1. Ask a question:
One of the many things that I learnt from my mentor Prof Amod Gupta is to learn the art of asking a question. Though our society is changing with times and encouraging the students to ask questions, I still see hesitation amongst our residents to ask a question about any subject being discussed or question the way of management; even though they may not agree. As a result, many of the research ideas that could have been generated by an honest question, remain unanswered. Each research proposal starts with a question and if every young student is inquisitive to ask questions; try to find answer if they exist and finally try to solve issues that do not have any answers yet, we will be able to solve many mysteries that will help in better management of our patient. It may sometimes take a lifetime to answer a very simple question but believe me that’s totally worth it. I remember when I was a junior resident and there was this beautiful study by Dr. Biswas published in Retina where he showed 5 enucleated eyes with a diagnosis of Intraocular TB. It may sound strange to many of you, but prior to this publication we were not even treating ocular TB as we did not believe it existed. I remember asking Prof Amod Gupta a simple question ‘Sir, how can we diagnose ocular TB at the earliest so that we can prevent these eyes from reaching a stage where we need to enucleate them?’ His answer was, ‘There is a new diagnostic thing called PCR that is coming up in a big way. You should meet Prof Shobha Sehgal from Immunology and try to find out whether we can do PCR for TB from aqueous humor’. That was the beginning of my journey for Ocular TB, starting with innumerable visits to the department of Immunopathology.
2. Observe :
As a young fellow, we tend to get sucked in the routine… the routine of seeing patients, doing surgeries, writing notes, struggling to establish one's practice, trying to woo patients, and so on. In this hullaballoo of the routine, we become so robotic that we fail to observe a new finding, an unusual image, new side effect of a drug being used. I think if we come out of our robotic mode and try not to fit every patient into something that we have read in book, one would find that there are so many patients with newer findings that may be worth reporting. A good case report on the new way of treating or new way of surgery or modifying the old instrument to make it more useful is by no means a small achievement and it should be shared with your community. You will find the difference when you start looking at each patient differently. One does not have to be terrifically brainy to observe these findings. Almost every case is interesting if studied in sufficient detail and each patient will teach you something. Make a note of all interesting patients you see so as to have a small data bank of your own that will be very useful when you are making presentations.
3. Learn Statistical Methods Early in your career:
Statistical analysis is the heart and soul of any publication and it is worth spending time and money to learn all about statistics in the earlier year of your career. This knowledge will go a long way in understanding the published literature, speaking about any topic in the meetings as well as designing and participating in multicentric trials. It is a very long journey and you don’t want to live a boring and monotonous life doing the same things over and over again. Learning Research Methodology earlier in your career will give you the edge over others in several forums and the thrill you get out of this recognition will help you strive better and enjoy something beyond routine patient management. Use the early years of your career to learn as many techniques as you can as they may come in handy to solve myriad problems in the future.
4. Come out of Your Comfort Zone:
We all love to be in our comfort zone because that is something that is comforting. However, get out of your comfort zone to learn new technology. I recently took an online course on Artificial Intelligence just to understand what was this whole thing all about. Believe me, I did not mind staying awake for it during the night as it was totally new thing for me and challenged me. If you are doing the same surgery that you were doing a few years ago and doing the same things that you have been doing for the past couple of years; there is no thrill. You should do something for yourselves. Just like you would like to learn a new musical instrument or learn to play golf; try learning something new; something cutting edge that may or may not help you in patient management but that will add newer perspectives to your thought process.
5. Visibility is important:
Prof Amod Gupta used to say “If the tree fell down in forest and no one heard : Did it make a sound ?” And as usual we used to be perplexed. Whenever he would ask us a question He would then smile and say that the answer is “NO”. Sound is a vibration that travels through the air to reach a person’s ear. If it did not reach any one’s ears, it is not sound. It is important that your peer know about your research so start participating in the conferences by making presentations, asking questions and interacting with the experts. You will be amazed how small tips from the senior colleagues in a relaxed atmosphere will become lifetime lessons for you. Conferences give us the opportunity to meet the leading experts in our field and interact with them and learn things from them. So be active and be visible.
6. Stay out of Local Politics:
Politics at the workplace are time-consuming and drain a lot of your time and energy. Whether you are in the public sector, institute, corporate, or group practice, you will always have people trying to find faults with you and nag you. Stay away from such politics as your recognition to the world is through the work that you are doing and not through your title or seniority at your place of work. This lesson again was thought to me by Prof Amod Gupta who told me that people remain so busy fighting over the number of patients, number of fellows, seniority, etc. that they have no energy left to do any research. I remember sitting with Dr T.P Das of LVEP at a social event during one of the VRSI meetings in Jaipur when I was still a fellow. He said that if you need to compete with your colleagues; it should be a healthy competition to publish in a better journal. There is no place for trivia if you wish to excel. So, don’t indulge in petty politics. Somehow his words have stayed with me throughout my career and this is exactly the advice I would like to give to all my young colleagues.
7. Learn the art of Communication:
Learn the art of making good presentations. Note down the points you enjoy in a particular speaker and think of yourself as an audience. Always make your presentation keeping what your audience wants to hear by putting yourself in their shoes. You may have made a super scientific presentation working on it for hours but if your audience don’t understand, it is not worth it. Practice it in front of your peer and mentors and learn the art of speaking slowly. Maintain eye contact with your audience if you are giving a talk in person and most importantly, don’t overshoot the time. Rehearse when you are in the early stage of your career and say things that you would want to hear as an audience.
8. Collaborate :
Research is not for loners. Build a team that has people with different capabilities and join hands together to make a difference to your patients and mankind. Learn to listen to others and don’t dismiss any ideas. The best work is always generated through collaboration… so learn to collaborate with the best in the world, both nationally and internationally. Don’t restrict yourself to your friends, your institute, your team… broaden your horizons and find the like-minded people that you would enjoy working with. When I had an idea of doing a multicentric trial on ocular TB without a single penny, everyone thought I was joking. But please remember that once you send out a thought to the universe, it will be picked up by like-minded people and then you can make difference. The problem that our uveitis colleagues all over the world were facing was that no physician will give Anti TB therapy to their patients simply because a Uveitis Expert is telling them to do. During my interview for promotion as Professor, one of my external examiners asked me the same question as to why would anyone treat these patients as you don’t have any histopathology evidence. Dr. V M Katoch was the chairman of the Interview board. He said, “ Vishali, I agree with what you are saying but if the same thing is said through Multicentric trial, it makes people believe.” That was the beginning of Collaborative Ocular TB Study (COTS) for me, a multicentric trial with over 25 participating centers from all across the globe. This study was done purely based on the passion of researchers as we had no money to pay. However, along the way, people recognize the good work and we received endorsements from all major Uveitis Societies including the International Uveitis Study Group, IOIS and Foster Ocular Inflammation Society. All the participants of COTS (145 Uveitis experts) are like an extended family to me and we continue to work together with a motto “Together towards Tomorrow”. We have now come up with Consensus guidelines on treating TB and recently ICMR has incorporated the STWs for ocular TB.
9. Follow your heart:
In the early stage of your career, you will meet all sorts of people who will make an impression on your young mind. There will be few who will encourage research, writing paper and you will feel fascinated by such faculty who is heavily into research, always traveling, world-renowned and well respected and maybe you wish to be like them. But then you meet the second group of people who will tell you that there is no point doing any research as you are now going to win a Noble prize anyways!! They may tell you that this path is full of hurdles, favoritism with lots of groups and lobbies and it is best not to do any research. My advice to all the young people out there is that you just do what you enjoy doing. Nothing is right or wrong but doing research should not be out of compulsion, it should be done for the sheer pleasure of adding something useful to the scientific world. Having a great mentor will always be a great boon as the path becomes so much easy to follow. I had gone to Dr. Narsing A Rao for a short fellowship in Uveitis. I distinctly remember entering his office and the first thing I noticed there was a framed publication with the title “Prof Rao’s 300th Publication”. For me, it was like ..wow! I wish I could have it in my office someday. Today, nearly 20 years later, I am going to be able to have that in my office (still have 4 more publications to reach that magical number of 300 ) and it is a beautiful feeling. The feeling is not only about the number of publications, but the memories of all wonderful mentors, teachers, thesis students, fellows, colleagues, my collaborators, and of course Prof Amod Gupta who have been instrumental in bringing out these publications with me overall these years and the joy of working together. I think that feeling of belonging to the scientific community is something unique and I would want all of you to experience it.
10. Enjoy yourself:
My last piece of advice to my young colleagues is that it is no longer fashionable to behave like a stuffy guy whom the students are scared of and who has a big persona. Don’t be that. Please remember that research does not always mean to stop enjoying and keep working all the time. It is OK to waste time, have coffee with your colleagues, laugh together with your students, have your hobbies. Research does not mean putting long routine hours; it just means a great effort of concentration. For me, most of the research ideas were generated in the airport lounges and not sitting in my office. So, I am sure there is some niche like this for each one of you and that you are entitled to follow what works best for you. Just go easy, enjoy your research as well as life, and don’t let anyone bully you to do what is not your passion.