Canada·First Person

It hurts to say bye to my daughter and fly to the U.S. But I can't find work as a doctor in Canada

As an internationally trained physician, Syeda Qasim was unable to find a residency in Canada. As she parents from a distance, she reflects on her journey as a wife, mother and doctor.

The path for an internationally trained physician like myself is not easy

A smiling woman in a doctor’s coat puts her arm around a girl with pigtails.
Syeda Qasim, left, with her daughter, wore a doctor’s white coat for the first time after six years as she celebrated her acceptance into a pathology residency in New Jersey in 2021. (Submitted by Syeda Qasim)

This First Person piece is written by Syeda Qasim, who is a Pakistani-trained doctor and divides her time between the U.S and Canada. For more information about CBC's First Person stories, please see the FAQ.

"Mama, when will we start living together again?" asks my six-year-old daughter as my husband drives us to the Billy Bishop Airport in downtown Toronto for my flight to New Jersey. 

"Soon, jaani," I say to her, using an endearment in Urdu. "As soon as Mama's training finishes." 

We're sitting in the backseat of the car and holding hands. I see my husband glance at my reflection through the rearview mirror, and I swallow the lump in my throat and look out of the window so neither of them can see my tears. 

I am halfway through a multi-year residency in the U.S. After four years of pursuing a spot at a hospital in Canada, it's the only place where I have been able to find a spot that accepted me — an internationally-trained doctor. 

Living away from my husband and daughter while doing my residency has been challenging. My daughter lives with my husband in Toronto, and we share the responsibility of taking care of her. We try to squeeze in weekends or vacations to meet up and spend quality time together. I appreciate his support and that he stands by my side as I pursue my dream of working as a doctor. 

A smiling woman stands outside the airport while a girl holding a stuffed toy sits on the trunk of a car and a smiling man leans against her.
Qasim, left, with her daughter and husband outside of the Billy Bishop airport in downtown Toronto in July 2022. She regularly commutes between New Jersey and Toronto. (Submitted by Syeda Qasim)

But every time I leave my family behind in Toronto, I wonder whether studying to be a physician was the best decision of my life or the worst. Medicine instilled in me the passion to serve humanity and pursue my career, but it's also a tough profession, with long hours of work and study and time away from loved ones. I graduated from medical school in  Lahore, Pakistan, at one of the institutions where parents pray and wish their child gets admission. After five years of going through countless books and exams, I graduated in 2012. I was preparing for my licensing exams in Pakistan while working part-time as an instructor at a medical college when I got married in 2013. My husband and I immigrated to Canada in 2015, and that's when I began the long journey of becoming recognized as a physician in North America. 

I studied for 10-to-12-hour per day, even through my pregnancy, and eventually cleared my U.S. and Canadian licensing exams. Meanwhile, I started working as an instructor at an Ontario school that prepares other foreign medical graduates for their licensing exams. Initially I only applied for a residency spot in Canada, but three years of not landing one took a toll on my mental health. 

We decided to change our game plan and I applied for a residency in the U.S. — a larger population meant more spots — and I finally got accepted to a pathology residency program in New Jersey in 2021. 

When I got accepted into residency, telling our then four-year-old daughter was difficult. It took, and still does, take a lot of "bribery" toys to help her see the brighter picture. 

The first year I spent without them, I would travel to Toronto every two or three weeks just to spend the weekend together. This long-distance relationship has taught us some tricks to stay connected — from finding cheaper airfare tickets to having "dance parties" on Zoom. 

Sometimes I feel that this limited time we get to spend together has brought us even closer as a family. It's as if we try to make up for the time we spend away from each other. Before I leave for New Jersey, I try to create a small "treasure hunt" in the house so my daughter can hunt for a small surprise every day so she can miss me a little less — or at least that's how I convince myself that it's OK to leave her. 

Since then, I've missed milestones in my daughter's life, such as her kindergarten graduation and her first tooth falling out. But whenever I question my decision to pursue training, I know deep within that if I do not, I cannot be a good mother and a good wife as I would not be satisfied with my life. 

My husband always tells me we have come too far now to back out. When I see him and my daughter cheering me on, I know I can make it to the finish line. 

A smiling man kneels on the floor while holding the hand of a smiling girl.
Qasim says she couldn’t make it through the long separations without the support of her loving husband, left, and daughter. (Submitted by Syeda Qasim)

I know I'm not the only internationally trained doctor in this situation. Even Canadian-educated doctors often have to work apart from their families during their residencies based on where they find a spot. But as Canada faces an acute shortage of doctors, I question if there can't be a better solution to this shortage that helps other foreign-trained doctors integrate into the system and also relieves the burden on those already practising medicine. 

These are the thoughts that run through my head as we pull up to the parking lot at Billy Bishop Airport. It is raining, so the three of us and my daughter's two stuffies try to squeeze in a big hug inside the car. 

When I get inside, I learn my flight is delayed by two hours due to the rain. Oh, how I wish I had known this before I came to the airport. Maybe we could have had vanilla milkshakes from McDonald's (her favourite) instead. 

As I wait for boarding, I video call my teary-eyed daughter and tell her once again to be brave. 

I have a long week ahead with long days and longer nights, which will keep my mind busy but heart aching for my family. The years go fast, but the days go slow; I had always heard of this but now know what it actually means. 

A smiling woman in hospital scrubs and a doctor’s coat sits in a patio chair.
Qasim is a pathology resident at RWJ Barnabas in New Jersey. (Submitted by Syeda Qasim)

I tell myself this time will pass and maybe eventually we will reminisce about these drives to the airport on the Gardiner Expressway. It may be something that my daughter is proud of one day — how her parents worked hard as immigrants and how she and her father helped her mother achieve a dream together. And I hope other internationally trained doctors don't lose heart. The light at the end of the tunnel might be a small pinprick, but I feel it growing brighter each day. 

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Syeda Qasim

Freelance contributor

Syeda Qasim has a medical degree and is a postgraduate trainee in her second year of pathology residency at RWJ Barnabas in New Jersey. In her free time, she loves to bake and dance with her daughter.