Medical College Director Interview: Build trust to develop better clinical knowledge and procedural skill, says AIIMS Delhi Director
Careers360 in an interview with Dr. M.C Misra, Director, All India Institute of Medical Sciences, Delhi brings you expert speak on evolution of India’s most prestigious medical institution. Read the interview of AIIMS Delhi Director who shares his insight on AIIMS-like institutions.
In this interview, Dr. Misra also talks on evolution of critical care in India and AIIMS Trauma Center, besides speaking on the standard of research at medical colleges.
Careers360: You became the chief of AIIMS Delhi in 2013. Can you take us through your 30-year association with AIIMS?
Dr. M.C. Misra: I moved out of a small town near Agra to pursue UG from Maharani Laxmi Bai Medical College, Jhansi followed by MS (General Surgery) at Moti Lal Nehru Medical College, Allahabad. Even in those days everyone wanted to work in AIIMS. I also came to Delhi to take the entrance for Senior Resident’s position. The offer letter from AIIMS came in 1980 as lottery for me. I got the opportunity to work under one of the biggest names in surgery fraternity, like Prof. Atamprakash. In three years of residency, I saw such a great volume of work and complex cases of surgery that my teachers at Jhansi Medical College will not receive even in 15 years.
Careers360: Does AIIMS still hold its charm?
Dr. M.C. Misra: I have travelled across the globe, and still feel AIIMS is one of the best in the academic sphere. Look at how it provides top patient care. Prof. Atamprakash was the personal physician to former Prime Minister Indira Gandhi and simultaneously treated anyone walking into the OPD. That philosophy still remains. I treat VVVIPs and any common person in the OPD. Everybody in the society gets a chance to be taken care of by the best person at AIIMS.
Careers360: Now we have six more AIIMS-like institutions and the government has announced setting up some more. Will this improve healthcare needs of the masses?
Dr. M.C. Misra: We are trying to replicate the same model as that of IITs. These institutes can reach out to every nook and corner of India for patient care. AIIMS-like institutes cannot be compared to the standards of Delhi AIIMS, as it will take years to build such breadth of work. Although 90 percent of healthcare is in the private sector, the major problem is how many can access it? Sadly, only around 10 percent. The rest of the population competes for space in hospitals like AIIMS, LNJP, GTB, Safdarjung and RML in the context of Delhi. So the government cannot shy away from the responsibility of strengthening public healthcare.
Careers360: Critical care has gained enormous importance. How do you see the evolution of critical care in India?
Dr. M.C. Misra: As students we never heard about critical care. Now critical care has become a huge speciality. Years back only 10 percent of hospital beds were for critical care needs, but almost every standard hospital has all the specialities that require 30-40 percent critical care beds. Transplant programmes have matured over a period of time – be it heart, kidney, pancreas, cornea. Even haematology and oncology have expanded tremendously. So the fatal diseases are being tackled and today a large number of patients affected by such diseases are surviving.
Careers360: Do you collaborate with other institutes to enhance quality of healthcare?
Dr. M.C. Misra: I am very proud of being part of Stanford-India Bio design project – where AIIMS is in partnership with Standford University; IIT Delhi in partnership with the Indo-US Science & Technology Forum (IUSSTF). We are also collaborating with other universities for other projects – Michigan University, Erasmus University, Australia's Alfred Health and Monash University, Medical Research Council UK and Osaka University, Japan. We have taken up about 3000 projects in last five years.
Careers360: What inspired you to develop AIIMS Trauma Center? What is so special about this?
Dr. M.C. Misra: It was high time we provided compassionate patient care to acutely injured patients and those requiring specialized care. The center is equipped with full range of specialists and equipment is available 24 hours a day, and will be able to admit high volume of severely injured patients. Today it’s a referral center for patients who require specialized trauma management and rehabilitation. The digitization of cases became the focal point for many hospitals to replicate electronic medical records. Our website shows live statistics from the trauma center – how many are in the red area (critically injured), yellow (dangerously injured), green area (walking wounded). We were the first one in India to acquire mobile CT scan to do repeat CT scan.
Dr. M.C Misra
Healthcare sector will never go slow. You have a range of options to work in many upcoming areas. It was in news that Apollo Hospitals will provide 500 family physicians to the UK. When we don’t have family physicians for ourselves, how can we provide to other countries? You require more doctors, nurses, and paramedical specialists, as it’s a global deficiency.
Careers360: You received an awarded for conducting the first minimally invasive surgery in the country? What were the challenges?
Dr. M.C. Misra: In 1989, the news of someone removing a gall bladder in France created ripples across the globe. It actually changed the lives of millions of people around the world. So we no longer have to make a big cut into the tummy. We can go through small holes with less loss of blood and patients recover fast from the painless surgery. I badly wanted to adapt it in India too. Luckily I got a training opportunity; I went to Europe to observe the procedures and borrowed video of removal of the gall bladder. I returned to India and performed the first operation in 4 hours. The challenge for my team was that no monitor or camera was available at that time. Now with technological advancement our operative time started coming down from 6 hours to just 3 hours.
Careers360: AIIMS is popular for training medical teachers. What do you focus on?
Dr. M.C. Misra: Today we are in the era of skill- based learning, and in surgical discipline it is much more required. It’s crucial for institutes to maintain a good patient care training system for doctors. In surgical field, when you see someone performing you learn by just observing them. Because of the volume of cases at AIIMS, naturally there is great opportunity to learn here. Since the establishment of training center in 2007, we have trained about 5000 surgeons on minimal access skills. Every surgeon must be equipped with best operating techniques to prevent harming the patient while operating. We at AIIMS focus on maximum exposure.
Careers360: What’s the standard of research at medical colleges?
Dr. M.C. Misra: Research is happening in islands. We have increased the faculty positions because it will help them to pursue research. Institutes like AIIMS, PGI Chandigarh/Lucknow, JIPMER, and NIMHANS Bangalore are doing pretty well. Several national policy programmes came from AIIMS research. For instance, 'Universal Salt Iodization Programme’ of the Government of India came from our lab. Our contributions to control iodine deficiency extend to Bhutan, Nepal, Bangladesh, Maldives, Indonesia, Thailand and several countries of Africa and the Middle East. By using modern DNA technologies at AIIMS, it has now become possible for the first time in India to study the strains of the parasite responsible for an epidemic.
Careers360: What’s your expectation from today’s doctors?
Dr. M.C. Misra: I feel good communication can improve outcomes for patients and doctors. If you build trust, then you could develop better clinical knowledge and procedural skill.
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