POST GRADUATION TRAINING
MASTERS DEGREE IN GEN. SURGERY (M.S.) JUNE 1976 – DECEMBER 1980
Done from All India Institute of Medical Sciences (AIIMS) New Delhi. AIIMS is an unique autonomous Institute established under Indian constitution with funding from the commonwealth.
1st Year Junior Residency: Selection by All India competitive entrance test - selected in June 1976 at AIIMS.
June 1976 – Dec 1976
Worked in Department of Pediatric Surgery (headed by Prof. P. Upadhyaya) which was one of the few centres in India treating Hydrocephalus, Meningomyeloceles, Crouzon’s disease, Hirschprung’s diseases, Post urethral valve with Hydronephrosis apart from usual paediatric surgery cases. Since Prof. P. Upadhyaya was the one, who had devised indigenous Hydrocephalus shunt known as AIIMS valve, the centre had already treated over 500 cases of congenital Hydrocephalus when I joined this department. During my training it gave me immence exposure to the management of these cases. At that time, this centre was associated with Sheffield University and had collaborative study with Late Prof. Zachary in survey of detecting congenital defects in children in North India (Ballabhgarh district of Haryana). As residents, we had the responsibility to carry out this survey. Programme included once a week door to door survey of all the children’s of the geographical area to examine and detect congenital anomalies carried out with the assistance of social workers employed specially for the project.
This pediatric surgery unit also had unique distinction in treating Siamese twins, since this centre had successfully separated a Siamese twins for the first time in India in 1972. As a resident it was our responsibility to even supervise the feeding of those unfortunate babies.
The exposure I had in treating Hydrocephalus Meningomyeloceles did give me immense confidence in managing these cases subsequently while in Neurosurgery training and now in private practice.
January 1977 to June 1977 (AIIMS)
During this period I was trained in General surgery under Prof. B. M. L. Kapur and Dr. S. Nundy.
This unit of General Surgery at AIIMS was associated with Gastroenterology unit at AIIMS (one of the few G. E. services then available in India). Because of this association, as a resident, I was exposed in managing complex Gastroenterology cases such as Cirrhosis with Portal Hypertension, Gall bladder diseases, Pancreatic diseases (including malignancies) and intestinal malignancies. This G. E. Centre had a major exposure to Non cirrhotic Portal Fibrosis with Portal hypertension with massive variceal bleeds. This period gave me very good opportunities in managing real complex emergencies due to haemorrhagic shocks, Jaundice and other complications related to major surgeries of G.B., Pancreas, Colon, Rectum. As a junior resident, I was trained in not only managing these cases, but also in assisting and planning of surgical procedures that were routine to this surgical unit.
January 1978 to April 1978
As a surgical post graduate posted in Neurosurgery department of AIIMS – A very busy, well established centre for quality of its work. This period gave me exposure to management of all kinds of head injuries and other trauma and management of all kinds of brain/spinal tumors and conditions. (Joined this very department subsequently for my superspeciality training in neurosurgery).
April 1978 to July 1978
As a surgical post-graduate it was a rotational training posting in Cardiothoraccic and Vascular Unit of AIIMS under Prof. N. Gopinath and P. Venugopal.
This period gave me good exposure in understanding the management of all kinds of heart diseases (mainly valvular diseases at that time) pertaining to valve replacements, lung lesions both begin and malignant and thoraccic emergencies. As a resident, programme included day to day case of all these cases and assisting in all kind of complex surgical procedures.
January 1978 to December 1979
2nd and 3rd year Junior Residency (AIIMS) leading to masters degree in General Surgery in December 1979.
July 1978 to December 1979
During this period I worked under Prof. B. M. L. Kapur and Dr. S. Nundy. Because of the association of Gastroenterology unit the training consisted of
managing surgical Gastroenterological cases apart from routine surgical emergencies admitted to AIIMS (There was no surgical Gastroenterology unit then).
During this period I also had exposure to plastic surgery and renal transplant under Prof. I. K. Dhawan, to whose unit the resident were posted by rotation. This unit was handling routine general surgical cases, plastic surgery and renal transplant. I got good exposure to these subspecialities especially (burns) and renal transplant. As a resident I carried out / assisted many of these procedures independently and at times under supervision.
January 2000 to June 2000 - Senior Resident in General Surgery (AIIMS)
During this period I worked as a Casualty Medical Officer handling all kinds of surgical / orthopedic / neurosurgical emergencies brought to the emergency division of AIIMS Hospital. It was the duty of Casualty Medical Officer’s to stabilise these surgical emergencies before respective department residents took over the cases.
M. Ch. (Neurosurgery) July 1980 to June 1983
Three years training in neurosurgery leading to the degree of Magister de Chirurgie (M. Ch.) in Neurosurgery AIIMS., New Dehlhi, India.
Selection by all India competitive written examination. Only the candidates who have post graduate qualifications are eligible.
The curriculum for this course was unique at AIIMS. This was the Premier Institute wherein the examinee had to fulfill an operating session as a part of his M. Ch. Examination conducted by external examiners.
Day to day programmes gave sufficient importance to neuroradiology, neuropathology and regular teaching programmes such as journal clubs, seminars, clinical combined round and grand round apart from operating sessions both supervised and independent. Although AIIMS was the first hospital in the country to acquire C.T. head scanner (1978) residents required to perform all the neuroradiological procedure such as carotid angiograms, ventriculogram and pneumoencephalgrams apart from myelograms. Day usually started with neuroradiology discussions with neuroradiology faculty before proceeding to operating session and ward rounds.
Neurosurgical unit at AIIMS during my period of training performed around 1500 operative procedures per year. Most of the operative procedures were carried out under the supervision in the intial training period and later on independently depending upon the complexity of the procedure.
Residents also required to work in microneurosurgical hands on laboratory once a week during the same period.
Other academic activity included
Neuropathology discussion including autopsies, brain cutting sessions and weekly discussion of all operated cases with qualified neuropathologists headed by Prof. Subrinal Roy.
Neurology, Neurosurgery combined ward round and case discussions every week.
Selective posting to neurology services for three months and four weeks special posting to neuropathology.
Under the auspices of Neurosurgical Society of India, I was selected for Visiting Fellowship to the following recognised neurosurgery training centres in India.
Christian Medical college, Vellore.
National Institute of Mental Health and Neurosciences, Bangalore.
Bombay Hospital Research Centre, under Prof. S. N. Bhagwati.