It is overall ok, but there is some adjustments you can do.
-If you want to have something else than just the doctor pasted on a bacground, you can: Duplicate the layer a couple of times, smudge the underlaying layers, add a filter or two and it will look brilliant. -Maybe use some effects on the text layer. -Work a little more when you are using the Wand/Lasso tool. -Fiddle with the lighting tools and filters as long as the background goes.