In early 2006, Karam made the final table of the European Poker Tour Grand Final and finished fourth. The extra cash gave Karam enough of a boost in confidence and bankroll to quit his job and become a professional poker player.

Since then, Karam made a World Poker Tour televised final table at the North American Poker Championship as well as a final table at the Aussie Millions championship; he placed sixth in both. Karam went back to the EPT Grand Final, after a year of playing poker professionally, with the goal of besting his fourth-place finish. Incredibly, he did, and finished as the runner up, which came with a more than $1.4 million prize. Karam is also a contributor to Card Player Magazine.