Q&A: Meet the DO helping physicians practicing in Iran use the DO title

Sohayla Rostami, DO, spent much of her childhood visiting Iran, where her parents lived until immigrating to America before she was born. She attended EMT training and volunteered in a Tehran emergency room before enrolling in osteopathic medical school and entering training at St. John’s Episcopal Hospital in New York City, where she’s currently a second-year surgical resident.

Despite that fact that she holds a DO degree, Dr. Rostami would be required to use the MD title if she returns to practice medicine in Iran someday. That’s because although osteopathic physicians have full practice rights in Iran, the country’s only government-recognized designation for physicians is MD.

A few years ago, Dr. Rostami took initial steps to change this fact by opening a dialogue with the Iranian Health and Medical Education Ministry about gaining recognition of the DO title for osteopathic physicians practicing in Iran—a development that would also benefit DOs and osteopathic medical students who intend to practice there.

In this edited Q & A, Dr. Rostami discusses her international advocacy work, her experience volunteering in Iran and commonalities between the two health care systems.

What first got you interested in starting a dialogue with the Iranian medical community?

Iran takes a very whole-person approach to medicine that parallels the DO approach to patient care. Our training and modern technology could work really well with what’s currently being practiced there. Their health care system is pretty advanced and their medical education is good, and having osteopathic involvement in their medical system is a strong addition.

I wanted to see if there was anything I could do to help DOs gain full recognition of their titles. With proper documentation and information from the AOA’s Department of International Affairs, I set up a meeting with the Iranian foreign minister of health and medical education.

What did you discuss in that meeting?

I explained to him what osteopathic physicians are, what our training entails, and what we do in practice across all specialties. He noted that there are osteopathic physicians who practice in Iran, but they are only referred to as MDs. What they essentially have to do is a three-to-six month rotation and prove that they have graduated from a U.S. medical school and completed a U.S. residency. Iran doesn’t have a definition for DOs yet. Not that they won’t let them work, but they just don’t have a state-recognized title that represents what we do. Therefore, the minister defaults to the MD title when providing licensure.

The minister asked about our whole-person approach to patient care. He was very open to having discussions and hearing our proposal. A lot of the hurdles are just logistics and administrative work. I’m still working with them. I’m optimistic that we will make headway in the near future.

What was your experience like volunteering in an Iranian emergency room? How does it compare to working in health care in New York?

The patient populations, illnesses, injuries and available resources are very different. In New York and large U.S. cities, a lot of traumas result from gunshot wounds. This is in contrast to Iran, where the volume of gunshot injuries is much lower as guns are banned there. Therefore, many younger physicians in emergency medicine and surgery are not familiar with the treatment for gunshot wounds. In Iran, motor vehicle accidents are much more prevalent, so treatment of polytrauma from that mechanism is more well-known compared to some U.S. locations.

On the other hand, the medical vernacular is consistent with what we use in the U.S. Regardless of where you might be in the world, the foundation of medicine stays the same and it’s nice to have that as a way to communicate with colleagues in medicine. But of course there are going to be different people, different pathologies, different responses to pain or recovery and different resources for treatment between the two countries.

What would it mean for American DOs to be able to practice medicine while using the DO title in Iran?

Iran would become an additional voice in the global medical community to properly recognize DOs based on their distinct training. Osteopathic physicians are at the forefront of medicine and have been since the degree was established, so it is only appropriate that they are addressed correctly.

Also, it would raise awareness on two fronts—Iranian patients would learn about DOs, and more American DOs would realize that practicing medicine in Iran is an option for them.

Through my AOA contacts, I learned that other DOs are interested in practicing in Iran, but didn’t know they could go there. Getting access to the DO title would open a lot of channels for a lot of people, not just those with Persian heritage, but anyone who’s inclined to go there. Earthquakes are very common in Iran, so it would be nice for the medical community to be able to go practice there without a restriction, to be of assistance and even teach.