HCDM 25 | School Physician

 

A lot of new opportunities can come to healthcare professionals wherever they are in their career paths. After more than a decade of pediatric practice, Dr. Omaima Maaliki found her opportunity for a new career as a school physician and medical director of the American School of Dubai. It was an interesting career change, especially with the added challenge of managing that new position during the COVID-19 pandemic. Joining Dr. Richard Marn on the show, she talks about how fulfilled she is in a career that helps almost 2,000 students safe and healthy during the worst health crisis in our lifetimes. We also hear of how Dr. Omaima’s dogged disregard of a family friend’s “advice” has helped her create meaningful impact on many students’ lives many years later.

Listen to the podcast here:

Keeping Students Safe And Healthy With School Physician/Pediatrician, Omaima Maaliki, MD

We’re going to meet a pediatrician who became a school physician and medical director for a school in Dubai. This is the first guest that we’re going to be interviewing from outside the US. What we’re going to learn is not only how she achieved her goal of being a pediatrician but taking advantage of opportunities that reveal themselves to her as a leader in her career. For some, if not many of us, once we achieve that career goal, that’s what we’ll be doing for the rest of our life. That’s great for an overwhelming majority of us.

In this episode, it will highlight hopefully, that there are also a lot of opportunities that reveal themselves once we’re in a career. After you get into these careers, no matter whether it’s nursing, be a doctor, therapist or going into any allied health profession, opportunities will open themselves up to you. You have to have an eye for them and be willing to take that jump. My guest is Omaima Maaliki. She went to the American School of Dubai and grew up in Dubai. She went to Hamilton College in the US where she got a degree in Biology and French.

She then went to Virginia Commonwealth University School of Medicine where she got her MD degree and then went to become a resident at the Floating Hospital for Children in Boston, Massachusetts. Dr. Maaliki worked in a clinic outside of Boston for a while and then moved to Dubai in 2010 where she has worked as a pediatrician. In the spring of 2019, she became a school physician and medical director of the American School of Dubai, the school that she graduated from in high school.

During this episode, it was quite an introduction to a pivot to a new career as a school physician from being a pediatrician especially with managing that new position during this Coronavirus pandemic. She’s enjoying her career change as she’s helping almost 2,000 students that she’s trying to keep safe and healthy during this pandemic. I’m going to make a quick side note here before we get going with this conversation with Dr. Maaliki. I want to reveal something that she thought would be appropriate to bring up.

That was when she was in high school, when a family friend learned that she wanted to be a pediatrician at a young age, they were not supportive. In fact, this particular person discouraged her from being a pediatrician. That moment left an impression upon her that she would remember for many years to come. She tells me that she was able to persevere and still pursue her childhood goal of being a pediatrician. Because of that, she ignored the advice from that person and is now able to help almost 2,000 students and their families in this new position and role that she’s serving in. I want to highlight two points of why I mentioned this.

Number one, you’re going to get people that are not always looking out for your best interests and don’t understand what your goals are. They’re going to try to discourage you. You’re going to get a lot of naysayers possibly. There may be a lot of people out there, they’re going to try to put you down or distract you. If you do your research and if you want to strive for a particular goal or career to go for it. The second point I want to make is Dr. Maaliki made a decision to ignore that person’s advice. Since she did that, she was and is able to help almost 2,000 students and their families. Sometimes, the decision you make may not impact yourself or people around you immediately but sometimes years later. Without further ado, let’s talk with Dr. Maaliki.

With me is Dr. Omaima Maaliki. Thanks for joining us. How are you doing over there? As I introduce you, you are in Dubai. You’re ahead of us here in New York. You’ve talked to me privately about what’s going on with the Coronavirus. I’d like to talk about your career. It’s a little different as a physician and pediatrician and you’re also a school physician and a medical director. Could you tell me a little bit about being a pediatrician? How is that different as a school physician?

Thank you for having me on your show. When I moved to Dubai in 2010, I went into a similar line of work that I thought I was going to do until I retired, which is to work as a general pediatrician at an outpatient practice and in-hospital care as well. First, I joined a clinic called Medicentres. It was a busy practice. I saw similar cases as I had in Boston. The difference was the way clinics are generally set up here. You don’t have offices with a full pediatrics team, I was the only pediatrician. There were all kinds of other specialties under that roof like dermatology, EMT, different surgeons and family docs.

I had to think for myself without any support which was tough. In Boston, I practice with thirteen other doctors who are all pediatricians. Many of them had 20 to 30 years of experience. If you saw something you weren’t sure of or a new rash, you could run it by them. It was challenging but I learned a lot. I was happy doing what I was doing, I wasn’t looking to change my career or looking for anything different. My kids were going to the American School of Dubai which is where I also went to school and graduated from in ‘94.

It’s a K-12. We have a large campus and the three schools are separated a little bit from each other, but we all share the same campus and facilities. It starts from pre-K, three-year-olds all the way through twelfth grade. I was the usual, dropping the kids off at the gate and jetting off to get to work on time, and the superintendent came chasing after me in the parking lot. She was like, “I need to talk to you, this is important. I have a proposal.” I had no idea which one of my kids must have got in trouble or whatever. I was like, “Can we deal with this later?”

She was like, “No, this is something good. Let’s set up an appointment and chat. I have a nice proposal for you.” We connected about it. She talked to me about this new position that the school wanted to take on as a pediatrician or medical director as they were growing quickly and they wanted someone to manage all facets of student health and well-being. They felt like a pediatrician and someone who was also an alum of that school would be a good fit, and my kids went there as well. She talked to me about it but I had my own misconceptions about the field of school health. My first reaction was like, “I’m confused. Why would you want a pediatrician to do this job? I don’t get it.”

We sometimes think that the school needs a nurse.

That was exactly my misconception. I thought that when a kid got sick, they went to the health office, the nurse called the parent, they got picked up, they went to come and see someone like me, and I would check what’s wrong or they take them home to rest. I thought they provided basic first aid and sent them home if they were unwell. I was wrong because when I started reading about it, I realized what a huge field this was and how much impact you can have on students and their families. You have the ability to affect them at the most sensitive times in their lives which is those thirteen years that they’re going through school and spending most days of the week and hours of the day with us, their educators, teachers and the health office team.

Honestly, at first I said, “I’m not sure I want to do this but let me look into what the job might entail before I make a decision.” I happen to be going to one of the pediatrics and see conferences. There was a book there called School Health: Policy And Practice. I’m like, “School health is a thing.” All throughout the book, it’s all over the place. We encourage that residents get experience in schools and we encourage pediatricians to be strongly involved in their school systems and all this stuff. Everything ranging from mental health, how you can help with nutrition, deciding when kids go out to play depending on the heat index here, it’s a factor and humidity levels, all kinds of things.

School health is a thing. Click To Tweet

I realized that it can have such an enormous impact when you can be involved in making decisions at those higher levels. We start with anticipatory guidance trying to avoid injuries and risk management. We do a lot of work with the kids setting up in-school, vision screens, hearing screen, scoliosis checks and we even do full physicals. These are mandated by our health authority here at certain ages. Not every year but at certain critical points in kids’ development. We’ll see every single student in that grade level and do a full check.

How many students are in your school?

The total number is about 1,800, under 2,000. Since Coronavirus happened, the numbers might have come down a little bit because a lot of people had to move out of the UAE and go back to their home countries for financial hardship reasons. We’re around 1,700 starting out this academic year.

As a school physician, you help with making policies and decisions, applying public health regulations and apply them to your school until you’re tailoring it. It’s something that you didn’t do as a pediatrician because as a pediatrician, you’re seeing one patient at a time and 30 to 40 patients a day.

You can see a kid and recommend a vaccine. The family doesn’t agree with you and you might spend an hour trying to convince them that vaccines are important until you’re blue in the face and you may get somewhere you may not. On the other hand, I realized, “We can say you can’t enroll your child until they’ve got their vaccines.” Two thousand kids have made sure they’re up-to-date with their vaccine. I think it’s how a politician might be able to get things done on a wider scale in many ways. The school administrators and leaders of the school can make changes that everyone has to abide by in order to send their kid off to school so it makes people more compliant, if you will.

This is how it’s coming across. I want to clarify it. Do you feel you have a greater impact and influence therefore on a young person’s health as a child than as a pediatrician?

I think so but on the flip side, it’s been hard for me to fully cut my ties with private practice. It’s harder to build those special relationships with the families because this is unique at school. You don’t interact much with the parents. Some people might say that that’s a good thing. If they’re in pediatrics, you can treat the child and deal with the child. Meeting the family, parents, siblings and being you become part of their lives when you’re their pediatrician, you get invited to their birthday parties and you get Christmas cards. You feel sometimes like you’ve become part of their family. It’s a little bit more of a personal connection when you’re in practice in the community versus in the school, you can make a bigger ripple effect but it may not feel as gratifying and rewarding as getting to affect a family, have them see your heart and have a human connection.

What is your typical day like in this role that you’ve been in as a school physician and medical director?

This is going to be an atypical year with all the Coronavirus guidelines but a typical year would look like starting off the year collecting medical updates and reviewing all our chronic kids who have diabetes or any chronic medical condition like allergies or asthma. We’ll make sure that they have care plans and emergency action plans in place. If we notice that there’s a child in first grade who has severe food allergies, we invite all their teachers to come in and get trained on what that looks like in case they’re having an anaphylaxis reaction like a severe food allergic reaction.

We’ll even train them on pillows on how to use EpiPens. We want to make sure that we do a lot of education to make sure that everyone who’s going to be responding first to a kid’s emergency, they know how to reach us and what to do. There’s a lot of education at the beginning of the year. We even go to the classrooms and give some slideshows on basic hygiene. It’s a little step up with wearing masks properly, cough etiquette and physical distancing. It’s going to look a lot more intense with Coronavirus but those are things that we did anyway.

It’s basic hand hygiene, how to keep our immune systems robust, get your healthy diet, make sure you’re getting enough sleep and all that stuff that we like to reiterate to students to start out on the right foot. As the year goes on, we are scheduling those mandated physicals that they have to have at certain points in their developmental ages throughout the year. We’ll also work with the athletics department because the kids are heavily involved in all kinds of sports especially the high school kids and they practice competitively. We’ll help them set up their concussion testing and make sure that we do some proper risk management if they’re prone to certain injuries that they’re getting hooked in with therapy if they need it to get them ready for their season.

In every aspect of health, we have a big obesity epidemic. Even in the UAE, we have high rates of diabetes mellitus. High blood sugar amongst the population here. We work hard to push out the importance of exercise. We’ll even work with the food vendors and say, “We don’t like that you have this on the menu, can you switch it to a healthier choice?” It’s nice that they’ve asked for our input and our advice when it comes to setting up the cafeteria for the kids.

Since it’s a campus, are you also a first responder to any events that happen? Things like a kid does get a concussion, they pass out, someone faints or a seizure.

What’s different for me is I’ve had to be the first responder to adults as well. It’s a long time since I’ve treated an adult so I do rely on the nurses who have a little bit more experience than that. We’re the first responders for the students, all the faculty and staff. Many teachers do faint in the first week of school, believe it or not. We bubble wrap everything on the playground and yet someone will find that jetting out the edge and cut their head on it. There are plenty of emergencies and injuries that we do respond to on campus. We stay busy.

HCDM 25 | School Physician

School Physician: As a school physician, you the ability to affect children at the most sensitive times in their lives, which is those 13 years that they’re going through school.

 

Leading up to this conversation that the idea and the role of a school physician have been around since the 1800s. Obviously, that has grown over the years in terms of what your responsibility is. It’s great that you’re a public health advocate. You’re involved in nutrition and orthopedic-like related injuries. A lot of pediatrician-related issues like shots and how you detect certain rashes? Do you think only a pediatrician is qualified to fill this role or specialization in medicine, the best fit for this type of advanced role?

There was a doctor who was part-time before I joined and she moved back to the US. Her kids also went to school. She was an emergency medicine doctor. The nurses who have seen both of us and how we practice is hilarious for them because she didn’t raise an eyebrow unless someone was in shock. Meanwhile, if a kid comes in with a sore ear, I can’t wait to look at it and tell them whether they needed antibiotics or not or whatever. They’re like, “Do you like seeing kids?” I’m like, “Of course, this is what I do.”

An emergency medicine doctor could be, in many ways, excellent for the role but may find the pace a little bit slower than what they’re used to. They would be well trained in first aid, emergency response and someone who majored in public health. I have a Master’s in Public Health. I forget about a doctor. One of the nurses has a major also in public health. I sit down with her every time we need to write a new policy especially now, we’re writing policies almost daily related to COVID-19. I’ll sit down with her and say, “Do you like my policy?”

She’ll tear it apart like, “Where is the purpose? This is how you write a policy.” I’m like, “How do you know that?” She said, “This is Public Health 101.” I’ve had to learn on the fly some of these skills, but someone coming from a public health background could be important in a position like mine. You can come at it from many different angles like family medicine, pediatrics make sense because it’s mostly children you’re seeing or emergency medicine.

Your career trajectory is what I want to highlight. You are a pediatrician but you took this other responsibility and turned it into a career. Do you recommend this type of what you’re doing for a future physician?

I do. At first, the career switch felt a little bit daunting. I compare it sometimes to my friends. I felt like I cut the umbilical cord. Leaving practice and the families felt overwhelming. I was emotional. I wasn’t sure I was making the right decision at that time. I was nervous honestly because whenever you take a leap, you’re leaping into something unknown and it’s not what you’ve done before, it’s a little bit scary but after I’ve gone through it, I’ve never looked back. Every day, I’m happy to work with the team that I work with at the school. I love it.

I would encourage and recommend a career path. Either a complete switch like what I did. I do still have some ties where I work part-time in an outpatient clinic as a pediatrician. That way, I feel like I can still stay connected. For a lot of the kids who go to school, I was their pediatrician in the first place. It’s been nice to be able to keep those connections but I would recommend it and people can do it in many different stages depending on the size of the school they might be joining or consulting forces. Someone might want to keep their full-time job and do it the other way around.

Their part-time job might be something in school health but I do think a pediatrician’s voice or a doctor’s voice in school health is important. Once we’ve gone through our training, we are experts in what’s good for child health even if we don’t realize that we have those skills, we do have gone through our training and we have the right intentions, you can say. Ultimately, we want this child to be healthy. This is why we’re advocating for a vaccine. We’re not trying to be stubborn or heartless to inject kids with needles with vaccines. We know that this is the best way to protect them. It’s a great field if you believe in that final outcome of what you want to see happen. You can move people in that direction a little bit faster with education.

It’s also great that you see the impact of what you were doing on the ground as a pediatrician. You take a step back and you say like, “I can see my impact as more of a public health advocate in this sense.”

All doctors promote the flu shot every year. Now that we’re in the midst of a pandemic, we don’t encourage it. We want you to get your flu shots this year. I talk to my team and I said, “What can we do?” We decided we’re going to bombard our families. Every time there’s a communication coming out of the school, every place on our websites, we’re going to remind people to get their flu shots. The minute they’re in and they’re at doctor’s offices, we’re going to remind people. Our voices can reach our patients and they can be loud when we’re coming from this angle of the school.

You went to the American School of Dubai when you were in high school and you grew up in Dubai. At that time, were you a student that was already thinking about going into medicine and healthcare and being a physician?

Not only did I know I wanted to be a doctor, I knew I wanted to be a pediatrician.

How did that come about? Were your parents encouraging you?

I don’t remember the exact moment. I dreamt it up a long time ago that I wanted to be a doctor and I wanted to help kids. That’s what my parents told me I used to say all the time. My parents encouraged me when they heard that. They’re like, “You want to be a doctor. What can we do to help?” They played a huge part in supporting and paving the way to help me get there. I remember asking my mom like, “What does my name mean?” She goes, “That means little mother.” I supposed I’m destined to be a pediatrician then. It was a long time ago. Early on, I didn’t know if I wanted to be a teacher, biologist or pediatrician. I thought about those three fields because I loved science, guiding and teaching others but then I knew it had to be something to do with kids. In my head, it pieces together as well. A pediatrician fits all of that.

A doctor’s voice in school health is important. They are experts in child health and they come from a place of good intentions. Click To Tweet

What kind of student were you, Omaima, in college? Were you one of those nose to the book? How would you describe yourself?

I worked hard. I mellowed out when I realized that there’s more to life than worrying about the grade. My academic advisor is someone who was one of my mentors. He’s a marine biologist and he happened to be my academic advisor. He used to tell me, “You don’t have to be perfect at everything. Do your best, work hard and study what you love.” I thought that was good advice because he studied snail tongues. It’s a bizarre field but he’s the expert until this day if you want to know anything about snail tongues. It’s fascinating research for that niche and he’s the person you would want to talk to if you had any questions about it, but his point was like, “It’s not the end of the world. Try to pull back and look at the big picture. You have your goal in mind and don’t worry about the small things. You do have to work hard, keep that final goal in mind and don’t stress over the little things

What would you have done differently if you have to look back on how you got to where you’re at?

I would have tried to do more internships when I was in high school not because it would have changed what I would have gone into but I feel like it would have prepared me a little bit better for what to expect and what I wanted to get out of each of my rotations. It’s not possible sometimes to access those internships especially in the healthcare field with all the confidentiality issues but I wish I did more within the field of Pediatrics as a student to reinforce. Shadowing not a general pediatrician but shadowing all the different sub-specialties within the field. I would have hated to be the person. One of my friends decided to go to Hollywood after anatomy. You feel like you wasted all those years. He didn’t want to do medicine but sometimes that realization can happen earlier on when you see what you’re getting into.

It’s when you do your research and due diligence. Your friend wants to be an actor and quit medical school.

The sad thing is he had the highest grades in our entire Anatomy class. We’re like, “You don’t even try. It comes easy to you.”

Omaima, I want to go through some brief questions if you don’t mind. It’s fun questions. It’s nothing too stressful. Whatever comes to mind first is an answer. Would you rather be able to speak every language in the world or be able to talk to animals?

I always say to speak every language in the world.

You speak English and what else?

English, French and Arabic.

What’s your ideal outside temperature?

In Fahrenheit, about 75 degrees.

If you could travel back in time, what period would you go to?

The 1960s.

HCDM 25 | School Physician

School Physician: You can come at it from many different angles, but pediatrics makes sense because it’s mostly children you’re seeing.

 

Favorite ice cream flavor?

Chocolate chip.

What’s something you could eat for a week straight?

I don’t think you’d know this dish but it’s stuffed squash with rice and meat. It’s called Kousa. It’s delicious. It’s a Lebanese dish.

You could eat that straight for a week?

I could easily.

What’s the best age?

I love four when kids start telling stories and you start to learn their personality. Four was one of the most fun times of our lives like figuring out who they were as people. They’re past the tantrums and they’re turning into cute kids again.

If you could ask God one question, what would it be?

Why Coronavirus?

How long would it take you to get ready in the morning?

Twenty minutes.

Finally, if you’re stranded on a tropical island with two things, what two things would you want with you?

I’m laughing because my kids play this game with me all the time. Music and a microphone.

You don’t have to be perfect at everything. Do your best, work hard and study what you love. Click To Tweet

A karaoke situation here.

Much to the embarrassment of my children.

Omaima, thank you for being on the show. I learned a lot and people have learned a lot about what you’re doing. You’re helping your school out tremendously especially with Coronavirus kicking in. It’s such a learning experience for you. Thank you, Omaima. I appreciate it.

Thank you. You’re welcome.

To learn more about our guests or other past guests, check out my website HealthCareerswithDrMarn.com or HCWithDrMarn.com. Go to my website, add your name and email to my email list. That way, you can get the latest announcements and news as they arise. You can also find me on Instagram at @DrRichardMarn. Thank you. I’ll catch you next time.

Important Links:

About Dr. Omaima Maaliki

HCDM 25 | School PhysicianMD, FAAP, Specialist Pediatrician

Hamilton College, NY (B.A in Biology & French)

Medical College of Virginia (Doctor of Medicine)

Tufts NEMC Floating Hospital for Children (Pediatrics Residency)