The Two CTVS Surgeons

Dr. Dev (Fictional Name) when he was a junior resident (JR) in the Department of Surgery, AIIMS, New Delhi, was posted on rotation posting to the CTVS (Cardio-Thoracic-Vascular-Surgery) department.

He was to report daily to the operation theatre (OT) at 8.00 am and do alternate day ward duty in the evening and night. 

A Warning: Unlike, Dr. Shahid Hasan (Fictional Name) in The CTVS Selected Doctor https://agnipathdoctors.blogspot.com/2020/05/the-ctvs-selected-doctor.html, before the rotation posting, Dr. Dev had limited exposure to the CTVS department and the Surgeons working there. Even there, he was on the fringes, not privy to the life and thinking of the surgeons working there, so his impressions are at the least incomplete if not entirely wrong.

Professor P. Venugopal was the head of the CTVS department at that time and Dr. Dev was initially posted in Professor Balram Airan’s OT and then later posted to Prof. Venugopal’s OT. 

Before his CTVS posting, Dr. Dev thought that only the JR in surgery were the most hard-working doctors in AIIMS. 

He was shocked to see even the senior cardiac surgeons in the CTVS department working 14 to 20 hours a day. First, there were the pre-OT rounds to see the patients operated the previous days, then the long OT hours with the operation going late in the evening, then the ward rounds and in between the urgent call to see any serious patient or re-exploration for some complication in a patient operated before. This was in addition to the Out-Patient clinics, and the teaching classes and the research activities and, last but not the least, the administrative work. 

The stress, the tension, the long work hours was just unimaginable. Watching them work continuously where sometimes one-day changes to another workday without a break makes you feel that all cardiac surgeons are aliens or robots. 

After a few days, Dr. Dev noticed that not all cardiac surgeons are following the same routine of work, work, and work. 

While Dr. Dev was assisting Dr. Balram Airan in the first case of the day, a CABG (Coronary Artery Bypass Graft, or ‘Heart Bypass’), a senior cardiac surgeon entered the OT. As Dr. Dev later learned, he was Dr. A. Sampath Kumar. 

Looking around he remarked, ‘Oh, CABG. Looks quite complex.’ Midway in the operation with the most difficult part underway, Dr. Airan just made some acknowledging sound and kept on working. The Mch senior resident, perhaps to sound civil to his teacher, asked, ‘How are the cases in your OT, sir?’ Dr. Sampath replied, ‘I am going for lunch. The senior resident is closing the last case in my OT.’ 

This was a moment of epiphany for Dev. He started looking around and observed things that were a revelation.

Most cardiac surgeons in AIIMS used to post either a single case of CABG in their OT or in combination with a simpler (relatively) case like heart valve repair/replacement or ASD repair so that their OT finishes by early evening. Dr. Venugopal used to run two OT simultaneously and used to operate a minimum of one CABG case in each OT with sometimes even 2 cases in one of the OT. He had two teams of supportive surgeons, which will start and finish the cases while he goes from OT to another without taking a break. Sometimes his operation time gets extended to the night.

In contrast, Dr. Sampath used to post only a maximum of two or even one cases of heart valve repair or replacement in his OT.  He used to finish both cases before other surgeons used to finish their first case of CABG. So, he was able to have a leisurely lunch and have the rest of the afternoon free for his other work, while other surgeons were toiling in the OT. This enabled him to even have time to go to the college gym in the evening and play a game or two of badminton.

There were other differences as well. The patients for CABG were usually elderly, well connected, rich, or VIPs. The patients posted in Prof. Venugopal’s OT were usually big politicians, senior bureaucrats, the ultra-rich, or their relatives. The patients with CABG usually had other co-morbidities such as hypertension (Increased Blood Pressure) or diabetes, requiring much more close watch and care in the post-operative period. So, the surgeon performing CABG had to do frequent hospital visits and do close personal monitoring of his patients, keeping them busy and worried, and leaving them little personal time. In fact, even with a well-qualified team of doctors to take care of his patients, Dr. Venugopal used to stay for almost 18-20 hours in the hospital.

In contrast, the patients coming with a defective heart valve were usually from a poor socio-economic background. They were generally not so choosy or demanding as the patients coming for CABG. They used to get satisfied by the senior resident taking care of them and not demand the senior cardiac surgeon to attend them personally in the evening or night time. So the cardiac surgeon operating on them had a relatively relaxed mind and more free time in the postoperative period. 

But the opportunity for fame and fortune was in operating on the rich and VIP patients with CABG. Cardiac surgeons skilled in CABG operation were in high demand in the private sector with big pay packages.

So, choosing what surgery to do, how many to do, what kind of patient he will serve, Dr. A. Sampath Kumar was able to strike a work-life balance.

When it comes to your profession or work, what are you? Are you like Professor P. Venugopal or like Professor A. Sampath Kumar?

Whatever it is, remember: It is a question of your choice.

 

Don’t blame your job, your career, your industry, your profession for the lack of your time, or ill-effects on your mind or body. 

It is you who have chosen to give or not give the extra time to your work.

It is you who have chosen to relax or work hard for progress in your life or career.

It is you who have chosen to have success or peace from your profession.

It is you who have chosen to earn fame and fortune or obscurity and paucity from your profession.

It is your choice.

Love it or Leave it.

Please also read 'Where is the Time' https://agnipathdoctors.blogspot.com/2020/05/where-is-time.html

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The CTVS Selected Doctor

If you ask the students newly joining medical college what they want to ultimately do in life, chances are that you will get the answers that; they will like to cure cancer, became a cardiologist or neurologist, or a cardiac or neuro-surgeon. As time goes, many lose their passion or set their sights on something more mundane or achievable, but some keep the flame of their passion burning throughout their career.

One such person was Dr. Shahid Hasan (Fictional Name). A highly brilliant student, Dr. Shahid wanted to become a cardiac surgeon since the day he joined as an MBBS student in AIIMS, New Delhi. 

After clearing his first year, where they were taught only the non-clinical basic sciences, the second year started which had a mix of basic sciences like Pathology and also clinical postings. While most students in the second year restrict themselves to going to the wards during their clinical postings, Dr. Shahid started visiting the General Surgery minor operation theatre. By the 3^rd year, he started visiting the main operation theatre and by 4^th year he had started assisting in the major operations in the main operation theatre, a task reserved for the interns after clearing their 4 ½ year MBBS course. This was all the while having a brilliant academic record in all MBBS subjects.

During his one year internship, he started visiting the Cardiac surgery center to get an early start in learning cardiac surgery. There is no direct admission to the Cardio-Thoracic and Vascular Surgery Mch course (at least in India). One has to join and get a degree in General Surgery (MS) to be qualified for admission in the three years CTVS Mch course, which was also thru an All India level entrance exam.

 After completion of his internship with the extra CTVS experience as a bonus, Dr. Shahid joined as MS General Surgery junior resident (JR) in the Department of Surgery in AIIMS, New Delhi. Even when working as JR in the surgery department, Dr. Shahid took time out of his busy schedule and kept on visiting and learning in the CTVS department. 

Finally, the much-awaited moment arrived. In the final months before his MS general surgery exam, Dr. Shahid filled the form for the entrance exam for admission to the Mch CTVS course. As the course starts almost as soon as the MS general surgery course ends, the entrance exam was held sometime before the final MS exam. In the All India level exam with only limited seats, with both written and practical exam, Dr. Shahid, as expected was selected with flying colors. 

Once the result was out, Dr. Shahid’s joy had no bound. After all his lifelong goal was about to be realized. He was on the way to become a great cardiac surgeon like Prof. P. Venugopal, who did the first heart transplant in India. Shortly after the Mch entrance exam, there was the formality of the final MS Surgery exam which had to be cleared before he can qualify to join the Mch CTVS course. A joyous and confident Dr. Shahid appeared for the MS exam.

A few days after the MS exam, the result was declared. Dr. Shahid had failed in the MS Surgery exam. He could not join the CTVS Mch course as he did not have the qualification of MS Surgery. Dr. Shahid had to appear and clear both the MS Surgery exam and the Mch CTVS entrance exam again after six months.

Now the exam hall, including the practical exam ward, is a closed confidential area, so what exactly happened for this highly unexpected result is anyone’s guess. But there were rumors that Dr. Shahid got too confident about clearing the Mch entrance exam and took it for granted that he will pass the MS Surgery exam. His taken for granted approach, that as he had cleared the national level CTVS Mch entrance exam, he will easily pass in his final MS Surgery exam, hurt the sentiments of the General Surgery faculty members. A faculty member is believed to have allegedly made the remark while commenting on Dr. Shahid's result, ‘First learn general surgery before learning cardiac surgery’. 

No exam is too small that you cannot fail in it. A student, whoever brilliant, is never bigger than the examiner taking the exam. 

कोई भी एग्जाम इतना छोटा नहीं होता की आप उसमे फेल नहीं हो सकते, और कोई भी स्टूडेंट, चाहें कितना भी होशियार हो, अपने एग्जामिनर से बड़ा नहीं हो सकता। 

 

Be very careful in the twilight period between leaving your old position and joining a new one. Even though in the inside your heart may be jumping with joy on the prospect of joining the new course or position lying ahead of you, it is better to portray that you are saddened with the prospect of leaving your old position or institution till you get away with your full clearance or degree. 

This is especially important if your present teacher or employer can affect the joining of your new post. Have a balanced act and never in any way, directly or indirectly, belittle your present position, department, teachers, or employers in comparison to your future prospects.

But don’t lose hope. Dr. Shahid after successful completion of his Mch CTVS course from AIIMS, New Delhi, migrated to the USA where he is a very successful cardiac surgeon. Don’t let temporary hurdles discourage you as life is like a cricket test match and not a 20-20 match.

(Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

Where is the time?

Whenever a doctor advises his/her patient to do some exercise, do some relaxation and meditation, take better care of his/her body, the common excuse we hear is that, ‘I don’t have the time’. 

I received a WhatsApp message a few days back that stated,

‘After this lockdown, if you don’t come out:

With a better body, a new degree or skill,

Then it was never a question of lack of time

But a lack of discipline and will power.’

True?

Although the work of many essential service providers like doctors and other para-medical staff, the Police, the administration, etc., might have increased, many others are indeed having extra spare time on their hands due to the lockdown to contain the coronavirus infection. Even those working from home are saving time in traveling to and from their offices. Out of these, how many have done the things they had justified not doing previously because they did not have the time?

Deep down I knew it to be true, as I had seen this in action right in my post-graduation (MS) days.

Dr. Dev (Fictional Name) was MS Surgery Junior Resident in AIIMS, New Delhi. This is the same AIIMS whose junior residents had challenged Indian Prime Minister Shri Narender Modi Ji to work a single day like them. Under the pressure to complete the Sisyphean task of the ward work to the perfection of the senior resident and consultants, Dr. Dev and his fellow junior residents like Dr. Murari (Fictional Name) struggled to find time to eat even a single full meal in a day.

In contrast, on many nights, the same unit’s final year junior resident, Dr. Robert Gupta (Fictional Name), even before the evening round started had done half the work, finished most of the work within few minutes of completion of the senior resident’s evening round, and then giving a list of the remaining work to be completed to Dr. Dev and Dr. Murari, he will be off to dinner with one of his lady friends.

While Dr. Dev and his fellow junior residents struggled to have a decent meal a day in the hostel mess, Dr. Robert was able to find/create time to take his lady friends to dinner in restaurants. So it was a question of prioritizing, smart work, short cuts, delegation, not running after the impossible target to complete the ward work to perfection and not just lack to time, which Dr. Dev was too stupid to realize at that time.

Wait! You are probably shouting now. A young male under the influence of his male hormones and driven by the passion of love can accomplice impossible tasks. The same cannot be applicable to doing things like exercises and self-improvements.

For that we will have to hear the story of another junior resident, Dr. Biplab Mishra, who joined as a junior resident in the Department of Surgery, AIIMS, New Delhi, around the same time period.

During the residency, the junior residents are posted in different departments of AIIMS, such as CTVS, Neurosurgery, Urology, Orthopaedics, etc. Since the junior resident is seen as a visiting doctor on their rotation postings, some department gives some more free time to the junior residents on rotation as compared to the parent general surgery department. Instead of wasting this relatively free time in just watching movies and TV, Dr. Biplab, when on rotation used the free time to do the basic course of Meditation and Pranayama (Yogic Breathing Exercises) and Sudarshan Kriya® of the Art of Living Foundation.

During the course, the instructor highlighted the importance the doing the yogic exercises daily without a gap of even a single day. If the person misses doing the daily Kriya even for a single day, the cycle gets broken and the beneficial effects on the mind and body get interrupted. A person has to start counting again as day one when he restarts doing this yogic practice once again. Also, the entire breathing exercises, which take around 40 to 45 minutes, have to be completed without any interruption; not even opening the eyes or talking to someone.

Unperturbed, Dr. Biplab resolved that he will do the pranayama and Sudarshan Kriya® daily without any gap. When people learned of his resolution, they thought that it is impossible to find the uninterrupted 40 to 45 minutes daily to do these yogic exercises while working as a junior resident in the Department of Surgery in AIIMS.

With the great determination that there should not be even a gap of a single day, Dr. Biplab Mishra managed to do this Pranayama and yogic exercises daily even when working as a junior resident in AIIMS, New Delhi. Even now, while working as Professor in AIIMS, New Delhi, Dr. Biplab takes time out from his busy schedule to practice his daily yoga exercises.

These two example shows without a doubt that it is never lack of time, but your interest, your priority, your time management skills, your dedication and discipline that determine if you do something or not. Don’t justify your laziness and lack of interest by labeling it as a ‘lack of time’.

On a lighter note, when next time I ask you, ‘Have you read my blog?’ and you say, ‘I did not have the time’ ……. 

(Based on allegedly true incidents)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, leg,al and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, leg,al, and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms.

The Chronic Ulcer Lesson

Dr. Dev (Fictional Name) was sitting in the surgery OPD when a patient entered the room followed by 9-10 persons. Even before he came near him, Dr. Dev noticed that he was having a small ulcer, around ½ inch in size, just below the elbow crease, covered with dirty slough material. 

When the patient sat on the patient’s chair, Dr. Dev took the old OPD slips from his hand and inspected them. Dr. Dev, who used to speedily cram heavy medical textbooks on the night just before the college exam, quickly noted from the patient’s old record, that as he had suspected, the patient was having the wound for around 15 days, which occurred when he received an intravenous injection at the common site near the elbow crease, which unfortunately spread outside the vein and caused the ulcer. Also, he was diabetic and the last recorded sugar in his slips was also high. 

Making a diagnosis of delayed healing of the ulcer due to uncontrolled diabetes and movement of the ulcer site as it was near the elbow joint, Dr. Dev asked the junior resident sitting with him to take the patient to minor operation theatre and under local anesthesia remove the necrotic slough from the ulcer, do a good dressing, write antibiotics and pain-killers and refer him to the physician for the change of drugs to control of his diabetes. He directed the patient to go with the junior resident for further treatment. The entire sequence occurred in just 1-2 minutes.

On hearing the patient turned livid and angrily shouted at Dr. Dev, ‘You doctors don’t want to work at all. You are advising me treatment without seeing me properly and just shunting me away!’

Dr. Dev tried to placate the patient, saying, ‘I have gone through your records and read the full history and treatment given previously which was correct. Your wound is not healing because of high blood sugar, which the physician will treat, and the movements of your elbow joint, which you will have to restrict. The minor surgery I advised is very well done routinely by my resident. There is no question of negligence on my part.’

Dr. Dev's words fell on deaf ears. The patient continued his harangue, with the persons accompanying the patient joining in by making aggressive gestures and sounds of resentment.

To defuse the situation, Dr. Dev got up, put on pair of sterile gloves, slowly palpated the patient’s ulcer and the surrounding areas and moved his forearm in different directions, all the time, with a look of intense concentration on his face. 

Dr. Dev did not want to do this palpation in the first place as it was painful to the patient and its finding was not going to make any difference to the treatment. 

Once he felt that the patient looks satisfied, he stopped the examination and removing the gloves he wrote the treatment of the patient by his own hand in his OPD slip. This was the same treatment that he had asked his resident to write and then requested the patient to please go to the minor OT with the resident.

It is logical that the time you devote to a patient or a problem should be in proportion to its seriousness. But in actual life, you have to devote time in proportion to the size of the ego of your patient/client/customer. If you appear to be devoting less time than their ego demands then you may face resentment and retaliation, for being ‘superficial’ or ‘not serious enough’.

It is not enough to just provide the treatment or solution to most people. Most people want their doctor or service provider to listen to them, empathize with their hardship, devote time to them and provide the treatment or solution only after due deliberation. 

If you skip any of these either due to lack of time, work overload or the minor nature of problem according to you, then your patient or client is not going to be satisfied, even with correct treatment or solution.

Remember, you may see someone’s problem as minor, but to most persons, their own problem appears to them as the biggest problem on earth.

It may not be true in other professions, but when a crowd accompanies a patient to the hospital than the patient and the crowd either think that the patient is a VIP or that he is suffering from a very serious life-threatening disease. So be ready to respond accordingly to avoid any unpleasantness.

(Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purposes. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The Female Surgery Resident

An academic JR left soon after joining the Surgery department of AIIMS, New Delhi, leaving his seat vacant. This increased the workload of the other JRs. They approached the unit head who got the post of locum resident sanctioned against the vacant academic PG JR post but there was no hope of anyone joining it due to the heavy time-consuming schedule of the surgery department.

For Non-Medicos, A little background: After doing the basic graduation in medical sciences, MBBS, the young doctors usually opt for further studies in the form of Post-Graduation (PG) in various branches of medicine and surgery. The admission to the PG courses is through an entrance exam. During the PG course, the MBBS doctors study and also do the various patient and academic work and are known as academic junior residents (JR). 

If the number of JRs is less as compared to the workload or if some seat remains vacant in the department then some MBBS doctors may be hired to work against the vacant seat, to do the departmental work and are known as a locum or non-academic JRs. They get salary equal to the academic JRs but do not have academic work. 

Those MBBS doctors, who do not get selected in the PG courses, join this non-academic post to earn some money while they are preparing for the next PG entrance exam. As their main target is to secure a good rank in the next PG entrance exam, they generally choose to do locum resident jobs in non-clinical or other departments, such as laboratory medicine, etc., where the workload minimal with limited timing, leaving them plenty of time to study.

To everyone’s surprise, a female MBBS doctor joined as the surgery locum resident. On her first day in the AIIMS surgery ward, the new female JR got the shock of her life. 

The female JR was from an all-girls/women MBBS college. The hospital attached to their college was also an all-woman hospital. The situation has much changed now, but earlier there was very less number of female surgical patients in general. The all-female surgery ward in her hospital was usually half empty, with limited work for the interns and resident doctors working there. Also, there was a difference in the complexity of cases being operated in AIIMS, which was further increasing the AIIMS workload.

Since she had already joined, she decided to give it a try to work in AIIMS. After the morning round, on finishing the work allotted to her she went home. 

The next day, the senior resident, asked where she had disappeared after the morning round. The JR replied that she had left for home after completing the morning round work. The senior resident told her, as she was getting a salary equal to other residents, she has to work like other residents and not to get any special treatment. He asked her to stay in the ward and go only after completing the ward work after the evening round. (The evening rounds used to start around 6.00 p.m. but end in the night at around 8.30 p.m.)

The female JR became crestfallen. There was the problem of staying in the ward the entire day and then completing the evening ward round work which used end in the night and then going back home in the night alone as a security risk. 

With almost tears in her eyes, the JR pleaded with the senior resident, that she has to study for the PG entrance exam and there is the risk of traveling alone in the night. She made the counteroffer of staying in the ward in the day and attending any call while the other unit doctors were busy in Operation theatre or OPD but be relieved in the evening.

The senior resident got adamant that she has to work like other junior residents and to make arrangements to stay and work after the evening round from the next day.

The female junior resident did not turn up for work the next day and left the job at AIIMS.

On hearing this, the senior resident responded, ‘The trouble with female residents in surgery is that if you handle them roughly they cry, and if you handle them softly, they make you cry’. 

(Not my personal feeling and counterpoint is given below.)

The same position in name can have vastly different workloads, responsibilities, timing, etc. depending on the organization/company/institution. Before joining/taking any new position/job/responsibility, please find out the actual working conditions, timings, expectations, etc. 

And vice versa, before hiring someone, give him or her, an idea about the job, the hours of work, responsibilities, etc., explicitly and not just assume that they have the knowledge as they have applied for the job. This will avoid surprises and disappointments on both sides.

How someone work is just not based on his/her salary but his future plan. The academic JR course is of three years after which they have to appear in an exam, on passing which they get their PG degree. The academic JRs generally work far beyond normal workers, as they want to get maximum experience by doing maximum work which will help them in becoming a better specialist in the future. There is also the factor that the department’s faculty gets to decide who passes or fails in the final exam, so creating a good impression by hard work is important to secure a good rank in the exams. 

So if a person is planning on staying in the same field or subject and wants to create a good impression on his superior, then his motivation is going to be much more than otherwise. This was the primary reason between the difference in work of the normal surgery residents and the locum resident and not her being female, as erroneously assumed by the senior resident. There had been very good, hard-working female junior residents in surgery, like Dr. Jayanthy, who had come for the 3 years MS Surgery course.

When someone new joins your organization, think of the cold swimming pool or bath situation. When faced with the prospect of swimming in a pool filled with cold water or taking a bath with un-heated, cold water, people usually adopt two different approaches. 

Some take the slow gradual approach, first dip or wet their feet, then immerse of wet their legs, then thigh, pause in between, then start once again and dip/wet their lower body, upper body and finally their head. This approach may be slower and gradual but safer.

In contrast, some just brace themselves and jump quickly in the pool, dipping them completely in a single go. This approach is faster, exciting and impressive, but may sometime cause cardiac (heart) shock and even death due to sudden exposure to the cold temperature.

Similarly, if someone new joins your organization, you may give them the full workload in one go or increase their workload gradually. The full, sudden shock approach is suitable if there are other candidates waiting to take the job if the present person leaves. The sudden shock approach will show you whether the candidate can survive and bloom in your setup or force him/her to leave quickly, allowing you to search and fill with a more suitable person.

The gradual approach is more suitable and sometimes necessary if there is no other candidate waiting to take the job if the present one leaves. Remember, a half worker may be better than no worker.

If the senior resident had agreed to the reduced work hour and responsibilities of the female junior resident, she would have stayed and relieved at least some work from the other unity doctors. Some people consider this approach, especially if someone other, in this case, the government, is paying the salary.

 (Based on an allegedly true incident)

— ND

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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use the information herein is at your one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norms. 

The Cheteshwar Pujara Situation

In the previous post, we saw the difficulties faced by Dr. TP and Dr. Robert (both Fictional Names) due to their previous college. Please read it before reading this post at:

https://agnipathdoctors.blogspot.com/2019/02/the-gi-surgery-viva.html

In 2018, before proposed India vs England test series, Cheteshwar Pujara, an Indian cricketer, decided to play in the England county cricket from the Yorkshire team.

This was apparently to get him some experience in playing on England’s cricket pitches and against English Bowlers so that he will be better prepared for proposed India vs England test series. He had a streak of bad luck and had a poor showing while playing for the Yorkshire county team.

When the team for first India vs England test match was announced, Cheteshwar Pujara was not selected in the team. Some experts then commented that if Pujara had not gone and played in the Yorkshire county cricket team, he may have selected for the team based on his performance in the domestic cricket.

His plan of playing in the English county cricket back-fired and what was to be his strong point became the reason for his non-selection.

A similar thing got played out in front of Dr. Dev (Fictional Name) when he was posted in the rotation posting in the AIIMS, New Delhi’s Neurosurgery department.

Dr. Thomas (Fictional Name) got a temporary job as a non-academic senior resident in the Neurosurgery Department. Probably due to a combination of factors, his work was not up to the expectation of the Professor A.K. Mahatma (Fictional Name) who was the unit head.

When the time came to fill the form for the Pre-Mch admission exam for the various colleges, Prof. (Dr.) A.K. Mahatma strictly forbade Dr. Thomas from filling the AIIMS Neurosurgery pre-Mch exams form.

A surprised Dr. Thomas asked the reason for it.

Dr. Mahatama replied, ‘Your work is not found satisfactory by me. Even if you clear the theory part of the exam, I will not select you in the practical part of the exam. I will rather take my chance with a fresh unknown candidate who may turn out be bad resident, than selecting you who I know definitely to be bad.’

So, Dr. Thomas had a better chance of getting selected to AIIMS Neurosurgery department if had taken the temporary job in some other hospital to get experience in Neurosurgery, rather than to take the job in AIIMS itself.

In a temporary job in your dream institution or company, if you are able to impress your superiors by your work and personality, this may open the path to a permanent position there. But if you are found to lacking due to any reason, then this may backfire and your dreams and wishes may not get fulfilled.

So choose wisely even your temporary jobs or position and avoid a 'Cheteshwar Pujara situation'.

(Based on allegedly true incident)

— ND
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 DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost. 

DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Education should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost and according to MCI and other Board’s norm. 

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