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Good evening everyone. We'll be starting the event now and before we do so, I would like to introduce myself and our lecture today. Uh My name is Jasmine and our doctor is Doctor Marwan Clausum. Um Before I do so, I'll um I'll mention some important notes. Um Once the event is finished, we will be handing out participation certificates. Um And it's very important that you guys keep your cameras off and if you have any questions, feel free to pop them into the chat and either if it's relevant, uh we can talk about it after a slide has been presented or we'll have AQ and a session afterwards. Uh When Doctor Klassen presents his presentation. Uh OK, now we can officially begin. Uh Doctor Manan Klassen is a doctor who works in Lietz and he's going to be discussing everything surrounding working in the Czech Republic. Uh The how to um what it's like as a foreigner, someone who doesn't speak Czech and the entire assimilation process as well as his personal experiences and his reasoning behind saying in the Czech Republic. Uh So doctor, thank you. Uh I just like to point out that I do speak Czech right now. Uh At some point, I didn't uh when I first moved to the Czech Republic. Uh but then during the studies and afterwards, um I was able to kind of improve it to work it out. So let's start and I will, I will uh take you throughout my uh journey briefly and then talk about uh what uh uh the Czech healthcare system is about uh in case you're in the younger years, you maybe don't have an idea or have a brief one. So we will try to uh reaffirm that then we'll go through uh benefits of starting your medical career in Czech Republic. Some pitfalls, of course, um how to get your uh uh C check Medical uh Council uh license to start here. Um And then we'll talk about uh how to find a job, what to look for, what to ask about um and so on and uh how to prepare for Czech Residency and what to expect out of it. And then I will leave my contact in the end in case you have a further, some further questions. So we'll start with the presentation. Uh I hope you can see it right now. Are you able to see it? Uh Yes, me, yes, yes, we can. Yeah. Yeah, perfect. So I will start uh these are my uh uh credentials I just wrote there that this picture is intended to share my personal experience, not life coaching. It's not an attempt to recruit you for residency. Of course, encourage you to listen critically, make your own judgment. I will not be held responsible for uh whatever results out of this. Uh So who am II complete my high school in uh Kuwait at the school, I graduated in 2015 from uh high school uh started uh studying at uh the Faculty of Medicine Charles University in 2015, graduated within the given six years, 2021. And uh this year I started my uh phd in uh studying screening methods and diagnostic methods in uh diabetic liver disease in the medical department, medical Biophysics Department uh of the first Faculty of Medicine and four internal Clinic of the general faculty hospital. Um My clinical background uh consists of uh 2.5 years as a clinical medicine, junior doctor uh completed my uh so called ET men, which is the basic internal medicine uh training in uh October 2024. So like uh two months ago, uh it was the end of a 3030 month period which I will discuss uh further um in the next slide, what it means like to have an intern men or some other men uh of some other uh specialization. I now I am officially a gastroenterology and Hepatology resident since uh July. Um I also undertake shifts in the emergency department, internal medicine wards and which is uh which means uh long term care department. It's something like uh a link uh between the acute uh departments of the hospital and the home care. It's kind of linking those, for example, the patient after a fracture, the femurs uh requires some rehabilitation. They don't have somebody to rehabilitate them at home or help them out. So they go to this department. And uh because I'm uh because I'm interested further in expanding my knowledge, not only in gastroentero, I have told you but elsewhere so soon, I will be taking up taking more shifts in the dialysis department of our hospital. So I would be taking care of those patients who are coming for regular dialysis, uh free time interest, running, basketball, traveling, being in nature, I'm interested in philosophy, history and politics, uh which is like not super related to this but just uh get to know each other kind of information. So I will start with the check healthcare system. Uh It's a centralized healthcare system. Uh I would say quite well structured uh provides universal co uh coverage to all residents through uh public he healthcare. Uh public health insurance. It has a very strong emphasis on uh preventive care. Uh primary secondary prevention is very highly uh prioritized. Regular screening programs are set up, which is one of the things I'm mostly interested in, mostly interested in screening for liver disease. But Czech Republic has led quite a successful uh colorectal carcinoma screening program which has helped to reduce mortality and morbidity with this disease. Uh The checkups are uh usually covered by insurance and this uh of course, the insurance companies have a vested interest in reducing socioeconomic burden of disease. It's a lot cheaper to treat uh arterial hypertension with some antihypertensive than to uh than to later on in 1020 years of untreated hypertension uh treat an infarct or uh um or a stroke. Um The system uh in the Czech Republic is int has an integrated, is an integrated referral system where there's a, a good uh and there is a collaboration, whether it's good or bad, depends on your point of view uh between general practitioners and specialists to ensure a seamless uh patient journey. As you know, in the Czech Republic, you uh patients uh which is maybe not a very good uh aspect uh of uh Czech healthcare that they can see a specialist straight away uh based on their, on their choice. I it is allowed by the C insurance companies. Uh So a patient has abdominal ba pain. Uh They wanna see a gastroenterologist, they can order themselves directly to an examination with this gastroenterologist. However, um it is obviously better when the general practitioner is deciding uh if the abdominal pain is uh related to the GI T or the or to the kidney, for example, or uh something totally not related to the GI T. So this is just one thing to be debated later. It's not for uh the scope of this uh of this uh seminar or this talk um as with other um healthcare um or let's say, functioning public healthcare systems uh check uh healthcare is divided into primary secondary and tertiary care. Primary usually is the general practitioners and district hospitals and check its practice like uh OK. Uh Kana Monica, which is regional, a regional hospital. This is the secondary and then the tertiary is more about faculty and Monica or an English faculty hospital. So uh let's say a patient goes to the GP they have some infection in the throat, they're able to solve it only in the primary healthcare. Primary healthcare is responsible for preventive care, preventive checkups and so on. And they're able to solve those uh kind of uh everyday practice uh kind of problems, uh prescribing antibiotics, prescribing antihypertensives and solving those basic diseases that every doctor and especially every internist should be able to solve. But uh me, but I would say every doctor should be able to solve. The reality is not so, so, so clear and or does not. Uh no uh like sometimes when you have a, a system that allows you to specialize in the beginning in something, for example, urology, you tend to ignore other uh important basic things like um correcting antihypertensive medications or uh correcting anticoagulation for a patient and so on. But there's always uh especially in a slightly bigger hospital like a secondary care. Uh hospital, like a regional hospital to phone up an internist such as myself who will fix all the medications and, uh, uh, help you with correcting those, um, patients medications. However, it's also good, uh, to know, to know, to know for yourself. And so in the, in the secondary care, uh, usually, uh, like a regional hospital, there's the more complex operations, more risky patients. Uh, there is the so called Cardio Centrum, which is a cardiovascular center responsible for catheterization, responsible for um responsible for um more complicated operations on risky patients and more specialized uh care uh towards the patient also. And the secondary ones uh there is the socalled trama syndrome which is a center specialized in um mm in trat uh cases especially polytrauma and um simply more, more, more, more demanding uh patients or more critical care. Uh Faculty hospitals are usually for rare diseases for very complicated patients who require simply the uh highly specialized equipment and expertise, which can only be found in faculty hospitals which are distributed all over the Czech Republic. And there's uh usually a very clear pathway on how to uh escalate this kind of care. So the doctor from re would according to their expertise, either directly communicate with the tertiary healthcare facility or a secondary one, depending on the patient's needs and uh work up uh from there. Um One more thing about Czech healthcare system, this seems to be at least for me to uh be all over the Czech Republic. So working hours starts at 7 a.m. They end at 330 in the afternoon or 1530 in this 24 hour format. Uh this includes 30 minutes calls for lunch. So this is uh from what I have seen is how it actually works. Uh Other countries like the UK uh depends, of course on your contract, but a lot of the jobs have this 12 hour shift where for a few four days you have 12 hour night shift starting at 8 p.m. for example, ending at 8 a.m. the next day and then the next week you have four, or three or five, morning shift or day shift from 8 a.m. to 8 p.m. which I think it's not for me because it's very demanding to switch your, your, uh sleeping patterns. And um, yeah, just to, to switch around your sleeping patterns can be, can be very demanding, but it depends on the person, what they prefer, what they want. Uh Furthermore, night shift on the ward usually continue from 1530 until the next day in the morning. So you're usually there for 24 for 24 hours. And, uh, it's limited, it's limited to 24 hours since, uh, first of January 2024 because, uh, they don't want doctors to be there for longer than 24 hours as it's not safe for the doctor or for the patients. Um, so this is good that there is some move towards uh regulating uh working hours and uh to have a better work life balance. So some benefits of starting your medical career in the Czech Republic, there is international recognition uh Czech Medical qualifications IE at which is the check word for specialization uh are globally recognized which allows for career mobility uh in European Union recognition of specialization qualifications. So this means if I decide after specializing that I want to move to Germany, the move is not as hard as if I have specialized outside the eu. So as a specialist gastroenterologist and hepatologist, I would have to learn German pass those local exams and then the move would be a lot, a lot easier how they, how they wanted, of course to move. Uh There's uh as in my case, uh opportunity to uh participate in post graduate study and research, there is a lot of phd programs which can be full time or part time. Uh There's a lot of grants and funding opportunities, a lot of grants to fund your research and also a lot of grants to send you abroad to complete international uh internships or uh fellowships abroad. So in this sense, I think the Czech Republic is uh very great, especially because they have access to eu funding um and as well as uh local, local uh society funding. So uh conferences and workshops, I think there's a lot of specialized conferences and workshops in the Czech Republic from cardiology to dermatology, endocrinology to very specific scenes uh such as uh for example, a conference for uh transient elastography, which is a specialized method in gastroenterology that's used to uh evaluate the liver stiffness and the liver steatosis. So, elasticity and steatosis of the liver and it's a very specific topic that even has its own, has its own conference. Once a year, people from this field who are interested in it, either want, want to learn or want to uh participate by, by lecturing can go there, you uh get together, make connections and with other people who are interested in this field uh later uh connect and uh do a research together or um expand their uh their possibilities in this field. I think conferences are great, great possibility for this. And Czech Republic has a lot of them and usually a lot of the hospitals can even uh uh excuse me, uh a lot of the uh hospitals depending on how also uh department depends on your, on the department you're in in the specific hospital they can send you abroad for specialized conferences. So for example, uh I don't know to the European Hepatology conference 2025. I can start to because I'm interested in it. I interested in it. I can start to um uh discuss it with my hospital management, with my department management to send me abroad to, to uh learn from uh these uh experiences abroad and potentially uh you know, and um like im improve my skills and also bring this knowledge back to the Czech Republic and expand the possibilities in my own hospital. Like it's a, a symbiotic relationship. They send you abroad, you improve yourself and you bring those skills back to the Czech Republic uh and to your department, uh specialization and carer development uh check health care system encourages specialization. They offer uh well structured postgraduate training programs. Uh Each specialization has its own uh training pathway starts by basic training. That's uh the command that I told you about and then a subspeciation. So for example, for me, I had to complete the internal medicine command or basic training. And then I chose gastroenterology and hepatology, which in the Czech Republic is just one specialization. Uh However, for uh however, if I wanted to specialize in another field in uh and which is, which comes under internal medicine. So I have a whole lot of uh subspecialisation. So, gastroenterology, uh uh general internal medicine, uh cardiology, uh hepatology and uh endocrinology, um aller allergology and uh pneumology. So there's uh a lot that you can choose if you choose to. Uh actually, I'll speak about that later. So the Czech Medical li license exam. So uh the requirements to be registered here is a certificate of completion of medical studies from a Czech University. Uh I'm not gonna go into detail about this uh for other countries, but for Czech Republic, you just need to graduate or uh have the temporary confirmation of completion, which is a paper you get as soon as the day you do your last state exam in sixth year, uh as well as the certification of uh Czech language competency, which uh must be according to this uh law uh which uh is here on the blue uh blue uh box. Uh uh it's uh exam targeted at uh English curriculum students. Uh and it's carried at the Ministry of Health. The exam itself is not very hard. I think you can pass it with an A to uh l uh uh speaking level of Czech uh language or yeah, the exam is really basic. Uh it's not one of the hurdles for you to become a successful doctor or just a functioning doctor in the Czech Republic. I think there's a big focus um rather than this exam on you developing your check abilities on your own uh either through work or preferably of course before work. But uh even during work, like you have to be showing that you are improving month upon uh month after month with your check language. And I've even noticed that um basically, uh whenever my check uh improved, whenever I hit a new milestone, I felt like my medical uh knowledge was also advancing uh proportionally. So uh I think it's extremely important to work on your check even since fifth year, sixth year. Um uh so that when you want to start to work, you already have a basic uh level and you start to learn on the job. Furthermore, if you start the earlier you start, the more you can take out of your uh study. So this means that um you are uh I don't know, going on an internship to uh surgery, you will be able to examinate the patients, you will be able to understand the patients, you will be able to understand your colleagues. So this is quite, quite important, I'll examine your teachers um in the department. Um which of course uh can also uh help you to build connections and later on find a job in the department where you have an internship uh if you're interested. So um another bef uh another let's say benefit regarding check Medical Council licensing. So it's for uh so let's say a student graduates in June, they can start in September. In my opinion, it's quite realistic, maybe October if they wanna take, take their time. Uh Paperwork is minimal. There is uh no need for a long notification process as if uh uh you uh because if you were to uh apply uh for a foreign country, you would need a lot of paperwork, a lot of notifications uh throughout Prague, which can take some time and effort. Um Registration with the Czech Medical Council. Uh uh Yeah. So this is what I was just talking about. Uh human resources at each hospital can usually help you with this process. And uh you do get a job seeking visa as of right now for nine months, which allows you to uh take your time until you get your paperwork done. If you wanna have a small break before you start working, then of course, you can always discuss it with the, the department where you want to uh um start working. So uh finding a job where to look, uh this was a problem for me because I was looking in the wrong places all the time before. So the right place is to uh find the city that you like or find the hospital that you like. And uh once you do that find the hospital in that city or directly uh target the uh hospital that you want for me, I found the city. I like the city. The hospital seemed nice. I went for an interview when I went to the interview. Uh I spoke to the head of department. He showed me around the hospital, he showed me around the department where uh I would be working. I had a chance to speak to some uh older uh doctors there who told me how uh life is. And um it was, it was quite uh nice. So uh I would recommend to go for this interview as soon as possible if possible. Also do one of your internships um that you uh uh like which are compulsory as part of your study in the, in that hospital. So you can see uh how the excuse me. So um so this is, for example, uh my hospital, it's uh liberate, which means the Regional hospital of liberate. Um It's a hospital for um you know, for, for our region about a million people and for the city of Zs around 220,000 people. Uh Here it shows all the three positions. So for you, you are, you are a like a vent, which means you're just a fresh graduate and you would look in this uh column right here for the free positions and you would check the departments on the left here, it's uh like a specialist that are specialized and the rest are non, non doctor jobs. So for me, uh I wanted to, I knew I want to do internal medicine. So I chose uh sent Interni o which means the center of internal uh department, internal medicine department. And here um like if like if you don't know how to do it, just get Google translate or uh if you don't understand it, so get Google translate, change everything to English and just uh read through like this. So the program internal plan, how I told you 30 months, fully accredited. This is a very important point uh because not all hospitals are fully accredited, some hospitals are accredited for some things and then you will have to go to another hospital to, to acquire those uh internship months so that you can uh later on uh complete to this 30 minutes, 30 month uh basic training and internal medicine. Um Yeah. So uh so here's the information I would send my CV here to this email and then they would get in contact with you if you have an internal contact. For example, I don't know, you, you were here on an internship and you know, the head of department so you can call them or you can send an email saying that you are interested in a position and you would like to come for a meeting. So, uh uh uh the next thing to look at is uh let's go back to the presentation and then we will work it uh from there, find the hospital where you would like to work, locate the career section on the website and find open positions. If an open position is not available for your selected specialization, you can still find a way it means that let's say I uh go to, for example, uh gastroenterology, there's no position for fresh graduate in gastroenterology, but I was there on an internship. I spoke to the head of department and uh I like it there. Uh I would like to work there so you can go and speak directly to the head of department and they might be able to tell you when they will be opening up a position or uh direct you, for example, like uh yeah or directly to another department, for example, internal medicine. So you get your basic and technique, men, basic internal medicine class, uh sorry, classifications. And then you can after getting the internal command move to get through. So it's all about talking, it's all about spending time to see what you want and see um how to get it, uh what to look for in the job. So the working hours kind of kind of contrast. So uh uh contract, so either full time or reduced working hours position, you can even discuss the pay. Uh which I think is a good idea. So you can expect how much you're getting paid plan your life. It's not a rude question in my opinion, to ask uh benefits. So there's the Multisport which gives you access to a lot of gyms and climbing walls and so on. Uh canteen discounts uh holiday days per year. It's usually 25 days or uh five weeks in the Czech Republic. Uh sign up bonus, a lot of hospitals, especially the understaffed ones can give you some bonus when you sign up and stay for a year. So you get it in the beginning. But in uh under the um condition that you will stay there for at least a year, sometimes you can get even some housing support or uh some free months in the uh uh hospital accommodation. So another thing to look at is if the, uh, selected department is well staffed, if the department is not well staffed, it means you're gonna be working for, uh, for many hours unpaid after work. It means you're gonna have a lot more patients, um, to care for than you are able to. It means that very quickly you will get to, um, um, be more and more independent. Um, and if there's, uh, and if it's not well staffed, so ask if there's some compensation for the fact that you are working on a socalled understaffed department, usually there is. So like this is kind of uh a good thing and a bad thing when it's understaffed. So if it's severely understaffed, it's always bad. But if it's like mildly overstaffed, it's good because you can learn faster, you can uh get uh to do more stuff sooner. Uh and, and so on. Uh clinic Organization and Leadership Center Accreditation. We already spoke about this. And also you should ask uh if you will have a chance to go on the internship in time and finish in actually 30 months and not have to drag it to 36 months or uh longer. So it means rotation internships, uh pre specialization courses. There's five courses you have to uh do in the Ministry of Health or its affiliated partners or in a faculty. Uh I'm not gonna go into details what those courses are, but there's five of them, two of them you have to do in person. Three of them can be online. So you can you have to ask the ho the department if they will support you to pay for those courses or not. For example, my hospital paid for the courses and paid for housing in Prague when I had to go for these uh courses. So this is very important to discuss because the courses are not cheap. Um I think one of them costs 12,000, the others cost uh 4000 each. And then with the accommodation, it can reach 50 60,000 crowns, which uh it's better, obviously, if possible can be uh job, job flexibility and mobility. Of course, if you take a sign up bonus, so you will have in the contract in the beginning uh some limitations. So you, you're not so flexible unless you wanna return the money that they paid you uh or you would have to anyway, whether you want it or not. Uh And usually uh you have a three month trial uh period where you can be fired without a reason. Um which I think it's everywhere in the world world, like you promise something you don't deliver when you start working, although it's very hard to get fired, but some people can manage to, then it's followed by a one year contract. So you complete your first year and then you get an indefinite contract usually after one year, if they like you and you you, you uh do your job as uh it should be. So how to apply, how to prepare for Czech residency as a student. Uh check language comp competency is uh essential check ministry of uh check ministry exam. As I told you, it's easy. Uh You need a higher, way, higher level to uh to learn uh faster uh on the job. Um For me, I enjoyed having a very great private tutor if you want, I can give you uh his contact. I don't think he's taking new students right now, but you can try it or of course group learning. So two or three of you are interested in learning Czechs. So you can make a small group or join a bigger group like 2030 people in one of those uh Czech teaching centers uh learn by assimilation. Of course, start speaking Czech in bars, cafes during sport activities, just really try. You will make mistakes. Don't be shy, don't be embarrassed. Nobody is born uh speaking a foreign language. So you have to start somewhere. It's, it's, it's normal. Everybody expects it uh be oriented. Uh You should avoid the faux pas or faux faux pas uh situations where uh you think uh you're saying something, doing something thinking it's normal and in reality, it's um it's not normal, it's not accepted in the local settings and local culture and traditions. So it's good to orientate yourself, check culture and traditions and I do understand that you're living here six years. So by the time you graduate and you should be able to do that. But, uh I feel with the way that the programs are set up uh separately, so you don't get a la good chance to actually meet Czech people, especially if you're living in Prague, there's lots of foreigners. Lot of like, even when you go out for the night, you're usually meeting foreign students or uh tourists who are there for a visit. So I think it's like important to, to assimilate or to meet uh more and more Czech people, which is the language will help with. I think it's, it's all leading to, to, to one another. Of course, uh learn your way around the hospital to get the most up to your residency time and it's not as easy as it sounds. So to orientate yourself in the hospital again, you need the language you need to understand. Uh OK, so this patient is acutely bad. I need to call this department. I need to do that. I need to do this. I need to explain. Well, uh this acutely worsening patients on my ward, how they look like. What's the reason they are there? Um How did they worsen? Are they uh ins unstable? How fast do I need the resuscitation team or the consult to come and have a look at the patient? So it's all very important. Like this is very, very, very important and I feel as uh students who learned in English that we have a lacking in this. So make a clear plan. Uh you know, you start when you will be starting. So basic training in the selected selected field. So so far I spoke about internal medicine, there's of course, a lot of these commands, excuse me. And one of them, for example is for urology, cardiothoracic surgery, um uh general surgery and so on and so on. So you need to know which one of those you need, how long it is and uh how to uh plan with your life plan because not everything is about the specialization. You're also living here. You wanna take care of other things. Let's say you're thinking about when to have kids or when to have a family. So this is another thing you need to take into account when you're planning the time, time, time, the time frame. Um after you finish the men, then it will be uh the time to choose which specialization you want, which is called in check. So you will choose the subspeciation for technic men. You have cardiology, pm gastroenterology and hepatology and so on and so on. There's some uh many like mens, let's say, or basic training uh courses like urology. It's clear that you will afterwards go to urology or after cardiothoracic surgery, uh command or basic training, you're not gonna switch suddenly to urology specialization. However, some in some many are interchangeable after you complete the whole specialization. But that's too complicated and it's not typical route. So I will not discuss it, but just think about this like where you wanna get, how you will do it kind of thing. And if you wanna do phd in research, so ask in the beginning of the sleep possibility uh at the chosen department or if it's compulsory, some departments want you to do a phd and without it, you cannot join the team or they will try to kind of impose it on you. So ask about this in the beginning. Uh Make sure it's possible if you really want it. For example, for me, uh I asked in the beginning, I took my time to learn the basic internal medicine skills that you need to survive as a internal medicine doctor. And I started my phd after about 2.5 years of training after finishing my 10 examination. And only once I moved completely to the Gastroenterology and Hepatology department, which I think it's a, it's a good idea not to start all the way in the beginning of your uh specialization journey. So this is all uh thank you for your attention. You have my contact here in case you want to uh ask something preferably on the email or if you want to try the number. So uh on whatsapp, so that's all uh I'll hand it over to Yasmin in case you would like to uh ask some uh questions uh or if somebody from the crowd would like to, to ask you a question. OK. Thank you very much doctor. Um If anyone has any questions, feel free to pop them into the chat and we'll include them, I think I have um perhaps some questions that the, that the audience might be interested in and you mentioned that you started in a regional hospital if I understood correctly. Yeah. Yeah. Yeah. Um So why did you decide on a regional instead of faculty hospitals since a lot of students have access to faculty hospitals? And we do, we work there when we study um uh during the six years. So what was your, your thought process or like choice of reasoning? Um Like my, my choice, my, my choice uh came from the fact that uh uh I wanted to work in a slightly smaller hospital than in a faculty hospital. I wanted to have my um my, let's say my pace to learn my own. Um um Well, like if you wanna work in faculty hospital, there's a lot of speed required. So you need to already speak check. You need to not always, but you kind of do do do need to have some sorry, you need to have some uh good level of check. It's expected, it's more expected, let's say in the regional hospital, they're more willing to give you your space to learn your check at your own pace and uh and so on. For me, I like the department of Gastroenterology here. Uh It's led by a very good uh doctor, um a very academic also. So for me, it was a perfect uh fit for me. And of course, I had to undergo the internal basic training, which was in the general internal medicine department with certain internships in surgery, auto or ca uh as well as uh cardiology uh and internships in gastro internships in infection infectious department. So I think I was able to see a very good range of medicine. Sorry. Also, when you work in a faculty hospital, uh you're already jumping into the specialized stuff. And um and uh uh a lot of uh um a lot of doctors can already be too specialized right in the beginning. And then when you see something a little bit outside your field, sorry, you don't know how to deal with the patient. So it's good to start in a slightly smaller hospital and then move in my opinion. However, for some people, faculty hospital is great. It's um and for even, even for some specializations, it's not possible to start other than in the faculty hospital or the physicians are limited like cardiothoracic surgery or uh neuro uh neu neurosurgery uh which in limited, we do have a neurosurgery department. Quite a good one, but it's one of the very few cases where it's outside the faculty hospital. So there's a lot of reasons honestly. But I'm afraid it was more like a leap of faith, but I felt it was a good place, just a gut feeling. And when I moved here, I was quite happy with my, with my choice. Uh We also have two questions from the audience. Are you able to access them or would you like me to read them out? Uh I can see them. I see uh uh asking if the environment in the regional hospital was welcoming or if I felt like an outsider. Um At times, um um like I would say, uh it, it's very individual, some individuals were quite welcoming uh to the idea before me, there were other foreign doctors who worked in this hospital. So the idea of having a foreign doctor who comes there was kind of limited uh check, let's say and improved. It's a possibility and they already believed in me because somebody else has had done it already. So in that sense, I was lucky that somebody else went through this uh process for me. And uh I must say when I started the hospital was uh a bit understaffed. So they were just happy to have one more doctor. Uh Now it's not the case. Uh Libert hospital is quite well. Uh It's quite well staffed right now. So I feel, you know, ii in that sense, it's different. I'm not gonna say super welcoming. At times, I did feel like an outsider. Uh sometimes I still do. Um But overall, I feel like uh I belong in a team and I feel like people are treating me as if I'm actually part of this team and not uh an outsider, maybe just 1 1% of the cases, even, maybe less that I do feel like an outsider. And honestly, let's say, uh once or twice per year, I do feel that that kind of sense, but in general, I don't treat it, but this is my experience in my hospital. So in another hospital, it could be a toxic work environment, more close minded people not willing to accepted for you who you are or for your limitations and your uh good side, sorry. Um So it really depends on the department, but this can be anywhere in the world even in your home country once you graduate. Um So as as somebody who graduated outside of your home country, so and I, and I have seen this in a, in a, in a couple of cases. So yeah. Um There's also another, I hope that answered your question. Let's see. Uh The next question is from Mahaf Mohammed. Uh Wait, it's horrible. The room is really dry and it's irritating my throat right now. Um OK. So the next question, question from us. Uh OK. Uh Glad to have answered your question. Um uh The question is if Czech Doctors, nurses and healthcare professionals are usually receptive to foreigners who don't necessarily speak Czech perfectly. But are trying, do they perceive them as a burden or they are kind to help out? It depends on the nurse. It depends on the doctors, I think, uh generally since they took you there, so it means they need you. It's not that you only need this department to, to specialize or to move ahead in your career. So, uh from that side, I feel that they're quite understanding, however, uh especially understanding in your own department. But when you come to call for a consult from another department, they might be less understanding. Um I, like I must say, II don't want to give an idea that it's all sunshine and rainbows. It is tough. Sometimes people will be angry at you for not being able to communicate uh to the level which they are used to from other doctors or native doctors. Uh So, uh um like I would say, from the side of doctors overall, ok, in your own department, from other departments, they might see it as an inconvenience. You're not able to reflect the exact image of how this patient looks like uh when you are consulting. So you want to say they have abdominal pain and you don't know what to do with them. This is not how a consult works works. You have to say, OK, they have abdominal pain, they have Murphy sign positive. I did an ultrasound, they have this and this finding, I think they have uh acute uh cholecystitis. So how can I uh so can you please come and have a look at them eventually uh operate them or take them to your department and they will come have a look and then you will discuss together how it is. So this uh all requires kind of intermediate to high level of check. So they are accepting not so much I would say, but it is really everywhere. If you would go to Germany, for example, you already have to speak see one before you start working. So that's why the there you will not have a problem, but it just means that one or two years uh you would be unemployed trying to get the language and figure out the research project and maybe then you can start to find a job. So it's just a longer process here. It was for me more straightforward finish. Do the exam, finish medical school, do the exam, start working kind of straight away? And then mm I did speak Czech before I did have some experiences from the days when I did my athletics in a Czech team, I used to have a lot of Czech friends and I used to uh I use uh uh uh I uh yeah. And then I had the private teacher and then I started working. So that really helped in that sense. Uh I must also emphasize that internal medicine is very, very, very heavily. Uh ve uh very heavily requires uh good check knowledge because check language is no, so sorry because the internal medicine is all about writing reports, writing request forms which in check um communicating with the patients, communicating with the uh uh patients families, communicating with the ICU. When you wanna transfer an acutely worsening patient on the ward, there's really or just calling the lab, the lab calling you telling you this uh like this uh, I don't know this uh test tube is not correct or it's, I don't know how to say it in, in English. Exactly. Uh let's say test tube is not the right one. And you have to communicate with the nurse to solve this issue. There's uh really internal medicine is even more uh demanding than other uh specializations, in my opinion, uh nurses, they see it as an inconvenience, something that can take them five minutes with a native doctor, takes them 15 minutes because there's a take and uh there's a, a to and fro and so on and a lot of them, especially the older ones do not speak English. I'm sure you have noticed. So when they do not speak English, they cannot communicate with you and they kind of get angry at you just because uh you are not able to, to communicate with them and check they're not able to communicate with you in English. So there from here, there can be a lot of friction that can later on lead to problems for me. I was lucky that the head of department where I worked was able to tell them that repeatedly. It's his foreign language. He's trying and just cement that idea in their mind. So they even started to try with me. So I go back to the idea of the toxic workplace environment versus um healthy workplace environment where they see you as a person, they see you as a, let's say, asset and they wanna keep you there, they wanna improve you and so on rather than bully you and try to get you to leave the department. So I see it like that. And uh also how do I overcome my anxieties about uh potentially not being able to communicate a patients state perfectly and that potentially leading to worsening of the patients state, potentially their death, especially in demanding specialty like internal medicine. Um um I think, yeah, like uh honestly, uh when I first started picking up the phone and calling it was mm a very traumatizing experience like thinking about it now um expecting that they will be angry that you're not communicating your idea as well, that you are uh not conducting the idea. Well, it kind of gave me some feeling of anxiety. I agree with you. And uh also regarding uh potentially leading to worsening of the patient's state and death and uh not being able to communicate a patient's state perfectly. I think even a person who speaks Czech sometimes have limitations in communicating a patient's state perfectly. You just have it worse and if they can like uh get away with it, let's say, or um somehow manage it. So I don't think you should, you should have the anxiety. You're still at work, you're doing work and you're working under supervision. So when you don't know, there's always a very good system where you can escalate to the next doctor uh who is older than you. So for example, somebody who's halfway through their specialization or a year older than you or your head of department, depending on how acute the matter is or just um yeah. So like in the beginning, it's hard, you, if it, if the patient is really, really sick, just communicate to an older doctor who can uh conduct this idea very quickly. Uh I think this is very important to, to understand always escalate the problem to the next uh support system that you have depends on the department, depends on the hospital. And um I think, I think that's how I would answer it. Like the anxiety will be there, the anxiety. It's a, a thing like I have uh lived through it. So um I don't know, you have to find your own way, how to manage it. Uh Yoga might help or I don't know. But, but this is very like very, very good question. It's like really uh uh realistic and uh how do I practice my check? Uh Did you attend uh language school or did you use less traditional methods? Uh I'm not really sure what you mean by less traditional methods. Uh I didn't go to a language school. I went to, I had my own private tutor. Uh maybe less traditional was uh like learning uh by simulation from uh people I know from um people in my surroundings. Uh As I said, they did athletics before I was quite a social butterfly. So that also helped me to uh break through the anxiety of speaking check. So I think that's, that's how I did it. Like, unfortunately, there was not any Czech schools in had that or there were but not what I was exactly looking for this uh medical, this Czech language teacher who I had was experienced in teaching medical students who aspired to work in the Czech Republic. Uh So he was very experienced, very like uh just very experienced in uh teaching medical check also. So that was really, really great. So for me, that's uh my answer if there's any more questions, so fire away and I will try to answer it in the meantime, just we'll give a little bit of time if anyone has any last questions. Um I think something that I would be interested in and I know that maybe many other students um is how did you decide on the Czech Republic? Like what was one of the like, was like the factors that influence your decision making? Was it accessibility? Was it uh like a balance? Um because I know a lot of people that doctors have come back to the Czech Republic because they prioritize a work life balance. Um Was it like an economic factor? You know, I'd, I'd be interested in hearing your reasoning behind and I'm sure everyone else behind why you decided upon Czech Republic or what do you think the benefits are? Yeah, like honestly, when you're choosing uh choosing a place where you want to work, so it's important to not just think about the specialization in the hospital because you're there even though you're there quite a long time every, every week, which depends on the hospital where you work at and how many doctors there are. So you can expect to be there between 60 80 hours every week. Uh Sometimes even more. Uh It's also about your life like uh do you enjoy the lifestyle here? Do you, do you see yourself working here? Is how long do you see yourself working here? Do you plan to start a family here? Is this uh environment suiting for you uh uh suit suitable for you uh and so on and so on. There's a lot of factors to take into account for me. I got, let's say I got used to the lifestyle. I like it. Um I enjoyed the, let's say the academic uh environment here I wanted to do a phd and that was the most straightforward route to that. I enjoy research. And I would like to, um, complete a phd for example. So I knew that, uh, in that sense, in, in all of these categories, just ticked my boxes and, and, and decided to stay here. So really, it depends on you. It's, it's, it's more about where you want to live and, uh, if it's good enough for you or you, or like what's good for you obviously can be bad for somebody else. Uh And vice versa. So it's all about being good for you, like an lifestyle worklife balance. Of course, it's important. You don't know that until you start the job, of course, unless you go there for an internship. Um Yeah, I think, I think that's it. Uh Yeah. Mm And like uh also the fact that the qualifications you will acquire here at the end of your specialization are you recognize that gives you a lot of flexibility, like once I specialize, let's say like right now I like it. I would like to stay here for a longer time, but let's say I decide, OK, I've had enough. I don't wanna work here anymore and I've always wanted to go work in Switzerland. So uh let's go work in Switzerland. What do they need? They need the language test B to French, for example, or German, you find a job, you apply, you go there sometimes for specific specialization, they might require an extra exam, but it's an extra exam that their doctors have to do also. So if it's an exam that their doctors have to do, so you have to set it as well. So for example, to do gastroenterology in Switzerland, I have to do an eu uh level exam uh that is not required here in Czech Republic. So II would need to plan for that from now already if I would like to move there afterwards. So I think this, this played a major role in uh or a major, major role in the choice that I made like to stay here. Like those, those, those um those things I just tasted. OK, thank you. That was a very like it was well well stated and yeah, I think it was very insightful, especially for students who are going to be graduating soon and um going to be entering the workforce and I'm sure that it's a very confusing time for a lot of students. Um Yeah, of course, like II see we're only four people and like one of them. Uh Yeah, so like four people, I think I know 22 or three of the people who are in this uh group. Um If you would like to even ask some personal questions like uh which are related to your specific case, so you can, you can definitely ask about that. So like before we end the meeting Um I don't know. So go for it. Otherwise I will leave it up to Yasmin to, to bring the closing remarks and call it a day. If, if no one has any more questions, I think, um, you've provided your context in case anyone has anything personal, perhaps, um, they'd wanna talk to you directly um, rather than on the broadcast, but in that case, um I will be bringing this event to an end. And first of all, I would like to thank Doctor Kassem for a very concise and very insightful presentation and explanation to working in the Czech Republic. And I know that you're very busy. So the fact that you took the time to even create the presentation and participate in this and offer insight to, to medical students is something that's very admirable. And I'm sure many people including myself are very grateful that you were able to do this for us. Thank you. It was my pleasure. Uh I just uh always think of it uh in the sense that if I had this option before actually committing to staying in Czech Republic, it would have been great. It would have uh simplified a lot of the issues that I had uh in my journey or in the preparation to start working. So I'm, I'm just uh like glad to actually get back my pleasure. We're very happy to hear that um As for the participants. Um I just want to inform all of you that, um, I will be sending a link to a feedback form. Uh, if you're interested in filling it out, we'd be very grateful to hear your feedback, what we can improve. Um, perhaps topics that you'd like to see come up more often. Um, and we'll be able to incorporate that and we're very happy to hear your opinions. Um, once again, thank you, Doctor Ken for all of your hard work and your willingness to participate. And, uh, if there aren't any closing remarks, then I think this brings the event to an end. Ok, nice to see you. Have a good day. Thank you very much. Have a good evening.