We invite you to continue the conversation with Part 2 of the DocScopy interview, where Sai Sindhuja K from MedBound Times engages in an in-depth discussion with Dr. Manekar Avinash.
Dr. Manekar Avinash, a highly accomplished anaesthetist with over 13 years of experience. He holds an MBBS degree from Siddhartha Medical College and an MD in Anaesthesia from Osmania Medical College. Following a successful career in India, he relocated to the UK, obtaining EDAIC, FRCA, and various resuscitation certifications. Dr. Avinash currently serves as a Locum Consultant Anaesthetist at Walsall Manor Hospital, Walsall, England.
Part 1 of our conversation with Dr. Manekar Avinash featured a comprehensive overview of his remarkable career, replete with valuable perspectives and expert insights. In this segment, Dr. Manekar Avinash shares a more intimate account of his remarkable journey, detailing the challenges he overcame and the successes he achieved.
Sai Sindhuja: Can you describe your experience working in an ICU environment/critical care, including your experience with ventilators, dialysis, and other life-supporting therapies?
Dr. Avinash: In Osmania, it used to be mainly respiratory ICU – predominantly involving patients needing respiratory requirements/ventilatory support, post complex surgical procedures, snake bites, poisoning. Depending on organ support – ventilator for respiratory, dialysis – for renal/kidney, inotropic medications/cardiac assist devices for heart. In KIMS, had worked in ICU having major neurosurgical, surgical, medically complex requirements. In UK, covid, post covid, extensive use of advanced critical care strategies.
Sai Sindhuja: You are working in the operating room and a surgeon requests a treatment that you do not believe is in the patient's best interests. How would you handle this situation?
Dr. Avinash: It’s different in different places, it’s not allowed in UK, surgeons need to consent patients before and do only what has been consented for. I would object if it’s not in the best interest of patients, subsequently report it. It’s difficult as you need to make sure the patient safety under an anaesthetic for a surgical procedure keeping the theatre dynamics non conflictive.
Sai Sindhuja: Can you describe your experience working with multidisciplinary teams, including surgeons, nurses, and other healthcare professionals?
Dr. Avinash: After working here in UK where all staff are equally respected, I can say that it's not the same back home where some of the theatre staff are abused a lot by the higher authoritative in most of the hospitals I've worked. It’s not pleasant and discouraging. Team dynamics plays a crucial role and respecting and knowing your team well goes a long way in having a positive workplace culture and also benefits patients outcomes.
Sai Sindhuja: How do you stay up-to-date with the latest developments and advancements in anaesthetics and intensive care?
Dr. Avinash: By doing regular reading, updates, attending courses and conferences to know recent advances and changes in practise. Everyone needs to do mandatory training here to keep with annual appraisal cycle and Good Medical Practise for GMC revalidation.
Sai Sindhuja: Can you describe your experience with teaching and mentoring junior doctors and other healthcare professionals?
Dr. Avinash: I’ve been involved in both formal and informal teaching of resident doctors and other paramedical staff in anaesthetics. In KIMS, I used to teach the theatre staff about use of eco-friendly ways of practise starting at an individual level. I’ve always tried to share my experience with my junior colleagues when needed.
Sai Sindhuja: Can you tell us about your background and experience as a locum consultant? What motivated you to pursue a career as a locum consultant?
Dr. Avinash: Career progression has been one of the long-standing things, having joined NHS midway and later knowing how it works made me realise that I need to work on some things. It doesn't automatically recognise your overseas experience. And the pathway to become a consultant in conventional route here is a long process. After clearing the exams and having necessary experience I'm exploring a difficult but challenging alternative pathway to prove equivalence to gain specialist registration.
Sai Sindhuja: What is your availability for locum consulting work, and how far in advance can you commit to assignments?
Dr. Avinash: Currently, I've got planned job work. I work 4 days in a week, on average about 7-night shifts in a 10-week period which are non-resident. But due to significant distance between my residence and place of work (35 miles) I stay at hospitals during on calls.
Sai Sindhuja: Can you give an example of a time when you had to communicate complex medical information to a patient or family member?
Dr. Avinash: Again lots, over the span of my anaesthetic career we need to speak to the patients and their families especially if they've got multiple problems. Daily communication when working in ICU is part of the job, updating them with any changes. In India, it was difficult as most didn’t have the basic medical understanding. Covid time was challenging where many patients got worse so quickly and deteriorated and passed away that the families couldn't sink the reality.
Sai Sindhuja: How do you maintain your medical licensure and certification while working as a locum consultant?
Dr. Avinash: We need to do regular mandatory training, annual appraisals, keep with recent updates and CPD activities.
Sai Sindhuja: Can you compare the healthcare infrastructure, facilities, and resources you worked with in India and the UK?
Dr. Avinash: Having studied and worked in government setup early on and working in private healthcare in India, there's a huge infrastructure gap. I don't know how things are currently, probably not improved much in the state-run government hospitals which have been ignored for decades despite having some of the best brains. Corporate – I can only talk about KIMS where I worked, it had some of the best, state of art facilities and resources, it was one of the best hospitals in Hyderabad, nothing less or probably better even compared to UK in many aspects, though it can be expensive.
Sai Sindhuja: Can you describe your career goals and aspirations, and how this role fits into your overall career plan?
Dr. Avinash: I want to achieve specialist registration by alternative route to become a consultant. This role although is equivalent but of limited contract period, during which I need to prove equivalence.
Sai Sindhuja: What do you wish someone had told you when you were starting your career in anaesthesia? Can you share a valuable lesson or insight that you've gained throughout your career in anaesthesia?
Dr. Avinash: Social media has made it easy to explore multiple options in different places. I've never heard or thought of moving out until at least 2017/18. Never knew about the international exams, was contended with what I had. It’s better to start early, plan ahead if you want to move and work out of India. It’s very difficult to adapt having worked in India as a consultant for few years and then start here. It’s at least 5 to 7 years' time to become a consultant by UK training route and involves lot of travelling between hospitals making it difficult managing childcare if you have young family.
Sai Sindhuja: As an experienced Locum Consultant in Anaesthesia, what advice would you offer to medical students or junior doctors aspiring to pursue a career in anaesthesia?
Dr. Avinash: Anaesthetic career is challenging with different shift patterns especially in India due to heavy competition. Working in multiple hospitals there's limited family time. Understand what your priorities are before choosing any speciality, it’s not everyone's cup of tea. All the best!!
MedBound Times would like to extend its sincere gratitude to Dr. Manekar Avinash for sharing his remarkable journey, expertise, and insights on the field of anaesthesia with us. We appreciate his time and willingness to inspire and educate our readers.