The Over the Shoulder program gives recent graduates of Iraqi medical schools a chance to get hands-on training with U.S. military physicians and other medical personnel to see how they do their jobs and in July 2010 Lt. Col. Edward McDaniel found himself in charge of it.
As the medical director of the Ortiz Medical Clinic at Forward Operating Base Prosperity in Iraq, Dr. McDaniel was responsible for personnel, resources and the training of medics.
Lt. Col. Edward McDaniel
During his 6-month stint at Ortiz, he oversaw about a dozen young Iraqi physicians who rotated through the Over the Shoulder program, before returning in January 2011 to Brooke Army Medical Center in San Antonio, where he is an internist and director of medicine performance improvement and patient safety.
How and why did the program get started?
When the Iraq war broke out, many Iraqi doctors fled the country, taking with them the ability for the future generation of doctors to get the training and the expertise to practice medicine.
The Over the Shoulder program started in March 2010 as a collaboration of the U.S. embassy and the Department of Defense to help transition from operation Iraqi Freedom to Operation New Dawn.
This transition from marked the beginning of a focus on diplomatic relations, which led to the formation of an outreach program aimed at giving Iraqi medical students a chance to learn about the American health care system at the Ortiz Clinic, which is the largest medical center within the Green Zone in Baghdad.
Straight out of medical school, two students at a time would rotate into the clinic and they literally watched over our shoulders to see how we took care of patients and worked with nurses, radiology, the lab, how we dealt with trauma patients, triage. We also spent time teaching them how we learn medicine. Their medical school training had all been in English so they know the language very well. Dr. Mike Bunning was the senior medical adviser for the State Department’s Provincial Reconstruction Team in Baghdad and was a key individual in putting this program together.
Describe your experience as director of the program.
I feel that we learned about their cultures and their health care system. I got there in July 2010 and was passed the baton by my colleagues who were going back home. It was my first time meeting Iraqi people in general. And it required interaction at an intense level for 8 hours a day, working together and discussing medicine.
Describe the students.
They were very bright, the cream of the crop from the University of Baghdad and teaching hospitals in other cities. They had volunteered for the program so I got the sense that they were really dedicated to doing it and open to trying something different. They rotated in for 2-3 weeks at a time, which sounds like a short period, but given that it was their first time meeting Americans and because of the intensity of the program, it probably felt like a long time for them.
And they were clearly dedicated. Just getting to the Green Zone each day was a big deal for them. They couldn’t just walk in. They had to have security clearance, which required getting up at 4 a.m. to get through various checkpoints on their roads and then they had to come through our checkpoints. It probably took at least 2-3 hours each way. When they left each day to go home, they had to be escorted out. And then once they had left, they had to take precautions to make it look like they were not affiliated with Americans. It’s still very dangerous to be seen working with Americans. They made tremendous sacrifices. The people who volunteered for this program were taking huge risks, and I really admired them for that. It seemed so important to them. I recognized that and really tried hard to make the experience worth it for them.
I really had a lot of respect for what they did as young physicians and for the fact that they took the opportunity to learn about a different health care system this early in their careers. I also was impressed by their knowledge given that they had lost their best professors and teachers. When the war broke out, they were 15 or 16 years old, and many of their families had left the country, so they had a major disruption in their schooling. Yet they stayed focused on their plans to become doctors.