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Alumni Spotlight: Arman Sabet, MD

Tuesday, January 16, 2018

Our first Alumni Spotlight of 2018 shines on Arman Sabet, MD, who completed his residency and EMG fellowship at Duke in 2000 and 2001 respectively. Now at the Gold Coast University Hospital on Australia’s Gold Coast, where he provides a mixture of inpatient and outpatient care. Sabet talks to us about why he enjoys the diagnostic nature of EMG and nerve conduction studies, and how the U.S. and Australian health systems compare. He also reflects on his time as a resident and fellow and shares his loves of the beach, being a Duke fan and family time when he’s not at work.

What are your current medical responsibilities? What does a typical workday look like for you?
I work at Gold Coast University Hospital which is a public hospital affiliated with Griffith University on the Gold Coast in Australia. The city has a population of about 500,000 people with a referral base for neurology of about a million people. There are 6-7 neurologists working here and we all take turn for inpatient work. The outpatient is fairly divided into subspecialties and I do the bulk of nerve conduction studies/EMG, neuromuscular disorders and botulinum toxin injections.

How did you first get interested in neurology? What about the field interests you the most?
I did my neurology rotation at the end of third year of medical school and I enjoyed it very much. I liked the “localise the lesion” approach of neurology, remembering various neuroanatomical pathways. Although we now often rely on MRI to do that for us, I still think clinical examination is a big component of making the right diagnosis in neurology. Electrophysiology, and in particular nerve conduction studies and EMG is the most interesting to me.

What do you enjoy the most about your current work?
I enjoy the diagnostic nature and logic of NCS/EMG. Also, patient satisfaction from botulinum toxin injection is very rewarding. There are not many fields in neurology in which we can make such a big difference in how patients feel.

What was the biggest work-related change you encountered when moving from the U.S. health system to that of Australia?
Australian health care system including the neurology training is very different than the US. There is a universal health care/medicare funded by the state and federal governments but many people also have private health insurance which allows them to receive care at private hospitals. Private setting has much less waiting time for services such as elective surgeries. I think the level of expertise and technology is similar in both countries but they are more limited in numbers in Australia.

Neurology is a subspecialty of internal medicine, just like cardiology, GI, endocrinology, etc. This means that medical students will need to train in internal medicine (basic physician training) for 3-4 years first and then apply for neurology training/fellowship which is an additional three years of training. This initially created a big problem for me when I moved here 11 years ago as I did not have enough “internal medicine” training. I had to convince the Royal Australasian College of Physicians that I was competent to practice as a neurologist and leave general medicine alone!

How do the neurology needs of the two countries compare?
There is certainly a shortage of neurologists, in particular in non-metropolitan areas in Australia. Public hospital wait time for outpatient appointment is long, sometimes months. Patients need to be referred to specialists by their GP/primary care physician so is no self-referred neurology patient. However, as mentioned before, the level of technology and available diagnostic tools is very similar to the US.

When did you complete your residency at Duke? How did your experience as a resident prepare you for your current work?
I finished my residency in 2000 and stayed for a year of EMG/Neuromuscular disease fellowship. Then I joined the faculty at University of Kentucky department of Neurology as residency program director until 2006 when we moved to Australia to be closer to the extended family. I started as staff specialist at Gold Coast University hospital and became the director of the department couple of years later. After seven years, I stepped down as the director to concentrate more on my clinical and research interests last year.

I think my training at Duke was excellent. We worked hard and for many hours (well in excess of 100 hours per week) but we learned a lot as well. My fellowship was particularly helpful as I am the main neurologist doing EMG/neuromuscular and chemodenervation work in our area.

What’s one memory from your time as a resident that stands out the most?

Playing my first game of softball when I was an EMG resident. Kevin Morley had organised a team of residents and EMG technicians. If I recall correctly, we lost every single game!

What passions or hobbies do you have outside of work?

I try to spend as much time with the kids as I can. My son and I play soccer and basketball. Still a Duke fan! Beach and water activities are also fun. It is hard not to get into those if you live here.

Sabet and family (wife, Houta, son Aryan, and daughters Tara and Nava) pose during a visit to Australia's Great Barrier Reef.

As a resident, Sabet (left), enjoys a party with colleagues Gandis Majeika, MD (center) and David McDonagh (right).