Dr. Pamelia Riviere

Raphaël Nahar Rivière became fascinated with medical professionals who treated him.    CBC (Canadian Broadcasting Corporation) News posted this article on May 24, 2019.    Raphaël Nahar Rivière graduated from the University of Ottawa's medical school on May 17. He was inspired to study medicine after surviving childhood cancer.  Rivière was diagnosed with Ewing's sarcoma, a form of bone and skin cancer, at age seven. He endured an 18-hour bone transplant surgery and rounds of chemotherapy, treatment that lasted months. It was a dark time for the little boy and his family, but there were also bright spots during his time at Toronto's Hospital for Sick Children. Rivière remembers playrooms, clowns, colouring books and visiting dogs. "At home we didn't have any video games, but at the hospital there was a Nintendo and I loved playing Pokemon Stadium," Rivière told host Robyn Bresnahan on CBC Radio's Ottawa Morning. He also became fascinated with the doctors who were treating him and resolved to become one. Kept up his studies Rivière kept up with his schoolwork while in hospital, and his oncologist and surgeon encouraged him to keep studying. He took their advice, motivated to learn more about his disease in particular, and medicine in general, so that he could help others the way he'd been helped as a child. "This happened to me, but I got out of it relatively unscathed. That's why I need to …follow this through a career." Rivière's mother immigrated to Canada from Bangladesh, seeking higher education and her children’s, Raphael and Kanita’s better health and education.  He was diagnosed three months later. 'It was very special' Rivière said his mother supported the family working a retail job and never let her son's illness become his focus. "You're sick. that's fine. But you're going to study," he recalls her telling him. She returned to school after Rivière had been cancer-free for 10 years and is currently working on her PhD at the University of Toronto. When he crossed the stage at the University of Ottawa to receive his medical degree on May 17, Rivière said he was thinking about how it wasn't an accomplishment he could have obtained on his own. When he embraced his mother afterward, she told him, "So proud of you. You did it! Congratulations, Dr. Rivière." "It was very special," he said, as CBC News reported.  

 Raphaël Rivière's journey is a compelling testament to resilience and hope. Before becoming an MD, his journey was tedious: Diagnosed at just seven years old with Ewing's Sarcoma in his left femur, he faced an arduous battle against cancer, a battle he was fortunate to win after undergoing rigorous treatment at SickKids Hospital in Toronto, Canada. Today, he stands proudly as a doctor, driven by his transformative experience and desire to help others. Raphaël graduated from the University of Ottawa's medical school on May 17, a milestone that encapsulates the culmination of his childhood struggles and his dream of becoming a physician.  His inspiration stemmed from the daunting challenges he faced while overcoming childhood cancer. In 2001, just three months after I arrived in Canada from Bangladesh, my son was diagnosed with this rare form of bone cancer. During that time, my husband had returned to Bangladesh to tackle his business responsibilities, leaving me to navigate an uncertain path in a new country. Raphaël frequently experienced debilitating fevers and excruciating pain in his left knee, prompting numerous visits to doctors and clinics for blood tests and X- rays.  Despite seeking various medications, nothing seemed to alleviate his suffering. Initially, the medical professionals we consulted were unable to determine the root of his pain—a frustrating scenario that persisted both in Bangladesh and Canada. In the early days of his illness, friends and family reassured me that it was merely a phase he would outgrow, a hope I desperately clung to during those harrowing times.

Yet deep down, my instincts raised alarms, whispering possibilities that masked a profound sense of fear and an intricate narrative unfolding before me.  Fate played a significant role in our journey to Canada: In 2000, while I was dedicated to completing my M. Phil in Anthropology, several universities offered me job opportunities. However, my supervisor encouraged me to pursue my studies abroad. In deciding to leave behind promising job offers, I never truly envisioned staying in Canada long-term; I always intended to return home after a few years. But life had different plans. I vividly remember one school day when my son, then in Grade 2, was reluctant to join his classmates on the playground due to the unbearable pain he was enduring. Unaware of his condition, school staff insisted he participate in outdoor activities, dismissing his discomfort as mere shyness or reluctance to socialize.

 “You can't stay inside and pretend to be in pain,” they told him. A mere day later, he found himself unable to walk to school. As a concerned  mother, I quickly sought help, taking him to a local clinic. He underwent routine blood tests and an X-ray of his knee, mirroring the protocol back in Bangladesh, only to be told that there was nothing physically wrong with him. The doctor remarked that my son was merely a “desperate youth seeking attention.”

My response was fierce and filled with disbelief, “How can you say that? How can a child fabricate such intense fevers for attention?” Seeking further validation, I insisted on a referral to a rheumatologist at SickKids.   It was during that pivotal first appointment that the gravity of our situation became clear: my son was diagnosed with bone cancer.  Two oncologists from the eighth floor came down to confirm the diagnosis, and I still remember Dr. Grant's calming words, “Mom, go home and do not worry; we will take care of him.” Yet, standing alone outside the SickKids Hospital, I felt an overwhelming mixture of terror and disbelief as I processed the gravity of the situation. Clenching my young daughter's hand with one grip and holding tightly to my son’s with the other, we returned home.

 Following a biopsy that confirmed the diagnosis of Ewing's Sarcoma, Raphaël underwent a complex operation to insert a metal port in his chest, a crucial step for the heavy dosages of chemotherapy that lay ahead. The routine of receiving IV treatments, accompanied by  numerous X-rays, CT scans, and MRIs, rapidly became a reflection of our daily existence—a whirlwind of medical procedures and emotional upheaval.Throughout these agonizing months, hope shone through as the tumour began to shrink, ultimately leading to an 18-hour-long surgery that would forever alter the course of Raphaël’s life.

 During this operation, eight inches of his left femur were removed, and a donor bone was inserted to ensure blood circulation, extending from above the knee joint to halfway through the ball joint of the hip. To further support the replacement, the fibula from his right leg was surgically connected to assist in the healing process, with a metal plate strategically aligned along the newly constructed bone structure, secured with numerous screws.  The journey through cancer treatment taught us the significance of community support—it was nothing short of astonishing to see how many people rallied around us, including family members, friends, teachers, doctors, and social workers. We were blessed to have survived this tumultuous ordeal, and I was especially grateful to envision Raphaël’s future and educational aspirations, just as every mother yearns for her child. Despite the trials, Raphaël continued his education, balancing studies in the hospital, at home, and eventually at school. His remarkable intelligence and determination shone through, as he was  identified not once but twice as academically gifted, prompting discussions about his inclusion in advanced educational programs.

 While I was proud, I hesitated to place too much pressure on him, wanting him to have the space to heal first. In high school, he received acceptance into the International Baccalaureate (IB) program and the Talented Offerings for Science Programme (TOPS). Ultimately, he chose TOPS, a testament to his deep-seated passion for the sciences and his ambition to make a difference. Motivated by his experience and the desire to give back, Raphaël founded the Youth Sarcoma Initiative (YSI) while still in Grade 10. This organization was born out of his passion to raise awareness and funds for the Hospital for Sick Children.  To support his mission, he organized a three-kilometre charity walk and an Art for Hope event, highlighting his belief in the power of community action.

His enduring message to others is encapsulated in his mantra: "I believe beyond belief." The 17-year-old stood out from the pack through tireless efforts to raise awareness and funds for a cause close to his heart. As a surviving patient of sarcoma, a rare form of cancer, he founded the Youth Sarcoma Initiative, aiming to promote understanding and education about this disease among his peers and the wider community.  TD Leadership Scholarship:  In the days leading up to the announcement that he was one of the 20 students selected for a prestigious scholarship, the Marc Garneau Collegiate Institute student had recurring dreams in which he envisioned himself celebrating a significant win.  His life took a remarkable turn when he received the life-changing phone call in late February while watching a movie with his family. Raphaël was among the select few chosen from a competitive pool of 3,400 applicants, marking an extraordinary achievement for this ambitious Grade 12 student.

The scholarship, valued at up to $70,000, will support his post-secondary educational journey, as he plans to immerse himself in the study of life sciences and human biology at the University of Toronto. With aspirations that reach beyond borders, he intends to participate in an exchange program at University College London and engage in critical research at Lyon University.   His commitment to global health is evidenced by his previous experiences working in developing countries such as Bangladesh and parts of Africa. In 2018, his medical team, which included Canadian physicians, residents, medical students, nurses, and pharmacists, successfully delivered $10,000 worth of essential medications to Bénin, West Africa, providing vital support to those in desperate need. Reflecting on my son's first day at Trinity College at the University of Toronto brings back vivid memories.

  Upon earning his bachelor's degree in Life Science, he ambitiously applied to five Ivy League schools and other top-tier institutions, including Yale, Columbia, Harvard, Oxford, Cambridge, and the Faculty of Medicine at the University of Ottawa, where he chose the French version of the program. Against all odds, he received acceptance into these prestigious programs, ultimately deciding to pursue a career in Medicine, a field that has long been his passion.  From a young age, he aspired to work as a doctor in underserved regions worldwide.  His dedication led him to become a Francophone doctor, enabling him to serve a diverse population in Canada and beyond. This dream transformed into reality when, on May 17, 2019, he proudly received his medical degree. Just a few weeks later, on July 1, he began his journey as an Anesthesiology resident at the University of Toronto, a significant milestone in his medical career.

Isn’t it wonderful to witness a child blossom into a determined young man who is now a physician, poised to make an impact?    Graduation from Kellogg College, Oxford University: Raphael’s past achievements were just the beginning of greater accomplishments yet to come. He has the potential to achieve even more in the future. On May 16, 2025, Raphaël Rivière celebrated another significant achievement when he graduated from Oxford University, earning his Master of Science in Medical Statistics. The path to this accomplishment was laden with challenges. Throughout his intensive five-year residency, he concurrently enrolled in the master's program at Oxford, balancing the demanding requirements of both roles.   We are thrilled to announce that Raphael has successfully graduated with distinction from the Master of Science in Medical Statistics program at Kellogg College, Oxford University.

Throughout his studies, he demonstrated exceptional analytical skills and a deep understanding of statistical methodologies, contributing significantly to his cohort. His dedication and hard work in complex subjects such as biostatistics and data analysis made us incredibly proud of his achievements. This accomplishment reflects not only his academic excellence but also his commitment to advancing the field of medical research.   Congratulations, Dr Raphael Riviere!  It added yet another remarkable accomplishment to his impressive list. The convocation ceremony at Oxford, a prestigious institution known for its rich history and academic excellence, celebrated his achievements with great fanfare. Surrounded by esteemed faculty, proud family members, and fellow graduates, he stood tall in his cap and gown, embodying the hard work and dedication that led him to this significant milestone.

 Raphael's sister, Kanita, a geophysicist, and other family members, including me from Canada, travelled to London and Oxford to attend his convocation ceremony.    Five Years long residency under the Temerty Faculty of Medicine at the University of Toronto:  While we were at Oxford, we received the news that he passed the Royal College of Physicians and Surgeons of Canada exam on May 22, 2025. And the convocation ceremony will be held on June 17, 2025.  The University of Toronto's Temerty Faculty of Medicine offers a comprehensive anesthesiology residency program within its Department of Anesthesiology & Pain Medicine. The program is one of the largest in North America and provides residents with extensive training in a supportive and rewarding environment. Residents benefit from world-class clinical experiences, a robust academic curriculum, and ample opportunities for scholarly productivity.

  Raphael was assigned to work for 5 years as a resident under the University of Toronto's Temerty Faculty of Medicine, which offers a comprehensive anesthesiology residency program. Raphael completed his residency period at several top hospitals in Toronto, including The Hospital for Sick Children, Michael Garron Hospital, Toronto Western Hospital, Toronto General Hospital, Women's College Hospital, and Sunnybrook Health Sciences Centre. He worked demanding shifts, often at night and up to 100-hour mandatory shifts.  As a concerned mother, I joined others in petitioning against 100-hour shifts, citing health risks. If doctors are not healthy, how can they effectively care for their patients? Residents must manage intense work hours alongside studying for evaluations, simulations, and the Royal College exams.  Raphael was required to study for and complete the United States Medical Licensing Examination (USMLE) after two years of residency.

Canadian medical students who pursue residency in the United States must pass the USMLE, which comprises three steps: Step 1, Step 2 Clinical Knowledge (CK), and Step 3. It should be noted that Step 2 Clinical Skills (CS) has been indefinitely suspended. Steps 1 and 2 CK are typically taken during medical school, whereas Step 3 is usually undertaken during the first year of residency. Step 1 is a one-day examination that evaluates whether the candidate understands the foundational sciences necessary for the practice of medicine.  The assessment also evaluates whether the residents can apply essential concepts of the basic sciences related to the practice of medicine, with particular emphasis on the principles and mechanisms underlying health, disease, and therapeutic modalities. The evaluation is divided into seven 60-minute blocks and is administered during an 8-hour testing session. For Canadian medical students, the USMLE Step 2 CK is a one-day, multiple-choice examination that assesses clinical science knowledge and patient care skills.

It is typically taken during the fourth year of medical school, although it can be completed earlier.   After completing the USMLE, Raphael enrolled in a Master's program in Medical Statistics at Oxford University. During this period, he continued his residency and prepared for the Royal College Exams. Royal College of Physicians and Surgeons of Canada Exam: The applied exams are conducted through a computer interface at the exam site. The Royal College of Physicians and Surgeons of Canada exam is divided into Part I and Part II, with an additional oral exam. Final-year residents from universities across Canada take the Royal College exam each year. The pass rate for fully Canadian-trained applicants is approximately 95%, while it may be lower for International Medical Graduates (IMGs).  The oral examination for the Royal College of Physicians and Surgeons of Canada (RCPSC) is widely regarded as challenging yet manageable. It requires a deep understanding of clinical reasoning, patient management, and organization, and generally results in a high pass rate.  

Proud Moment:  In June 2025, the Department of Anesthesiology & Pain Medicine at the University of Toronto's Temerty Faculty of Medicine held its convocation. Raphael attended the ceremony with his family. After 13 years of study, he received his certificate. Raphael received several job offers before he passed his exam. He will join St. Catherine Hospital in Niagara on July 01, 2025.  This dual commitment—residency at the University of Toronto Hospitals and a master's programme at Oxford—tested his resilience and dedication, marking one of the most challenging phases of his medical journey. Life is filled with countless opportunities for accomplishments, but those that emerge from overcoming adversity often stand out as deeply meaningful.

 As a Bangladeshi mother, I find immense pride in my role. I share a unique bond with other mothers who nurture and support their children's dreams. I am both thrilled and overwhelmed by Raphaël’s achievements. His most significant triumph—becoming a doctor after navigating life's toughest challenges—embodies his perseverance and dedication to his vocation.  To accomplish extraordinary things, we must not only dream but also act, not only have ideas and strategies but also strong faith in ourselves. I congratulate Raphael again with a few words:  Your current achievements are merely a prelude to far greater accomplishments that are yet to be realized. You hold the potential to achieve much more in the future.  Dr. Pamelia Riviere is a freelance writer and analyst.