Dr. Georges Karam spent his childhood in Lebanon and studied as an undergraduate at the American University of Beirut. He became a student at St. George’s University in 1999 and received his Doctor of Medicine in 2003.

After graduating from SGU, Dr. Karam pursued a general psychiatry residency at Washington University in St. Louis, Missouri, then a geriatric psychiatry fellowship at the University of Pittsburgh. He went on to qualify with the American Board of Psychiatry and Neurology in 2008 and the American Board of Geriatric Psychiatry in 2010. He returned to Lebanon following his stint in the United States in order to establish a psychiatric practice in Beirut.

Dr. Karam is now the acting chairman and assistant professor at the Department of Psychiatry and Clinical Psychology of St. George Hospital University Medical Center, Balamand University, Faculty of Medicine in Lebanon. He is also a senior member of the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) and the President of the Alzheimer’s Association of Lebanon. He sits on a number of committees, including the HelpAge Global Network, Lebanon’s National Committee for Palliative Care, and the Lebanese Psychiatric Society. In 2018, he was awarded the Arab Social Creativity Award by the Arab Thought Foundation.

Dr. Karam is a published researcher specializing in the mental health of older populations. In 2011, he contributed to a collaborative World Alzheimer’s Report for the World Health Organization (WHO) and Alzheimer’s Disease International (ADI).

Many SGU students go on to residencies in the United States after graduating. Was this something that appealed to you when choosing universities?

Absolutely. I knew that working in the US would open up terrific career opportunities and that SGU could provide the platform I needed to get there. I was also interested in psychiatry, having been influenced by my father (who was a psychiatrist) and I knew that SGU would be a good starting point for a career in this field. After SGU, I had the privilege of taking up a general psychiatry residency at Washington University in St. Louis and then a geriatric psychiatry fellowship at the University of Pittsburgh. St. Louis in particular was an exceptional place to practice psychiatry, and I flourished there and eventually became chief resident.

What were the other benefits of studying at SGU?

Firstly, I learned so much at St. George’s University. The teaching was excellent and it gave me the springboard for everything I have achieved since. The facilities and resources were outstanding, which made for a very pleasant teaching environment and campus. It was also a very collaborative environment. I made great connections and friendships there. I also took advantage of living on a Caribbean island and discovered a love of scuba diving.

You returned to Lebanon following your residencies. What did you hope to achieve in the field of mental health back in your home country?

I had developed an interest in geriatric psychiatry, including conditions like Alzheimer’s disease. Provision for this and other mental health conditions is limited in Lebanon, and I was keen to improve this and make a difference to vulnerable people. So, despite receiving a number of job offers in the US, I returned to Lebanon to set up my own practice in Beirut.

I’m now an advisor for the Lebanese Ministry of Health and work with NGOs to improve support for people suffering from mental illness. I’m the vice president of the Center of Studies on Aging, president of the Alzheimer’s Association Lebanon, and secretary of the Lebanese Psychiatric Society, as well as a member of a number of other committees including the HelpAge Global Network. This work is all interesting to me on a professional level but, more importantly, the organizations are indicative of the increasing commitments of policy makers and healthcare professionals to tackle mental illness in Lebanon.

How do you apply your research to your day to day work?

I have led a number of research programs looking into dementia, depression, anxiety, schizophrenia, and other mental health conditions and worked on international research with a number of countries. In 2011, I contributed to a collaborative World Alzheimer’s Report for the World Health Organization (WHO) and Alzheimer’s Disease International (ADI). The report raised awareness of dementia as a public health priority, and its findings and recommendations have been replicated in 27 countries.

The number of people living with dementia worldwide is estimated to be over 35 million, and this number will increase significantly in the coming years. I’ve seen how it can be devastating not only for the people who have it, but also for their caregivers and families. In 2017, I worked on research that looked into this issue in Lebanon specifically. While the burden on and mental well-being of family carers for the elderly, especially those with dementia, has been well studied in high-income countries, and to a lesser extent in the Arab region, our study of Lebanese carers gave us a local perspective and highlighted the importance of considering the psychological well-being of the family carer, and the role of dementia and depression in increasing the burden of care.

This local-level research prompted me to set up a daycare center for people who have dementia in Beirut. The center provides safety and security, organizes mentally stimulating activities and memory games which help delay the progress of the disease, as well as provides crucial respite for carers.

It’s satisfying to know that my work is important for Lebanon but also for the global population. It’s fascinating to be involved in research that I hope to see treatment and cures for diseases within my career.

Published February 2019

Undergrad/Graduate: Bachelor of Science in Biology and Psychology, Drexel University; Master of Public Health, T.H. Chan School of Public Health, Harvard University

Residency: Obstetrics and Gynecology, Maimonides Medical Center

Fellowship: Global Health Leadership, Massachusetts General Hospital

Fellowship: Female Pelvic Medicine and Reconstructive Surgery, University of Chicago/North Shore University Health System

How did your upbringing shape your perspective in general and in terms of health care?

“Growing up in the war-torn Bosnia in early 1990s, I learned that death and suffering is a part of life. Twenty years later, working in the small village in western Kenya, I was faced again with the similar challenges that I grew up in.

As a 15-year-old, I received a scholarship to attend high school in Philadelphia and was fortunate to have had family and mentors that supported my dream of becoming a physician. During my high school years, I volunteered in homeless shelters and learned that discrepancies in healthcare are extremely pronounced in American society. My desire to pursue a career in medicine is led by my desire to decrease the healthcare gap around the world and provide the best possible care to patients no matter their background or zip code.”

After finishing your residency, you worked as a global health leadership fellow at Massachusetts General Hospital. How would you describe that experience?

“During my residency, I was fortunate to have great mentors and have had the ability to travel to Jamaica, Eritrea, Tanzania, and Haiti and see healthcare concerns faced by physicians and patients in these countries.

“My desire to pursue a global health fellowship stemmed from the understanding that in order to have a long-term impact on the health system, you need to be physically present for a certain amount of time. During my fellowship, I spent about a year and a half in Kenya at the same site, within the same hospital system. I lived and worked there for three to four months at a time, two times a year. The majority of my time was spent providing hands-on education to physicians, nurses, and medical assistants. We also started a family and emergency medicine residency program and spent a significant amount of time collaborating with the local university to develop programs that would provide adequate training to physicians who are remote from large medical centers.

“Giving someone gift of education and empowering them to take better care of their society is one of the most empowering gifts that one can give.”

How did your career come to focus on female pelvic medicine and reconstructive surgery?

“OB/GYN combines surgery and medicine, as well as my desire to do global health work. Urogynecology as one of the gynecological subspecialties that directly addresses patients’ quality of life and has a great need for further education internationally. Patients are often not comfortable with discussing their intimate problems such as urinary incontinence, fecal incontinence or uterine prolapses.”

In what ways is the St. George’s University experience unique?

“The St. George’s experience provided me with the family of extremely diverse, open-minded and highly driven physicians. Taking in account that most of us were away from our families, we have become each other’s family. Today, I am proud to say that my SGU family consists of amazing, well-trained physicians all around the US, and many of them having leading positions in major universities or healthcare organizations.

How did it prepare you for clinical training and beyond?

“Having an ability to do my third and fourth year of medical school in Brooklyn was instrumental. We as medical students were intimately involved in taking care of a large volume of sick patients, with wide variety of pathologies. I did all of my third-year rotations at Brooklyn Hospital, and most of my fourth year at Brooklyn Hospital and Maimonides Medical Center. Our rotations were done with students from US medical schools, and I felt we were equally well prepared. Because it was such an enriching experience, a significant percentage of us desired to do our residencies in New York City and were able to do so.”

Published January 2019

Dr. Abdulla Al-Khan is the vice chair and division director of maternal-fetal medicine and surgery at Hackensack University Medical Center, which is part of the Meridian Healthcare System. He is also the director and founder of The Center for Abnormal Placentation at Hackensack University Medical Center in New Jersey.

As a double-board-certified physician, he holds academic titles as an assistant professor of obstetrics and gynecology at the University of Medicine and Dentistry of New Jersey, New Jersey Medical School, and Seton Hall University School of Graduate Medical Education. He is an associate professor at St. George’s University School of Medicine.

After completing medical school at St. George’s University, Dr. Al-Khan took an internship at Mount Sinai School of Medicine in New York City and a residency in obstetrics and gynecology at Seton Hall University in New Jersey. He was in academic faculty practice for two years and then proceeded to a three-year fellowship in maternal fetal medicine at the University of Medicine and Dentistry at New Jersey Medical School.

Dr. Al-Khan is recognized as an expert in high-risk pregnancy, caring for patients with the most complex medical and surgical conditions. He was the first physician in the world to perform a robotic transabdominal cerclage on a pregnant patient.

In 2008, he established The Center for Abnormal Placentation at Hackensack University Medical Center, a multidisciplinary center that was the first in the world to coordinate the care of patients who present with placenta accreta, a major cause of obstetric hemorrhage and maternal mortality.

What initially drew you to a career in obstetrics and gynecology?

I enjoyed all aspects of my medical studies, but I chose obstetrics and gynecology because it offers a combination of a number of disciplines, including pediatrics, surgery, psychiatry, radiology, and urology. It’s extremely rewarding to help women who have difficult pregnancies to deliver a healthy baby. It allows you to make an impact on the person in your care, wider society, and generations to come.

In 2008, you established the world’s first Center for Abnormal Placentation at Hackensack University Medical Center. What motivated you to do this?

Placenta accreta is a serious pregnancy condition that occurs when the placenta grows too deeply into the uterine wall and other pelvic structures (primarily the bladder). It’s a major cause of obstetric hemorrhage and maternal mortality. Fifteen years ago, I witnessed a pregnant woman suffering from placenta accreta in her second pregnancy. She required emergency treatment, 12 hours of surgery, and three days of surgical ICU admission on a ventilator with an open abdomen, followed by numerous surgeries in order to save her life. I told myself that I never wanted another woman to experience this. I dedicated my time to finding effective diagnoses and treatments for this condition and now have models which are replicated in the world’s leading hospitals.

The center provides much-needed comprehensive services to women who currently have no other place to go for expert care. Our innovative program has been developed and designed to serve as a template for regional, national, and international institutions. It has led to the improvement of pre-delivery diagnosis and delivery complications have been significantly reduced.

We have operated on 250 pregnant women with placenta accreta and have had a 100 percent success rate. I now have four PhD researchers dedicated to developing further diagnosis techniques and treatments, and our methods are being practiced across the world. We also have two senior research scientists actively working on data collection and outcome analysis. I have helped set up our care for placenta accreta programs across Europe, the Middle East, Far East, and of course the United States.

What are your hopes for the future of maternal health care?

Over 500,000 women die worldwide each year from pregnancy-related conditions. That is unacceptable. It’s heartbreaking to visit developing countries and see the rates of avoidable maternal death. Wealthier countries can change this by donating medical equipment we no longer use and continuing to research and share our knowledge with practitioners across the globe, particularly those with limited resources.

In developed countries, we’re seeing a significant increase in births by cesarean section each year, which directly contribute to problems with placental formation in subsequent pregnancies. Because of this, the incidence of placenta accreta will continue to rise, as will mortality rates for pregnant women. This trend is set to continue so further research is crucial if we’re going to improve the health outcomes of pregnant women and their babies. My goal is to establish methods for diagnosing placenta accreta in pregnant women with 100% accuracy as early as possible so we can provide timely treatment and avoid maternal deaths.

How did your experiences at St. George’s University shape your career?

My time at St. George’s was extremely beneficial. Living in the Caribbean for two years was very different to my childhood in Bahrain and teenage years in the United States. I was 21 when I started my studies there and it made me mature quickly and gave me a work ethic and drive to succeed. My class of medical students was relatively small so we became close and this created a great support system. All the St. George’s professors were outstanding, and they encouraged me to push myself and have belief in my abilities. I received a fabulous education at SGU, and my desire to learn and succeed is still with me today.

What advice would you give to medical students at the start of their careers?

I would say that, while nothing in life is easy, if you work hard and take opportunities as they appear, then there are no limits to what you can achieve. Throughout your career, if you have ideas, speak up and be persuasive. Think big and never settle for less.

Published January 2019

Undergrad: St. George’s University
Residency: Internal Medicine, SUNY Upstate Medical University
Fellowship: Gastroenterology, The Brooklyn Hospital Center

You grew up in Brooklyn and did much of your medical training there as well, including most recently as a gastroenterology fellow at the Brooklyn Hospital Center. How much did that background play a role in your decision to stay on as an attending physician?

Brooklyn Hospital is a great place to work. There’s great diversity in New York City. The people are quite friendly and grounded, which is important when you’re spending long days here and it’s one of the main reasons I stayed. I also stayed to be in an academic position, figuring ‘what better place to practice than the place in which I was taught?’ We have a number of fellows on the floors and with us during procedures, so there’s quite a bit of teaching and mentoring that happens each day. That’s the nature of the position, and it is extremely rewarding each day.”

What has the transition from fellow to attending been like?

Whereas a fellow is usually concentrated on the nitty gritty of a clinical case, an attending is responsible for that in addition to various social, administrative, and financial factors surrounding it. I have found that once you understand the medical aspects, the rest falls into place. There was some trepidation to remain in a program where I did my fellowship, but the process has been quite a natural transition for me. As a mentor, it’s rewarding when you’re doing procedures with a fellow, and you see significant progression in skill level over the course of a few weeks or months.

How did your upbringing shape your future as a physician?

I was born in Venezuela, and spent my formative years both in Grenada and Brooklyn. Growing up in each place really grounded me. Health care in Grenada is quite different than the US. However, as is the case in many parts of the world, both places are have groups of people with less access to specialized medical services. That was one of the driving factors in my decision to become a doctor and later to become a gastroenterologist. It’s important to me, as a physician, to give back and serve people who would otherwise not have access to specialty medical care.

During my fellowship and now as an attending, I’ve focused a great deal on colon cancer screening and awareness. There really is a lack of it in many parts of the world. We need to remedy that because, while colon cancer can be a devastating disease if caught in its later stages, it is also quite preventable.

I have to thank one of my mentors, Dr. Marios Loukas, who helped form the research fellowship in Grenada. I was part of the first class there and that experience was very beneficial and a nice launching pad into residency and even further into fellowship.

Was becoming a gastroenterologist always the end goal for you?

Not at all. I grew up playing the saxophone and piano, so at one point I thought I was going to be a jazz musician. Eventually though, there was a stronger calling to humanitarianism which guided me to pursue medicine.

At the start of my residency I thought I wanted to become a primary care physician, working in the community. I gradually realized that what I enjoyed more was being an authority on one particular field of medicine, which in this case was gastroenterology. What’s great about gastroenterology is that it isn’t monotonous. For me, I sometimes do consulting rounds on the medical floors and see office patients in the morning and focus on procedures in the afternoon. There is never a dull moment.

What advice would you give to a student who is just beginning his or her studies at SGU?

I encourage them to keep an open mind about the academic and cultural experience that SGU affords. In addition to focusing on their studies, I would try to immerse myself in some of the different activities that are happening everyday on campus. It is also important to forge long-lasting mentoring relationships and friendships that help you grow as a person and eventually factor into you becoming a great physician.

Published October 2018