Tuesday 5 April 2016

Article by my batchmate Dr Vivek Kumar on career choices.

Sir, should I join the forces or pay out?
Surg Cdr Vivek Kumar, Veteran (MD Internal Medicine and Intensivist) Z Batch AFMC
Page 119 Dhanvantari 2016

It is always a pleasure to write for the college magazine. There are many stories which come to my mind instantly, however this time around I will write on the most common question posed to me over the last few years – Sir, should I join the forces or pay out?

I have seen many students take a well-thought of decision in this matter and also an equal number who just tagged along with the decision of their friends. Like all processes in today’s corporate world, decision making is a structured process and I will suggest a way to go about making a career choice.

A few months back I was approached by an International recruitment firm for the post of Consultant, National Health Service, United Kingdom. I had to prepare for an interview and it was while doing so I realized how systematic the NHS team was in assessing candidates for recruitment. While preparing for the interview I had to go through a standard set of questions, at the end of which I realized that making a career decision is a structured decision making process and not a series of chat sessions at the college canteen.

An interview usually starts with “Tell us about yourself” followed by “Take us through your CV”. This is followed by the obvious question “Why do you want to join this trust?”, “Why should we give this job to you?”, “What can this trust offer you?”, “How will you contribute to the trust?”, & “Why did you quit your last job?” In answering these few questions you speak about yourself and your work but more important about your resolve to join a new organization and how you will align your career plans with that of the trust. This single question “Why do you want to join this trust?” sets you thinking. I had to open a diary and keep writing the points as they crossed my mind. This too at a stage of my life when I have completed 22 years of commissioned service and 2 years of private practice in a corporate hospital. I had never gone through this exercise before, or even spent 5 minutes on pondering over a similar issue at any time in my life. I remember my friends who payed out – for some, the decision was part of the patriarchal hierarchy and for others it was a default decision reached at by the process of exclusion, i.e. excluding the option of joining the forces. If you spend time pondering over this question it will become clear that you need to have a good knowledge about the organization, a fundamental flaw with all of us whether we join or do not join the forces. Our knowledge of the Indian Armed Forces or the British or American health systems is paltry and most of it based on hearsay. As far as the Armed Forces medical services is concerned my knowledge at time of commissioning was limited to that about AFMC, a few establishments, some flag ranks, availability of liquor, sixty days of annual leave, and the options for post-graduation. I spent 22 years in an organization I joined based upon this limited knowledge! Today when I prepared for the NHS interview I had to read up a lot about the organization, hospital I had to join, their future plans, the job requirements, besides being clear about my career plans. A proper answer to this single question will definitely clear your understanding of the system you wish to join.

The basis of your decision to join the new organization has to be very clear, e.g. NHS is a leading health care delivery system, it will give me a platform to excel in my field, it is fulfilment of a dream to be part of an evolved medical system, and so on. Similarly you should write down the points you feel are for and against your decision to join the forces. This process can start in the first term and culminate after the IX term results. At no stage should your career option compromise your academic performance. The desire to excel must outplay all career choices. Your first goal must be to achieve merit in all subjects. Once you have achieved this goal you can go ahead and navigate through your list of pros and cons about joining the forces.

The next set of thought provoking questions was “Where do you see yourself in five / ten / twenty years from now?” I must admit I never thought on these lines when joining the forces. One has to sit down and look ahead at life form a different perspective. Our foresight is usually ends at post-graduation or speciality examination. We all suffer from a short foresight and very long hindsight. Try imagining yourself in an appointment ten years down the line. It is a totally different experience. I wish I had imagined myself in specialist appointments outside AFMC. The truth is that there are numerous postings beside AFMC & life in AMC is different for those posted to AFMC versus those posted to other units. You must have an idea of how life is for those working in other medical & non-medical units. Before my NHS interview the organization had sent a brochure which described a day in the life of a consultant in my speciality, the call duty rotation, the leave programmes, familiarizing me with the job requirements and expected lifestyle. Similarly you should be familiar with the working schedule, duty requirements, and standard lifestyle of a serving AMC officer. It is preferable to find out the details yourself rather than through hearsay. Ask yourself “Can I fit into this job profile?”, “Is this I want to do in life?” Clear all your doubts by personally interacting with the concerned officers. Iron out all the discrepancies between your perceptions of the job and the actual scenario. Test your comfort levels on completion of this exercise. You will know what you are getting into and even if you have no choice this exercise will help you understand the system better and make your life peaceful. Even today for many of us the pride of wearing the uniform and serving our country overrides all our personal desires.

One of the interviewers was the Human Resources personnel. He briefed me about the values & behaviours of the particular trust hospital. They included pride, respect, empathy, consideration, compassion, and dignity. He asked me if my values matched their value system. The trust wanted us to “live our values & deliver the best patient care”, have “fulfilling & enjoyable place at work”, exhibit “right attitude & behaviour contributing to a positive patient and staff experience”, designing a “crucial role for each individual” and finally motivating us into “putting our heart into what we do”. I wish I had looked upon the Armed Forces from this angle prior to commissioning. The Indian Armed Forces still remains one of the largest organizations in this country. It offers a platform where one can serve with pride and dignity and live up to all his personal values. Like any organization in the world there are shortcomings but in no way will they compromise your personal values. To put it in other words if you feel you have to compromise upon your value system while in the line of duty, you should be strong enough to take a decision to adhere to your principles and either improve the situation or just let go of the situation without compromising your principles.


To conclude I have spelt out a few questions which you must answer before making a career decision. All these answers must be based upon extensive research done by you. The best way to do this research is to interact with as many people whom you feel are learned and see as a role model. Once you start the process of answering these questions you will find that there are many more questions arising which need to be addressed. Take your time and do so till no questions are left unanswered. You are then your own boss to make a career decision for you own self. If you feel confused after reading this article whether I want you to join or not join the forces, then I have to say that this write up was not about my preference but about showing you a correct way to go about making career decisions. 

Saturday 20 February 2016

Emergency contraception

Emergency contraception:

WHO fact sheet on emergency contraception: includes key facts, definition, situation, methods.

Wednesday 17 September 2014

Voter Registration

It will be heartening for interested individuals to note that their struggles to get registered as voters have been fruitful!

As a first step, all those above 18 years of age, residing in the Hostel have been registered as voters for the Pune Cantonment Board elections which will be held shortly in this year itself.

For your info, the person you will elect as a Member of the Board, will be the one who can get a pavement made outside the Hostel on the sides of the road leading to Fatimanagar and Bhairoba Nala. He / she can arrange to ensure that the garbage / refuse from the Hostel can be lifted regularly, he / she can arrange beautification of the general area surrounding the Hostel, can get the road signposting and zebra crossing painted.

So be aware of the above, and place your expectations before potential candidates.

In the second step, which was more difficult, it has been learnt that we have been partially successful in getting our students into the main voter list (which results in an Election ID card). However we do not know the exact details as yet.

Please visit the link http://103.23.150.139/marathi/
District is "25- Pune" Constituency is "214 Pune Cantonment"

Try out various combinations of your name, i.e first name and last name interchange etc, and see if you have got lucky,.

Please remember that it is your right and your  duty to vote. Be empowered, Be aware. In a democracy , you as a citizen have a vital role.

All the best
  

Wednesday 27 August 2014

Pune Dengue Alert

PREVENTION OF DENGUE

1. As all are aware, Pune is having cases of dengue cropping up regularly. We have had a few cases locally too, however they appear to be 'imported'. Still, beware, the Aedes mosquito is near.

2. Based on an average  students' academic knowledge,  you all are aware that the Aedes mosquito recognized by its black & white striped body , bites in the daytime and breeds in artificial collections of water, usually within the imdt vicinity of human habitation. Dengue is a viral disease, as is known by you all. 

3. Students are informed that a survey was done recently, and breeding of the “tiger mosquito” was found in broken bottles thrown around the area, in buckets with soaked dirty clothes, and in plastic packets littered around apart from in the vegetation. The enemy vector is within the hostel ! and in the Hospital and College campus too and of course in Pune!!. Be warned, be careful!.

4. Dengue is not directly transmitted from person to person. Persons are infective for mosquitos from shortly before, to end of the febrile period. The mosquito becomes infective about 8-12 days after the blood meal. The incubation period varies from 2 to 8 days. Promptly report to the MI Room in case of any fever. Further, it is imperative that Aspirin (Disprin) not be consumed indiscriminately for fever etc, as with this kind of viral fever, dangerous complications may occur.

5. The main measure for prevention and control of dengue, is very simply by eliminating breeding sites within the Hostel, for which your cooperation and participation is requested. Fogging is being done through the kind assistance of our local SHO. 

6. Please ensure that you do not throw bottles / containers / plastic packets around the campus. Please use garbage bins. Also, do not leave buckets filled with water for long periods. Do not let water stagnate in air coolers (change water every week). Report any breeding site within the Hostel to the Adm NCO. 

7. Don’t sit outdoors scantily clad and prefer to wear trousers. Mosquito repellent cream is being made available in the Hostel Office at the scale of one tube per cadet with imdt effect. Please use ad lib.         

Be safe. Keep Dengue Away!

Saturday 19 July 2014

Z Batch Devashish Sharma Monsoon Football Cup

All in the know, you know what the M for Monsoon actually stands for!
The rains have come to Pune at long last, and as the ground gets soaked, and the breeze is pregnant with moisture, the clouds hang heavy, its time for FOOTBALL!!

The second edition of the Z Batch Devashish Sharma Monsoon Football Cup is planned as per the following fixtures....

23 Jul Wednesday 
Inaugural session (all of 10 minutes!)
X2 vs Z2 followed by W2 vs Y2

24 Jul Thursday 
X2 vs Y2 followed by W2 vs Z2

25 Jul Friday 
W2 vs X2 followed by Y2 vs Z2

26 July Saturday 
1700h Finals.

May the best team win!




Sunday 27 April 2014

Its Hot in Pune!

NOTICE
PREVENTION OF EFFECTS OF HEAT

1.      The dangerous combination of heat (and on cloudy days a little humidity), is sapping to the strength of an individual to sustain efficiency, and will decrease productivity and work output, besides being detrimental to health. It is to be appreciated by all cadets, that the effects of heat, range from subtle to overt, and can take effect very rapidly. Currently, temperatures have begun to touch 40 degrees C in Pune, with higher temperatures anticipated. The important conditions arising from effects of heat are:-
(a) Heat Stroke : Characterized by sudden high fever and prostration.
(b) Heat Exhaustion : Fatigue, thirst , weakness.
(c) Heat Cramps : Muscle cramps , weakness.
(d) Prickly Heat : Skin rash with itching.

2.      It is of utmost importance that an early recognition and diagnosis of the effects of heat be made, and prompt treatment be instituted, as casualties may result otherwise.

3.      Preventive Measures  for Students
                             DO’s
          (a) Do drink clean, cool water often during the day.
          (b) Do wear a cap when going outdoors. Use of an umbrella is                           encouraged. 
          (c) Do walk in the shaded areas of the college campus when going to               class.    
          (d) Do loosen your collar button and your tie periodically.
          (e) Do have a bath daily and use talcum powder or deodorants.
          (f) Do report to your RMO in case of being affected by the heat.

                             DONT'S
          (a) Don’t drink sugarcane juice from roadside vendors.
          (b) Don’t drink very cold water or carbonated drinks.
          (c) Don’t play outdoors before 1730h.


4.      Please remember that heat has subtle effects on the psyche and the body. Be watchful and alert. Stay indoors as far as possible, and avoid abrupt changes of temperature from cooler indoors to the outdoors. 

Friday 11 April 2014

Airborne Diseases Prevention and Control

BOYS HOSTEL

AIRBORNE DISEASES PREVENTION

FAQs ANSWERED

1.    Infectious diseases like measles, mumps, rubella, chicken pox are caused by viruses and spread rapidly in closed communities like hostels, leading to loss of workdays and thereby affecting education. Rash of measles or chicken pox may be characteristic, however mild, atypical and inapparent infections may also occur. Past vaccination may or may not provide immunity.

2.    Mode of Transmission : Transmission is airborne or by droplet spread (respiratory route) and by direct contact with affected persons OR indirectly by contact with articles or items contaminated with discharges / fluid (fomites) from lesions of infected persons. However the scabs of chicken pox are not infective.

3.    Incubation Period : For Chicken Pox and Rubella -About 14 to 16 days ( range 2 to 3 weeks); For measles – 10 days to fever and 14 days to rash; For mumps – 16 to 18 days.

4.    Period of Communicability : Chicken pox - As long as 5 days, but usually 1-2 days before onset of rash, and continuing until all lesions are crusted (usually 5 to 6 days after onset of rash); Measles – 4 days before rash to 4 days afterwards; Rubella- 1 week before rash to 4 days afterwards; Max infectiousness in mumps is 2 days before onset to 4 days afterwards.

 

5.    Control of spread / occurrence of airborne diseases

       
   (a) Early detection & notification of cases:

A high index of suspicion to be maintained especially among cadets with rash and fever. Cadets are advised to promptly report to MI Room for examination by RMO.
                   
(i) Screening Daily checking of exposed group of cadets by Floor Monitors for minimum 3 weeks from last case of chicken pox. All cadets to be examined bare-chested in daylight for the characteristic rash of chicken pox. Verbal history of Cough / Coryza / Conjunctivitis for clinical diagnosis of measles may also be elicited. Floor Monitors will promptly inform the Hostel Office of any suspect cases.   

(ii) Isolation of all cases by admission in CH Isolation Ward as decided by RMO. This is reqd till all the lesions have dried (scabs) (in chicken pox) and for 4 days after onset of rash in measles.
       
Note:    Please don’t visit cadets in the Isolation Ward! Out of bounds for all except those admitted there.

(b) Segregation of exposed group : To remind cadets – ‘Isolation’ is for cases, while ‘Quarantine’ is for those susceptible who have been potentially exposed to infection as ‘contacts’. However a milder term ‘segregation’ is being used for the extant situation.

(i)       All cadets exposed to a case in the Hostel are to be segregated (quarantined) for a period of minimum 03 weeks from the exposure to the case, and stay in their rooms, with a separate training program if feasible.

(ii)      Sports and academic activities may be carried out in the segregated group together, without mixing with other cadets.

(iii)     The segregated group of cadets should be provided meals apart from other cadets in the outer hall of the CCM itself, from a separate serving point.

(iv)     They should not attend any general assembly, even movies for the period of segregation.

(v)     The gym and the reading room / library and other common facilities will be kept out of bounds for the segregated group.

(vi)     Daily screening as per para 5 (a) (i) above.

(vii)    All cases detected among the segregated group to be isolated, under orders of the RMO, by admission to the Isolation Ward.
       
(c)        Control of environmental factors:

(i)       Cadets to avoid ‘hanging out’ in groups. An arms length to be maintained when in groups (respiratory distancing). Cadets to avoid exchange of greetings by shaking of hands, high fives, or hugs / embraces.

(ii)      Cadets to improve ventilation by keeping windows and doors open in the daytime.

(iii)     Avoiding sharing of bed linen and clothes in the Hostel.

(iv)     Avoiding of mass assemblies in enclosed areas.
       
      (d)     Disinfection : Of articles soiled with throat and nose secretions.

(i)       Sun drying of all linen and bedding regularly.

(ii)      Daily ventilation of rooms and mopping with 1 % Cresoli Black.

      (e)     Respiratory Etiquette

(i)       Do cover your mouth and nose with the crook of your elbow / back of your hand when coughing or sneezing.

(ii)      Do not spit or blow your nose indiscriminately.

(iii)     Do use a handkerchief and wash the same regularly.

                   
6.       Personal Hygiene
          All cadets are advised to have a bath with soap and water daily, and use a suitable anti perspirant or deodorant. A change of clothes daily is advisable, with said clothing items being sent to the laundry regularly. Handkerchiefs are best washed individually and thoroughly sun dried. 

7.       Health Education

Cadets to ensure dissemination of info about prevention and control of  airborne diseases to all their fellow cadets, and ensure compliance with instructions issued by College authorities to control the situation, especially segregation guidelines.

A high index of suspicion for identifying cases in the Hostel is requested. Cadets are advised to promptly report to the MI Room in case of any prodromal symptoms.

There is no need for any panic, or fear. The situation is under control and adequate steps are being taken by the College to address the issue.

       
8.       Role of Vaccination

          Cadets are informed that College authorities are investigating the evidence in favour of vaccinating cadets against chicken pox, as a routine measure and within the requirements of existing policy framework.


However in the extant situation, there is no overwhelming evidence available to permit measles vaccination for all cadets. Please do note that immunity acquired from natural infection is lifelong as compared with vaccine derived immunity which may wane over the decades. The matter is being reviewed and updates will be provided as and when available.