"When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has been opened for us."
– Helen Keller

Being a cardiologist in a scarred country like Iraq, where wars and internal conflicts have torn the country apart, left me no choice but to look for the unmet needs in our practice. Among the needs: establishing a workforce nucleus and creating a clinical trials ecosystem from scratch that included raising awareness of and appreciation for clinical trial research among policymakers and the general population and collaborating with global experts to overcome financial hardship.

The desire to drive change motivated me to apply for a part-time online MSc in clinical trials at University of Oxford in 2021 – a competitive program that comes recommended by the legendary Eugene Braunwald, MD, MACC.¹ I was excited and a little scared when I found myself on the shortlist of candidates and was interviewed by giants in cardiology, including Jane Armitage, MBBS, director of the program.

I received an email from Oxford in February 2021 offering me a place in the course, but felt helpless a couple months later when I was notified that my application for an educational grant to cover the cost of the program wasn't accepted. Being from a low- to middle-income (LMIC) country, there was no way I could secure institutional funding nor reported educational grants from societies or industry in Iraq.

Yet I did not give up. The saying, "when life shuts a door, it opens a window," is true, and I continued to apply for research and educational grants through a variety of pharmaceutical companies and was finally rewarded with an education grant supporting gender balance in industry funding in Iraq that covered part of the fees. In June, I also received an email from the University of Oxford stating that I was awarded a partial scholarship to fund half of the course fees! In addition to receiving funding, being recognized with a scholarship from a prestigious university like Oxford is an outstanding accomplishment.

This experience taught me many things, among which is the importance of a supportive mentor. Hasan Farhan, MBChB, FACC, played a vital role in helping me get the industry educational grant. I also learned how crucial the relationship with industry is for advancing careers in medicine in general and in cardiology, in particular. More importantly, this experience made me realize that we really need to stop staring at the closed doors so that we do not miss it when other doors are opened for us!

I received the final unconditional offer from University of Oxford this past August. For a female cardiologist from the Middle East like me, I hope my achievement will empower other women in cardiology in my country. It is well known that one successful woman in a particular field can open the door for other women.

Looking to the future, including more women in leading positions of cardiovascular clinical trials will help in recruiting more female patients.² The more diversity in research workforce will be reflected in greater diversity among patient populations being studies. Outside of just women, it is crucial to study the Middle Eastern population in cardiovascular clinical trials as they have their own genetic, geography and cultures that can impact their response to treatment or intervention.

Participating in high-impact global programs like the Oxford program will also enable me to network with collaborators and experts and share my perspective from an LMIC. Finally, our voice – a voice that was unheard for a long time despite having the highest burden of cardiovascular diseases – will be heard.

I will prepare for this journey and seize this opportunity hoping that my voice one day will turn into actions that will counteract the gender segregation in my country and other Middle Eastern countries and will guide and mentor the next generation. I do not know what the future holds for me, but I am certain that this course will be a historical landmark in my life. University of Oxford, here I come!

References:

1. MSc in Clinical Trials – What makes it so unique? [Internet/ YouTube] Available at: https://www.youtube.com/watch?v=78CHTG9h84c&ab_channel=EuropeanSocietyofCardiology
2. Cho L, Vest AR, O'Donoghue ML, et al. Cardiovascular Disease in Women Committee Leadership Council. Increasing Participation of Women in Cardiovascular Trials: JACC Council Perspectives. Journal of the American College of Cardiology. 2021 Aug 17;78(7):737-51.

This article was authored by Zainab Atiyah Dakhil, DR, MBChB an interventional cardiologist at Ibn Al-Bitar Cardiac Centre and senior lecturer at Al- Kindy College of Medicine/University of Baghdad in Baghdad, Iraq. Twitter: @ZainabDakhil2