Learn more about the Meta-Analysis Academy: https://is.gd/BM9Xdm.In the #21 episode of MetaCast, we welcome Dr. Rafael Ayala, a cardiac surgeon from El Salvador now practicing in Germany. He shares his remarkable journey from a working-class upbringing to training at top German institutions, overcoming language, cultural, and academic barriers along the way. His story highlights what it takes to succeed as a foreign medical graduate in one of the most demanding surgical fields.We discuss the process of getting into residency in Germany, work-life balance in surgical training, and the importance of building a research-driven career. Dr. Ayala also shares how his first meta-analysis, developed through the Meta Analysis Academy, was cited in European guidelines—demonstrating how structured, meaningful research can create real clinical impact. 

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