Life as an Anaesthetist: Dr. Manekar Avinash on Challenges, Training, and Success (Part-1)
We are honored to introduce 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.
In this exclusive interview, Sai Sindhuja K from MedBound Times engages in a thought-provoking conversation with Dr. Manekar Avinash. This insightful discussion explores his illustrious career, offering valuable perspectives and experiences.
Sai Sindhuja: To begin, could you please provide a brief overview of your academic background, professional experience, and qualifications?
Dr. Avinash: Hello. I am Dr. Avinash and I’ve studied 10+2 MBiPC in KV picket which was CBSE, had tough time managing EAMCET which was state syllabus. After slogging for a year managed to get a government medical seat in Siddhartha, Vijayawada, where I have completed MBBS (2004-10).
Then I have done MD anaesthesia from Osmania medical college (2011-14). Joined KIMS in June 2014 as a senior registrar and then worked as a junior consultant (apr2015-mar2017) and then as a consultant till sept 2019 before I moved to UK.
I have done EDAIC, FRCA along with ALS, ATLS, APLS resuscitation courses and few other certifications. Worked as a JSD higher in anaesthetics in UHB, Birmingham (sept2019-oct2020), before moving to Derby where I worked as SAS doctor till June 2024. I'm currently working as locum consultant anaesthetist in Walsall Manor Hospital.
Sai Sindhuja: Would you mind sharing your experience and background in anaesthetics and intensive care? What influenced your decision to pursue a career in this area of medicine?
Dr. Avinash: Although it was not by choice, I quickly adopted a challenging mindset needed to enjoy working in anaesthetics. We had an amazing senior’s group who helped and guided in going through the initial rough patches at work. It used to be very busy with long working hours, nights but enjoyable. Working in Osmania, exposed to wide variety of anaesthetic challenges. And subsequently work at KIMS showed the other aspects which the private hospital setup is known for–recent advances and technology.
Sai Sindhuja: What were some of the biggest challenges you faced when transitioning from practicing anaesthesia in India to the UK?
Dr. Avinash: UK was never planned; I was trying to move to Dubai or Qatar. Later came to know these jobs are well recognised with western qualifications. And hence was preparing for EDAIC. I was successful in one of the interviews for a UK job (MMED). But it took time before it could process, I needed to complete IELTS, EPIC ECFMG, EDAIC certifications and there was a significant frustrating waiting period.
During this time, I applied directly to lots of jobs directly in NHS.jobs site. After 4-5 months I could get my 1st interview and was successful to get the post but needed a different path for registration. It took almost an year or more from the time of interview to join the job in UK, it was a difficult time to remember.
Sai Sindhuja: How do you think the EDAIC and FRCA certification has prepared you for a career in anaesthesia and intensive care?
Dr. Avinash: Definitely it helps to work in UK, and these are internationally recognised certifications. It’s lot of knowledge but to clear the exams you need to present them in a certain way.
Sai Sindhuja: How has completing the PALS course influenced your approach to working with pediatric patients?
Dr. Avinash: Again, these are 1 of the mandatory resuscitation courses for anyone working with young. Knowing the recent advances and developing the soft skills in leadership and management helps in improving outcomes.
Sai Sindhuja: How did you adapt to differences in clinical guidelines, protocols, and standards between India and the UK?
Dr. Avinash: I don't think it's that different especially having worked in KIMS where I had the advantage of availability of similar or advanced equipment. Agreed its more protocolized in UK but the essential practice at least to me remains the same.
Sai Sindhuja: Can you describe your experience with different types of anaesthesia, such as general anaesthesia, regional anaesthesia, and sedation?
Dr. Avinash: I've now worked in anaesthetics for more than 13 years and got a reasonable experience in a wide variety of anaesthetic techniques. Choice depends on the type of surgery, patient’s medical history, and few other things to consider. Each having its own pros and cons, possible complications.
Sai Sindhuja: How do you assess a patient’s suitability for anaesthesia, and what factors do you consider when making this assessment?
Dr. Avinash: Most important things to consider is patient’s medical history, their known comorbidities/diseases. Their baseline physiological reserve which is the most important determining factor for patients anaesthetic fitness for surgery. It’s important to know that the body will be subjected to stress under an anaesthetic and surgery and if they have a very limited baseline function (multiple medical problems, limited mobility) – they are known to be at high risk of perioperative complications. Other things- medications, allergies, smoking, alcohol and other habits. Along with scoring systems like ASA grades, clinical frailty, SORT, NELA, cardiac risk index scores and few others depending on the type of surgery.
Sai Sindhuja: How does your role as an anesthetist change when working with pediatric patients compared to adults?
Dr. Avinash: It’s important to be gentle, caring and having a child friendly attitude when working with kids and their parents. You need to be adaptable and its very challenging. It’s important to gain confidence of the kids and their parents by explaining them the anesthetic process.
Sai Sindhuja: Can you describe a particularly challenging anaesthetic case you managed, and how you overcame any difficulties that arose?
Dr. Avinash: There have been many but when you anticipate, plan prepare have a good team outcomes can be better. It's always unpredictable, planning, adequate preparation and utmost vigilance are crucial in this speciality.
Sai Sindhuja: What are the most common emergencies you encounter in pediatric anesthesia, and how do you mitigate them?
Dr. Avinash: Mainly airway related which can be very dangerous. Depends on type of surgical procedure and background of patient. Choice of anaesthetic techniques, medications that are used, and having trained staff minimises possible complications.
Sai Sindhuja: How do you prepare for cases involving critically ill or high-risk pediatric patients?
Dr. Avinash: Adequate assessment, explanation to the patient/their parents, team brief as to what is needed, keeping all equipment, medications ready. Multidisciplinary team discussions for complex management and seeking experienced/senior help.
Sai Sindhuja: What unique challenges do you encounter when administering anesthesia to children, and how do you address them?
Dr. Avinash: They are unpredictable, and can go bonkers in the anaesthetic room, securing a cannula can be challenge, explaining the process before in simple language, applying topical local anaesthetic cream at site of cannulation, and then oral sedative syrups or gas inhalational anaesthesia if they are not cooperative.
Sai Sindhuja: What strategies do you use to help children and their families feel comfortable before a procedure?
Dr. Avinash: Working with kids needs adaptability, explaining them in simple language so that they know what to expect, consenting after explanation of procedures. Using distraction techniques, colorful lights, stickers, ice cream promises!! And what not?
Tune in next for Part 2 of our exclusive interview with Dr. Manekar Avinash, where he delves deeper into his remarkable journey, overcoming challenges, achieving success and more!!
