Foreign Medical Graduates: Finding a Clinical Calling, and a Career, Through CDI

By Brian Murphy

Sulaiman Rasheed (“King Solomon,” or “Sully,” as his colleagues call him) took the long way to CDI. Literally and figuratively.

A native of Pakistan, Rasheed is a graduate of Gandhara Medical University. He once dreamed of being a doctor.

Today he has realized a dream he never knew he had—CDI professional.

Rasheed immigrated to the U.S. in 2014. He had hoped to get into a residency program and practice medicine, but the competition was too fierce.

The deck is stacked against foreign medical graduates (FMG), who are faced with long odds (30,000 applications for 7000-8000 open residency slots) and on top of that, often struggle with verbal and written communication.

“We don’t always present well in the interview,” he admits. “I came in, appeared in different interviews, and learned some skills. We don’t know the standards of resume in the U.S.”

His dreams of becoming a doctor squashed, Rasheed found work as a research associate, then as a first surgical assistant. But he was hungering for something else. One day a friend mentioned CDI.

“He was like, ‘What are you doing?’ At the time I was a surgical assist at a hospital in Ohio. He said, ‘why don’t you try CDI,’ and I was like ‘what is CDI?’” Rasheed recalls. “He said, ‘Google it.’ It opened things up… I really wanted to get in.”

Rasheed was finally given a chance by Prime Healthcare, a large organization which owns 45 hospitals across the country. Prime is FMG led, and a pioneer in hiring FMGs as CDI specialists, which is typically RN dominated.

“It was a really good experience, all the leadership and staff are FMGs, they have really good training for all the newbies in CDI,” he said. “After eight months I had personal family matters and had to move to a different city.”

Rasheed applied at Conifer where he works today as a CDI specialist. Although he is the only FMG on a team of nurses he doesn’t see that as a limiting factor. “My belief is, if you are confident in yourself, and you can defend yourself, you can work anywhere,” he said.

Rasheed says FMGs make great CDI specialists because of their intense clinical training. “I feel like I’m dealing with the patient. I have an eye on the treatment, lab findings, doctor notes, specialists like the nephrologist, pulmonologist, what they are concluding,” he said. “My clinical knowledge is actively being used, the treatment options, surgical operations. It’s very interesting and fascinating. If I knew what it was before starting out, CDI would be my first choice.”

He recalls his most recent interview at Conifer and nailing a clinical question that landed him the job.

“We always talk about it—they say ‘Sulaiman, you hit the right spot when you answered the right question about type of pneumonia,” he recalls. In the scenario there was no sputum culture, but the patient was administered broad spectrum antibiotics. Gram-negative pneumonia is DRG 177, higher than DRG 193. He passed the test.

Today he’s giving back, following in the footsteps of the late Rabia Jalal, who championed FMG CDI specialists for ACDIS. He leads a support group, a community of 200 like individuals on Facebook and WhatsApp. Most are working in CDI but others are trying to get in. His goal is to help others find work.

“I’m busy trying to bring people into CDI and bringing a change. I believe we can work alongside nurses and contribute a lot to this market,” he said. “This is something instilled in my genes. My father was a professor, a PhD, he always there to help others and impart knowledge. In my current position, I’m there because of someone. My thought is, if I’m helping someone, God will fulfill my needs. If I can give someone a little help in their journey, it’s worth it to me.”

He stresses the same message to every FMG looking to break into CDI: Be persistent, be patient, and be curious. And never give up.

“It’s not easy, you have to compete, you have to keep applying,” he said. “I didn’t restrict myself to one state or one city, it was with the intention to learn. It didn’t matter if the job was in Alaska, I just wanted to learn more about the field.”

He also says to not be discouraged if your first job is not CDI.

“When I talk to new FMGs, I say, just get into something. Don’t wait for CDI. Even a single day working in the U.S. healthcare system will benefit you. Take a job as clinical reviewer or chart reviewer, it will help you. If you have an interview for a CDI job, you can say, ‘I have experience with Meditech, or EPIC.’ Just get into something related where you can access patient history, treatment, laboratory findings, and plan of care.”

One common error FMGs make is their resumes, which make them appear as though they’re looking for work as a physician. Tailor them for CDI instead. “CDI employers are not looking for a physician, they’re looking for a CDI,” he says. “If your resume doesn’t match the CDI position, how can you expect them to pick up the phone and call people? You need to know the buzzwords.”

To learn the ropes Rasheed recommends getting involved in ACDIS, in particular the ACDIS CDI Apprenticeship program and the ACDIS Pocket Guide.

“There are a lot of resources, but no certification will give you a guarantee for a job, even the ACDIS CCDS, or CCS or CDIP from AHIMA. You have to compete for it, defend yourself, and be confident in yourself,” he said.

Contact Rasheed at farooqisulaiman@gmail.com