Thread by @OncoShravan

Learnings from a speciality residency at one of d top institutes in India -

In my last month of residency & 1-yr post-MCh bond as an adhoc Asst Prof at @TataMemorial Mumbai & @TMC_Varanasi here's a thread on what I learnt. (Might hv some snippets I wish I knew before I joined)

1. Oncology - To me, treating #CANCER is the highest form of medicine currently practised. If a fellow human being, is able to rid another, of d #EmperorOfAllMaladies, medicine shall hv achieved what it set out to. Cancer still lurks in d realm of that which needs 'conquering'

I saw this in TMH day in & out. The 'conquering'. I saw pts coming in the worst of conditions and walking back home. To a family. To a life.

I also saw d other end of d spectrum. Whr v had to meekly surrender to the malady. Where we could do precious little to 'save' someone.

2. Discipline - Right from the moment a resident enters TMH till the day he/she steps out, discipline becomes an inseparable & non-negotiable component of their existence. Be it starting ward rounds on time, or Consultant rounds, or starting a day's work in the OT. On-the-dot.

Everything goes on like clockwork. With ruthless regularity. Anything less is frowned upon. And it grows on u. u initially fight it -> negotiate it, eventually own it & then enforce it. It's a brilliant system where u learn d trade of being a doctor, in my case, a surgeon.

3. Surgery - If that word stirs something inside, u belong. Surgery for me (& for most colleagues) is life...Holy...Godly. At times, if fortunate, u see a surgeon metamorphosing right in front of ur eyes. U instantly know it. That's when doctors become surgeons. Class apart.

Surgery is an acquired skill. Diligence, honesty & thirst can get 1 on d path to surgical finesse. But each 1 of us is blessed with an 'x factor'. To plan/ imagine/spot/execute something a tad differently from others. And small changes result in profoundly different outcomes.

4. Enterprise - Wht u do for d institution over what d institution does for u. Having a good sense of this seems very important to me. Leaving a place ever so slightly better in ur own little way than how u found it goes a long way in empowering one professionally. It's a win-win

@TataMemorial real enterprise is encouraged & amongst a batch it isn't hard to spot them. Also there r ample examples around to look up to, emulate & assume a role that excites & inspires. The institution has churned out some brilliant clinicians so far with international repute

5. Operative opportunity - Trustworthiness, reliability, skill, hunger & honesty. If one is seen to possess these qualities, operative chances increase & rightly so. There is also a system of minimum training requirements which ensures a level playing field, but sky is the limit

OTs @TataMemorial & sister instt, are some of the most well-equipped & managed. And u realise this the moment u step out of d institute. Residents & nurses @TataMemorial are the backbone in keeping the OT well stocked & ready for any eventuality.

6. The Holy 'War'd - Wards are where the real fight takes place. Between disease & medicine. A brilliant surgery in the OT may still not guarantee a good outcome if ward care is found wanting. Daily rounds by multiple teams (surgical, nutritionists, physio) contribute to this.

It seems incumbent on the treating #TEAM to have a good sense of all aspects of ward management. Nothing is off limits. Be it nutrition, physiotherapy, rehabilitation, psychology or counseling. A wholesome approach is what can aspire to provide the best of outcomes.

7. OPD - the place @TataMemorial which 1 needs to see to believe. General OPDs are nothing short of chaotic. To the outsider. But look closely, & u ll notice order in the chaos. Every pt is looked after. Without exception. And I say this with profound responsibility.

Every1 pitches in with managing the OPD without hierarchy, including d highest of echelons. This is one of d things that was really impressive. V r hierarchical without being hierarchical. And that's the beauty of it. Patient care takes precedence over absolutely everything else

8. All work no play? #Oncosurg, Hospital Day, Freshers, #Verbena. 'Nuff said.

9. Service, Research, Education - No patient goes home citing they cudn't afford treatment. Financial, physical, mental & now even residential support, among others r extended to all patients who come for treatment from far & wide. It is phenomenal d way this support is extended

@tatatrusts @vcare24 are some of d NGOs to be thanked & congratulated for some phenomenal work they do supporting treatment. The hospital chips in with highly subsidised treatment for the most complex of surgeries, medications & care that only a few centres can boast

Some of d most highly impactful & well-cited research I have seen, comes frm home. Practice-changing, credible & impactful research is encouraged. Fuelled by diligent, hardworking & motivated consultants & residents with presence in all major national & international conferences

Also companies like @Ethicon & @Medtronic @COVSharpSafety to their bit in providing cutting edge technology for the ultimate goal of providing affordable and quality cancer care.

10. I can go on. A thread cannot do justice to this edifice that hs been built over decades of blood, sweat & tears of d people who envisioned it for #India, who toiled day & night & who persevered to bring quality and affordable cancer care without distinction & prejudice. End.

Tagging d ppl who have had a deep impact on my training, my psyche & my time here @cspramesh @Shrikhande_SV @pankajch37 @durgatoshpandey @drsabita @dnair78 @nitaN77 @Shalakajoshi15 @garvitchitkara @drgaganprakash @docgulia @vivekanandkem @niyogidevayani @docswapnil01 @raghurants

@jeetrohila @abhay_doc @nayakprakash @RimaPathak1 @naveenmummudi1 @VedangMurthy @sanketbankar1 @Saneya_2810 @qburhan @drpspai @ChaukarDevendra @Manishbhandare4 @DrVAChaudhari @sukumar_vivek @MufaddalKazi @AnantRamaswamy

@somedocs @me4_so @for_surgeons @Oncology_Events @TVASurg @surgeonapp1 @SocSurgOnc @ACTREC_TMC @M3IndiaOncology

#CReDO workshop. The best clinical research methodology workshop I had the fortune and privilege to be a part of. Helmed by internationally renowned faculty who are genuinely interested in bringing out the best research proposals. This CANNOT be missed!