Dr. Samer al-Sheikh anxiously looked at the photo of himself on his phone. The doctor pictured at the operating room was now almost unrecognizable to him.

“I lost everything,” he said.

After fleeing the Iraq war at age 16, Dr. al-Sheikh built a life in Ukraine as a trauma surgeon, gaining admiration for his work at the City Clinical Hospital in Kharkiv even as the Russian shells began to fall.

But now, the needles of job rejection emails, not running heart monitors, mark his time. After leaving Ukraine in March 2022, he is once again a refugee, this time in the UK, struggling to make a new start with his family and unable to find a medical position that matches his skills.

“When you have to lose twice, not every person can handle that. But I didn’t want my family to see what I saw in Iraq,” said Dr al-Sheikh, 33, who had a temporary job unloading trucks at a London supermarket, but is now unemployed again.

“If nothing works here, we will have to go back to where we are valued,” he said, referring to Ukraine.

With many Ukrainian hospitals operating with skeleton teams, some doctors who fled the conflict are considering returning and using their skills again. But for those with families, the question is complicated by the fear of putting their loved ones back in harm’s way.

“If I had been alone, I would not have left Ukraine,” said Dr. al-Sheikh. “But my wife asked me to think about our daughter.”

Hampered by language barriers and an arduous recertification process — Dr. al-Sheikh cited an 800-page application form he would need to complete — many doctors who have left Ukraine have given up working in medicine altogether, refugees say. Instead, highly qualified medical professionals often take low-skilled jobs just to get by.

Andrew Geddes, the director of the Migration Policy Center at the European University Institute in Florence, Italy, said it is not uncommon for highly qualified refugees to struggle to find jobs relevant to their skills. “Without the possibility of meaningful employment, you’re pretty much confined to the margins,” he said.

There’s even a term for it, he added: “Brain waste.”

In Dr al-Sheikh’s apartment in West London, the remnants of his past life are never far away: an engraved pen given to him by a patient whose life he saved; reams of medical records detailing the thousands of hours he spent at his profession.

He opened a cupboard and pulled out a box full of surgical tools, then explained what each tool was. But he was of little use to them anymore, he said, replacing the box.

He said he went to the job center and told them he had three majors. “They invited me to come to a job fair, so I took all my diplomas and went,” he said. “But it was like a bad joke.”

“They offered me a job as a cleaner at the hospital,” he said.

While many Ukrainian doctors are struggling to find medical work in the UK, the country’s National Health Service has been hindered by severe shortage of employees which contributed to long waits for treatment.

In the months after Russia’s full-scale invasion of Ukraine began in February 2022, online job boards across Europe filled thousands of offers for Ukrainian refugees; governments have waived visa requirements to make it easier to find employment. But a year later, for many Ukrainian professionals, the road to integration has been longer and more frustrating than they expected.

Dr. al-Sheikh spends his days handing out summaries. His mornings almost always start with a rejection email, he said. One recent day, it was for a receptionist role at a doctor’s office. Before that, he failed to get a hotel management job.

The voluminous application he must complete for re-accreditation requires detailed proof of his medical career, including patient names and contact details, which are difficult to obtain during the war.

“I’m doing my best,” he said, but he added that the situation has led him to seek treatment for depression..

These days, his wife, herself a cardiologist, bakes and sells cakes to help support the couple and their 8-year-old daughter, Dalia. Their weekly government allowance of 300 pounds, about $370, is not enough to survive, he said, but he remains grateful to Britain.

Draped over his balcony, a flag commemorating the coronation of King Charles III flutters in the breeze.

Dr Roman Cregg, the president of the Ukrainian Medical Association of Great Britain, a support and advocacy group, admitted that restarting a career as a doctor in the UK was difficult.

“The prospect of working here is not immediate, and many doctors have been unsuccessful,” he said, adding, “It could take years.”

“It’s very boring for them to just sit here,” he said, and the anxiety has increased because the doctors “see that their skills are needed back home.”

According to United Nations estimatesabout 47 percent of Ukraine’s eight million refugees have a university or other higher education qualification.

The overwhelming number of Ukrainian refugees, including medical professionals, are women, about 90 percent, according to the UN Human Rights Council. Many of them are accompanied by children who fled with them.

Dr. Svitlana Sadova, a cardiologist and single mother of 16-year-old twins, has spent two decades treating patients affected by the Chernobyl disaster in 1986. It’s a world away from her most recent role – scrubbing dishes in a restaurant kitchen on the outskirts of London for about $12 an hour.

“How could I have found myself in such a hopeless situation?” said Dr. Sadova, 45.

“I had a good life in Ukraine,” she added. “If I wasn’t responsible for my kids, I’d probably go back by now.”

By the end of most restaurant shifts, she said, she couldn’t feel her hands. Her hourly wages were barely enough to feed her family, let alone call a taxi home to the village in southeast England where she, her twins and her mother live with a host family. Instead, without convenient public transportation, she often walked the two miles in the dark.

She later left that job and is unemployed again.

For more than a year, she made repeated trips to hospitals to hand out resumes, but she said no one called her back. Sometimes, the frustration overcomes her.

“Some people tell me I’m strong,” she said, sobbing. “But I’m tired of being strong.”

Some Ukrainian doctors have already made the decision to return home. The International Organization for Migration ratings that 5.6 million people who fled Ukraine returned – mainly elderly people who struggled to adapt abroad.

Even for younger doctors who fled the Russian invasion, it can be difficult to find suitable work.

Diana Beliaeva, 24, says she dreams of becoming a family doctor. After working for eight years at the Bogomolets National Medical University in Kyiv, the capital of Ukraine, she took her final exams far from Sweden last summer.

Now living in Dundee, Scotland, Ms Beliaeva said she struggled to find work that matched her experience. The only option was a job as a health care assistant, but that mostly meant cleaning up after other doctors, she said.

“It’s really overwhelming,” Ms Beliaeva said. “Why did I spend so much time studying and now I can just change beds?”

She struggles every day with her decision to leave Ukraine.

“We are doctors, and now we have to beg for money from the government,” she said. “You feel like you’re doing something wrong in your life.”

Despite the setbacks, Ms Beliaeva said she still has hope and remains determined to pursue a career as a doctor in the UK.

“I want to give back to this country,” she said.

Anna Lukinova contributed reporting.

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