Macomb Hospital
Corporation.
When she arrived, Dr.
Khanukov was amazed by the
Dr. Eugeniya Khanukov
emphasis on hygiene and the
vast amount of disposable items
used in American hospitals.
"When I saw how they would Robert Bloom, director of Sinai
throw away things, I would say, Hospital's internal medicine res-
`What are you doing? That idency program. "We deal with
scalpel or syringe is still good," - patient-centered care and that's
she says.
not true worldwide. And that is
Sophisticated technology and as much of an adjustment (for
"It was like
a fairy tale."
new Americans) as the technol-
ogy."
Russian doctors say they like
the American patient-centered
approach to health care.
"It's a different approach to pa-
tients and that was a good sur-
prise," says Dr. Roman
Magidenko, an acute care and
anesthesiology resident at Sinai.
`They are treated like human be-
ings, with dignity."
Rules of etiquette are differ-
ent, too. Dr. Khanukov says
Russian physicians don't bother
to explain conditions and treat-
ments to the patients. And, in
turn, patients aren't encouraged
to ask questions. There is no such
thing as getting a second opinion
on a procedure. Even routine ex-
c
„„.
:pOS
'
.
§!;•\st
ams are not conducted with reg-
ularity.
Dr. Grinbaum sums it up:
"You have to change your whole
attitude."
Apparently, conditions haven't
changed much since Drs.
Khanukov and Grinbaum left
the Soviet Union. Dr. Magi-
denko, 31, arrived in Detroit from
Riga, Latvia, for his residency
program in June 1993. He says
Russian hospitals are still un-
derstaffed and under-supplied.
"We do have some of the (high-
tech) tools now, but they are still
not as readily available," he says.
"I practiced medicine for eight
years and I don't remember a
time when we didn't have a
shortage." ❑