Dr. Igal Kushnir was mentally prepared for his first cold Canadian winter – but not for the warmth of Canadians.
The Israeli oncologist, who arrived in Ottawa over the summer to begin a two-year fellowship at the Ottawa Hospital Cancer Centre, has been overwhelmed by the friendly welcome he has received.
“You have this stereotype of northern people as cold, but here in Ottawa, people are so friendly, so nice and so warm,” said Kushnir, 37.
“And it’s a very friendly hospital.”
Kushnir, whose specialty is urology, is the fifth Israeli fellow to do a medical oncology fellowship in Ottawa since the program started in 2009.
A first-generation Israeli from Kfar Saba (his family is originally from Moldova); Kushnir graduated from the Technion and did his first fellowship at the Tel Aviv Sourasky Medical Center.
He was looking for fellowship positions to improve his clinical research skills and advance his career when he heard about the Ottawa program.
“A colleague had done a fellowship here a few years ago and had only good things to say about the city, the hospital, and even the weather,” he said.
I’ve written in the past about some of the amazing breakthroughs that are happening in science, technology and medicine in Israel. So what would attract a young oncologist to Canada in general and Ottawa in particular?
“It’s quite interesting to see the difference in attitudes and the way we approach the patients,” said Kushnir.
“The differences are not so much between country to country as from institution to institution.”
He says that Ottawa doctors treat patients more aggressively than at his previous hospital. If a primary cancer had metastasized to another part of the body, for example, the team he worked with in Israel would have considered the cancer incurable, and offered palliative treatment only.
“Here, they try to cure the patient with more aggressive treatment.”
He says he’s also noticed a difference in the behaviour of patients and families compared to what he has seen in Israel.
“Israel is very much a Mediterranean culture, with very expansive emotions. Family members get very involved, and they try very hard to protect the patient.
“I’ve seen family members stand behind the patient and wave their hands at me to stop me from telling the patient bad news – sometimes even stopping me from telling the patient that he has cancer.”
Dr. Tim Asmis, a medical oncologist who specializes in gastrointestinal cancers and is the director of the fellowship program at the cancer centre, says that visiting fellows are also able to experience the team treatment approach that is one of the great strengths of Canadian oncology and not as well-established in many other countries, including the U.S.
“It’s not just the team we have here in Ottawa,” he said. “We’re constantly in touch with colleagues across Canada to find out what treatment is best for a particular patient.
“In a day, we can find the best solution for that person.”
The visiting fellow can see what works well here and try to implement it when he or she returns to Israel. In return, the cancer centre gets a fully-trained, highly motivated medical oncologist as part of its team.
“It’s a real win-win,” Asmis said.
Despite its size, Ottawa is also a major centre for clinical trials of new cancer treatments and protocols. There are close to 200 trials that are active or in follow-up mode, and the program employs a full-time staff of 100.
Although he’s been here only a few months, Kushnir is already thinking about things he’s learned in Canada that he can take back to Israel. He’d like to see more collaboration between the two countries, such as collaborating on a clinical trials database.
And he hopes to share with his Israeli colleagues the team approach that has been so effective here.
In the meantime, he and his partner – a scientist who was able to line up a great position at Agriculture and Agri-Food Canada – are getting settled in Ottawa with their 11-month-old daughter.
They are both nature lovers, so are out exploring just about every weekend.
“It’s been really enriching to experience a different culture and a different lifestyle – how other people live, how other people do medicine.”