‘Like a dream come true’: Ayman Shenouda’s remarkable GP journey

Associate Professor Ayman Shenouda knows better than most how life can turn on the unexpected: a chance meeting, perhaps, or a serendipitous conversation at a time of change.
 
The most recent winner of the college’s Rose-Hunt Award – the RACGP’s highest accolade – has had a remarkable career journey, but it was not one mapped from the start. 
 
In the early 1990s, he and then girlfriend, now wife, Dr Samiha Azab, were both young Cairo University medical graduates considering the next step.
 
Drawn to horizons beyond his home country Egypt, the young Dr Shenouda had by then narrowed the focus: America or Australia?
 
And then Dr Boutros Boutros-Ghali, later the Secretary-General of the United Nations, had his say.  
 
A friend of Associate Professor Shenouda’s father, a noted Cairo writer and newspaper editor, Dr Boutros-Ghali advised the recent graduate that there would be more opportunities to establish himself in Australia.
 
Along with encouragement from other medicos who told him of good surgical training options in the country, it was enough of a push for Dr Shenouda and his wife to board a flight to Sydney in 1992.
 
America’s loss would ultimately be Wagga Wagga’s gain, although years passed before he arrived in the rural NSW location that would prove so formative.
 
At the time of his arrival, Associate Professor Shenouda discovered that Sydney was usually subdued by 7 pm, an unfamiliar feeling after the bustle of Cairo, and he recalls taking some time to adjust both to the quiet and the culture of a new country.
 
It is an experience that has given him a very personal understanding of the challenges facing overseas doctors, one that he would draw on for advocacy work in later years.
 
‘No one can fit in without looking back,’ he told newsGP.
 
‘Every new adventure in life, whether it’s a new job or a new country, you begin with sussing out what’s going on, and trying to fit in.
 
‘Sometimes I could, sometimes I couldn’t. I wouldn’t say it was an easy life from day one.
 
‘There wasn’t a lot of help to navigate the pathway.’
 
Convinced he had to be part of the system before taking exams, Associate Professor Shenouda applied for jobs and landed a post as a surgical registrar at Launceston General Hospital.
 
‘And that’s where I started and I’ve been in the system since,’ he said.
 
‘But as a foreigner, to start with it was really challenging to navigate and I believe it’s still challenging to navigate the system now.’
 
Tasmania remained home for five years, until he and his wife decided on a move to Wagga Wagga for a switch in specialisms to general practice.
 
Planning to stay for ‘six months or so’, they had not anticipated how pivotal that change would be.
 
‘Like a dream come true,’ is how Associate Professor Shenouda describes the transition to general practice.
 
‘In my first consultation, I was really “oh my god, that’s what I wanted to do all my life”.
 
‘It was that big of a shock. Because this relationship with patients, you don’t find it anywhere else but in general practice.’
 
Almost immediately, he also recognised a pent-up demand for GP services in the area.
 
‘I found there is a great need for me and my wife,’ he said, recalling the surprise of one of his early patients when the newly arrived GP asked to take his blood pressure when he was coming in for a repeat prescription.  
 
‘The reason he was not really having the best care was because there wasn’t a lot of doctors in Wagga then. I was booked six weeks in advance, so the doctors were overworked.
 
‘It was lots of fun being part of the solution.
 
‘Being an advocate for patients in rural areas is something that I think every rural doctor will talk to you about, because you’re not just a number, you are part of a community.’
 
A few years after arriving, the couple set up on their own, and they remain the practice principals at Glenrock Country Practice, which they built from scratch in 2005 to become the busiest clinic in town.
 
Accolades followed shortly after it started, with the practice becoming NSW&ACT General Practice of the year in 2007, and Associate Professor Shenouda winning the RACGP’s GP of the year in 2009.

Associate Professor Ayman Shenouda receives his Rose-Hunt Award from RACGP President Dr Nicole Higgins.

The advocacy work also soon ramped up, and he began a long involvement in the RACGP Rural Faculty, culminating in six years as Chair from 2014–20, as well as a stint as RACGP Vice President, and Acting President following the untimely death of Dr Harry Nespolon.
 
During his tenure as Rural Chair, the RACGP and the Australian College of Rural and Remote Medicine (ACRRM) came together for the Collingrove Ageement, a move he reflects on with pride.
 
‘There was a lot of mistrust between the two colleges and misunderstanding, because of the split that happened before,’ he said.
 
‘I thought that the best way to start healing this for the future generations is to start to work on the commonalities rather than the things we disagree upon.
 
‘ACRRM is formed of rural doctors, and they are very passionate doctors, who want the best for their communities.
 
‘It is the same for RACGP doctors – they’re all working for the benefit of their communities, so I think that was a very strong agreement there.’
 
Unsurprisingly given his background, he has also worked hard to improve the situation of International Medical Graduates (IMGs) and feels a sense of achievement for the many overseas doctors he has helped mentor towards Fellowship.
 
Associate Professor Shenouda also has a direct assessment on the change for IMGs since he first arrived.
 
‘There is still a lot of work to be done,’ he said. ‘I think we have improved, but I wouldn’t say that it’s the end of the road.
 
‘IMGs are an essential part of moving forward, so if we consider them as an essential part and respect that part, I think things will change.’
 
In the meantime, he continues to engage with the ever-changing nature of general practice, pointing to the way the Wagga Wagga clinic adapted to COVID-19 in administering 40,000 immunisations in a town of 60,000.
 
‘There’s always opportunities to improve health outcomes and improve things in practice,’ he said.
 
‘That’s my passion. I will always be looking at finding ways to support my patients and colleagues.’
 
However, Associate Professor Shenouda admits to disappointment that more younger doctors are not choosing general practice. While he acknowledges the current systemic challenges, he is unequivocal in his enthusiasm about the job, and hopes to keep passing that on.
 
‘General practice is the best specialty ever,’ he said.
 
‘It’s so rich and so rewarding, and that’s part of the fun of mentoring, to get people exposed to your own experience and this wonderful profession.
 
‘I would never choose anything but the same pathway that I went through.’
 
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Ayman Shenouda Rose-Hunt Award Rural general practice