One neurosurgeon in a country with an 11.000.000 population and only one CT for the whole country is not the most desirable scenario to encourage you to become a neurosurgeon and then try to develop Neurosurgery in a difficult context. It was about Rwanda. See how a young and talented doctor is accomplishing this endeavor after her residency program in one of the WFNS Training Centers.

Claire Karekezi

You recommend that all young medical students never give up on their dreams or let anyone discourage them. Have you ever been discouraged?

I studied General Medicine in Rwanda, my country by the time I dreamt of becoming a neurosurgeon in 2007, we barely had 1neurosurgeon for 11M pop and 1 CT Scan for the whole country, so I had had little or almost no exposure to neurosurgery as a med student. When I was accepted into neurosurgery residency in Rabat, I had to learn everything from the very basic neurological examination to properly assess CTs and other imaging modalities, which usually you should master as a medical student. At each stage of my training in neurosurgery, I sometimes felt in a vulnerable position by not have had sufficient exposure but I was never discouraged to learn new things, I instead did my best to learn, adjust find good mentors to guide me and it was important for me to know that I was making progress. Sometimes we need just a little bit of validation.

Why do you place so much importance on the mentor in training?

Because when I thought I wasn’t ready enough, only “Mentors” picked up. I am forever thankful to those who invested their time in me, teaching me, those who acknowledged my presence knowing that regardless I will eventually go back to practice in my home country, if you think about it you would say why investing in her? So, I was lucky to meet these incredible people who not only believed in me but trained me and shaped me into a ready neurosurgeon. I remember each one of these Professors because they also built confidence in me. Teachers who invested less time in me, did not discourage me, they instead challenged and pushed me to learn more, this built more resilience in me.

What has the WFNS donated to your hospital?

The WFNS donated a drill and 2 sets of equipment (cranial and spinal).

This donation has helped us from moving to using manual instrument for craniotomes to an electronic system which is quicker and easier.

We thank the WFNS for this donation.

WFNS donated equipment

Do you think that, when we are students, we know the potential we can have?

We may, but at times we are confused, we are unsure of opportunities we have, we lack experience in the real world, why we really need mentors, coaches, teachers to accompany us.

How did you know you had the skills to be a neurosurgeon?

I first suspected I didn’t with my little exposure to neurosurgery, but I just had to one thing that makes you become a good one “PASSION” for it.  I heard many people telling me it’s a hard speciality, not for women besides I had nowhere to study at that time. It was an IMPOSSIBLE DREAM! The way things kept falling in place made me want to learn more about it, and I was easily able to pick up things quickly and learn new knowledge. Each door opened another one.

How do you plan to overcome the difficulties in Rwanda to fully develop your profession?

When I finished my training, I was sure I wanted to come back home, to also contribute to building neurosurgery here. It wasn’t easy because I had to build things from scratch and sometimes people do not necessarily understand what you need in terms of equipment, the team you need to help you. I had to create this environment and make it functional. I see many cases, most of the time the last decision is on me, I seek opinions and discuss with my former mentors who keep an eye on me. It has built more confidence in me. I feel ready.

I worry about career progression and continuous mentorship which I lack sometimes, learn new skills but I keep pushing myself for excellence, I keep myself updated, I read, I attend courses and conferences but also use all the online resources available, I keep discussing with other colleagues regarding complex cases. I still need to build my own learning curve and a solid team next to me to help me. I also wish to progress academically but it will eventually take time.

You say that your «guiding star» has taken you far beyond that your initial goal of joining one of the most demanding specialties in medicine. Tell us your story.

I am a normal african girl from a modest family with BIG DREAMS.

I was born in Butare, Southern Rwanda but I grew up in the capital city Kigali where I completed my primary and secondary school before going back to Butare for my medical education at the university of Rwanda;

From my younger age I knew I wanted to either become a doctor, a pilot or an astronaut, so when I started high school, I told my parents that I wished to pursue STEM related fields at that period I wasn’t completely sure which way I would choose to go. When I finished high school and had to choose a university option, it was at that time clear I wanted to become a medical doctor. I joined my medical training in 2002-2009 at the University of Rwanda

During my 5th year of medical school, I had a huge opportunity to do an exchange program as a visiting medical student in Sweden and to be in a department of Neurosurgery at the Linkoping Teaching Hospital for four weeks. I had planned to be in the department of Radiology, but during that summer period, most departments did not receive interns. Professor Jan Hillman who was the Head of the department kindly accepted me.

For the first time, I discovered the beauty of the brain attending numerous surgeries performed by him in person and he let me scrub next to him. This experience became an enormous inspiration that shaped my interest in Neurosurgery. I remember exchanging with him between surgeries, he said I could make an excellent neurosurgeon. He eventually wrote my first ever recommendation letter to Neurosurgery. He became my first Mentor!

Despite insurmountable difficulties to train and practice as a neurosurgeon in most regions of Africa and my country, I knew deep into me I would become a Neurosurgeon and I did not give up away my dream. Through perseverance, determination and patience while working as a GP in Kigali I kept looking for training programs abroad, that could accept me. It almost looked impossible to me. I remember most people telling me it is hard for a woman wanting that kind of training. 

I had heard about the World Federation of Neurosurgical Society (WFNS) and about their “Training Centers and Fellowships” at various institutions worldwide. The centre for Africa was located at The University Mohamed V of Rabat, Morocco and happened to be the very first accredited Center by the WFNS to train African Neurosurgeons, led by Professor Abdeslam El Khamlichi who later became my second mentor.

This revived my hopes for a chance to become a Neurosurgeon. I started emailing Prof El Khamlichi non-stop and the first response I got back from him was that the centre was full and not taking new applications. But that didn’t stop me; I emailed him consistently; finally, in April 2011, I was admitted. I was finally given the opportunity to specialize as a Neurosurgeon.

I joined the centre for a full five-year residency program in Neurosurgical Surgery. I completed my training in May 2016 and later joined my clinical fellowship in Neurooncology and Skull Base Surgery at the University of Toronto, Canada (2017/2018) thanks to Prof Mark Bernstein who sponsored me.

I came back to practice in my country at the end of 2018. I currently work as a consultant neurosurgeon at the Rwanda Military Hospital, in the capital city Kigali.

Is effort, determination and persistence the path to success?

I believe so, this worked for me and still does.

My story is a story of passion and perseverance chasing one dream that took me to Morocco and beyond, opening multiple doors, meeting incredible people. But also, a story of wanting to give back the opportunities that were given to me, shaping the future of other young female or male dreaming bigger, a story of Wanting, willing and possibilities.