For the strong of heart
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Three doctors, each working in a different field, tell us what a career in medicine is all about. It is a tough profession—what with years of study, training and, eventually, the pressure of saving lives. But at the end of the day, it’s worth all the trouble because the profession brings with it enormous respect and goodwill.
This is what keeps this surgeon, pathologist and medical officer going.
RAJENDRA BADWE, 59
Surgical oncologist and director, Tata Memorial Hospital, Mumbai
Grey-haired and soft-spoken, Rajendra Badwe has a calm, unhurried manner. A Padma Shri awardee, Dr Badwe has performed about 20,000 breast cancer surgeries and treated over 50,000 patients since he started practising at Mumbai’s Tata Memorial Hospital in 1992. He was appointed hospital director in 2008.
Dr Badwe has a postgraduate degree in surgery from the KEM Hospital in Mumbai, and specialized in oncology at the Tata hospital. He worked in Tokyo, Japan, and London, UK, before returning to the Tata hospital in 1992.
It was a tough choice: engineering or medicine. The toss of a coin decided it, though his family has been associated with the field of medicine. As a three-year-old, he would do the rounds of the wards at Kasturba Gandhi Hospital with his maternal grandmother, a nurse who rose to become the matron of the hospital. His father was an administrator—first at Kasturba Gandhi Hospital and then at the Tata Memorial Hospital.
Daily duty: It’s 8am when Dr Badwe walks into the out-patient department (OPD) at the hospital. There is a crowd there already; 50-odd patients with their families. Some are from Mumbai, and many from places like Ranchi, Jammu and the North-East.
The patient interactions, with examination and discussions, take time. “For a doctor, only 50% is treatment, the next 50% is giving comfort,” says Dr Badwe. “Today, we are good with cancer. The spectrum of curable cancers versus incurable cancers has changed,” he tells patients who panic at the dreaded C-word.
At 2pm, the OPD finishes, and Dr Badwe walks back to his office to move on to his second set of responsibilities: the administration of the 600-bed cancer speciality hospital. There are meetings and reviews of the various departments, including oncology and radiology.
The OPD resumes at 5pm. By the end of the day, Dr Badwe will have seen close to a hundred patients. On his rounds, he also speaks to the resident doctors.
A resident doing his DM (doctorate in medicine) in oncology asks him whether he should aim to work abroad. “It is good to get an education in one kind of environment and test that education in some other environment,” Dr Badwe tells the resident doctor.
For Dr Badwe, the experience of working in two other countries has been enriching. For Tokyo in 1992 was very different from London in 1989-92. “Tokyo was extremely disciplined, systematic, almost subservient. In London, things were a lot more research-oriented,” he says.
Money matters: At senior levels, oncologists at the Tata hospital can earn around Rs.2 lakh a month, plus housing and other benefits.
ASHUTOSH TARAL, 31
Medical officer, primary health centre (PHC), Bhorpadale, Kolhapur district
Ashutosh Taral wants to study further. Many of his batchmates from the Krishna Institute of Medical Sciences Deemed University in Karad, Maharashtra, have done so and become surgeons, paediatricians, orthopaedists, etc. Dr Taral, who did his MBBS from the Krishna university, has been working as a medical officer at Bhorpadale for seven years, but was formally confirmed a few months ago. If he were to write the postgraduate entrance medical exams, he would have to wait another three years to avail of government reservation for medical officers.
Daily duty: On an average, a hundred patients visit the primary health centre every day. The causes range from snakebite, fever and dysentery to a variety of small surgical procedures, including deliveries.
Dr Taral comes in at 9am and sees each patient. He records the details of their treatment—later in the week, there will be a meeting of the district’s medical officers at Kolhapur and he has to present these details, as well as figures on how many contraceptive pills, condoms and copper-Ts have been distributed and how many vasectomies have been performed.
It is past 2.30pm when the OPD ends. Dr Taral goes home for lunch. Just as he is finishing the meal, he hears a call outside. It is the A&M, the auxiliary nurse and midwife. A patient has just been admitted in an advanced state of labour. Dr Taral’s wife, who also works at the centre, prepares to leave. She has a postgraduate specialization in gynaecology.
Dr Taral now wants to join the Indian Administrative Service. If he makes the cut, he hopes to change policy and fix hours for doctors in public health centres, as well as mandate special training for them so they can deal better with the challenges of providing healthcare in a primary health centre.
In the evening, after OPD finishes around 6pm, Dr Taral sits down to his books. His subject of choice in the Union Public Service Commission exam is medical sciences.
“That way, if I don’t clear the exam, I will have still learnt something that is useful to me as a practising doctor,” he says.
Money matters: As a medical officer, Dr Taral earns Rs. 58,000 a month. But salaries are often delayed.
PANKHI DUTTA, 46
Consultant haematopathologist, Kokilaben Dhirubhai Ambani Hospital, Mumbai
“I was always fascinated by human biology,” says Pankhi Dutta, who can spend hours looking through a microscope. At Assam’s Gauhati Medical College, where she did her MBBS in 1992, she was most excited about assisting the surgeons at work. The study of blood came a close second. “It was a trade-off. There are very few women surgeons today, and not because there is any lack of talent. It is the long hours and the fact that women know their families won’t put up with it,” says Dr Dutta.
After training for three years to become a haematopathologist at New Delhi’s All India Institute Of Medical Sciences (2003-06), Dr Dutta spent a year as a consultant at Mumbai’s PD Hinduja Hospital (2006-07) and a year at the Institute of Pathology in the regional hospital at Randers, Denmark (2008-09). She returned to India in 2009 to help set up a laboratory at the SevenHills Hospital in Mumbai. In 2012, she took up her current position as consultant at the Kokilaben Dhirubhai Ambani Hospital.
Daily duty: Daughter of an engineer and a Hindustani classical singer and performer, Dr Dutta had trained in music for years and didn’t want to give that up. Her day begins at 7am with an hour of riyaaz. The day we meet, she’s singing O Aaj Kehne Bhi Na Diya, a song she performed in the TV series Coke Studio in 2011. Her eight-year-old son, Kian, nods along—he likes the song—but he runs off soon enough to get ready for school.
The laboratory at the hospital is College of American Pathologists (CAP)-accredited, and it is occasionally visited by CAP inspectors. The day we meet is one such. On her way to the hospital, Dr Dutta begins to review all the areas—the specialized tests, including the coagulation analysers and the flow cytometry, as well as the reporting on biopsy sections, peripheral smears, etc.
Once at the lab, there is the usual volume of 400-odd reports to check and sign off on. There are calls from colleagues and patients. A bone marrow biopsy has to be done.
Later in the day, she may get some time to work on research papers and on training technicians, as well as monitoring, and ensuring everything goes off perfectly at the 24-hour lab.
Money matters: “Can range from Rs.30-50 lakh per annum for laboratory-related jobs, depending on the institution. For surgeons and some other clinical specialities, the sky is the limit as such salaries have huge incentive components,” she says.
A CASE FOR CASE STUDIES
Why Deepu Sebin stopped practising medicine and became a medical entrepreneur
Deepu Sebin is the co-founder of DailyRounds, an app which enables doctors to share case studies. Set up in Bengaluru in 2014, DailyRounds raised around Rs.3.5 crore in funding in March, from investors like Kae Capital and GSF Accelerator.
Sebin practised medicine for seven years, deciding to turn entrepreneur in 2013. “As a doctor, you can literally save patients on a day-to-day basis,” he says. But practising at a primary health centre in Kerala and, later, Chennai, where he studied internal medicine at the Stanley Medical College, he began to see the difficulties that doctors in India face every day. “It’s very hard to be a doctor at a government hospital. There is a constant sense of negativity. You have to manage 100 patients with the resources for 10. And if something goes wrong, it is always the doctors who are blamed,” says Sebin. He felt he wasn’t doing enough. “I wanted a product , something that would last.”
In 2013, he visited the incubation centre at the Indian Institute of Technology (IIT), Madras. He began to see how developers worked.“They shared all their knowledge, posting code, problems and solutions on sites like GitHub and Stack Overflow,” he says.
Traditional methods of sharing knowledge in medicine were restricted to case studies in medical journals. Publishing an article in an international journal is hard. And getting to read them is expensive.
“The field was ripe for disruption. Today, doctors are taking their smartphones everywhere—into wards, consultation rooms and even the operation theatre. Photographing symptoms, ECG reports and X-rays and constructing a case study is instantly possible,” he explains.
Inspired by the developer model of sharing knowledge, Sebin started DailyRounds. He built the cases, and his programmer wife, Nimmi, built the prototype. The duo assembled a team of four doctors and eight programmers and relocated from Chennai to Bengaluru. Sebin says 45,000 doctors have already signed on, and medical schools are coming on board too.
“Being in a start-up is like being in an intensive care unit (ICU). Just like in an ICU, you may feel everything is all right and then suddenly some patient’s condition will turn bad, so can be the case for a start-up. Somebody will suddenly say I’m leaving or there will be some technical problem,” says Sebin. He finds managing is second nature to doctors—they are used to taking decisions at every point.
Every month, we explore a profession through the lives of three professionals at different stages in their careers. Tell us which profession you want to know more about at firstname.lastname@example.org