Is General Surgery a Good Course to Study

Question :

Respected surgeons, I am an aspiring surgeon. Got a rank of 2500 in neetpg and have always dreamt of being a surgeon. But now people are advising against it, saying that there is too much of frustration and money is not good, and that I should opt for obgy or radiology. Massively confused now… is it so? Is surgery no more a decent branch?

Answer :

Dear Doctor
There are 4 different aspects

  1. 1. What we are good at
  2. 2. What we love to do
  3. 3. What the world needs
  4. 4. What we can get paid

Of these
What we are good at
What we love to do
is our passion

What we love to do
What the world needs
is our Mission

What the world needs
What we can get paid
is our Vocation

What we are good at
What we can get paid
is our profession

There are few people
Who can have the all the four in one job / work
Many don’t have that
We must at least learn to distribute our time

For me

  • Passion is Neurosurgery
  • Mission is my work in Government like HMIS, TAEI etc
  • Profession is Web Designing and Software Development where I earn more 🙂
  • Vocation is writing and trying to bring change in Areas like Diet, Healthcare

You can do General Surgery and Still Earn 10 Lakhs
You can do MD Radiology and Still Earn 1 lakhs
What will happen after 3 years, 10 years you won’t know
First Chose the filed you like
with an understanding that you may or may not earn in the same field
If you are able to earn (that is if your passion and profession are the same), well and good
If not do your passion and look for alternative sources of income like Share Market etc in due course

Please note that very few individuals can have the same Profession-Passion-Vocation-Mission
If you have, well and good
If not, learn to adjust
Bottom Line is
As of now
Learn the Course which you love
But be prepared to find that your Co PG earning 10 times as you after 10 years or you earning 10 times as him after 10 years
That we cannot predict now

Hospital Management Protocols to Ensure Efficiency

Statutory Disclaimer : The Following Write Up covers many seemingly unrelated (but in fact related) topics and it may be incoherent / flight of ideas. Read at your own Risk !

These Images were taken in a Medical College in 2018. Those who have not seen this may be wondering about this. Let me explain. These are vials of Injections (probably Ampicillin) undergoing an elaborate process.

  1. Rinse the Penicillin bottle in Saline for 24 hours
  2. Use a scissor to prise open the metal cork (and get injured in fingers – cut or stab)
  3. Remove cork
  4. Keep in sun for drying

After these elaborate preparation, which is complicated and time consuming, these bottles are used to Collect Blood when the hospital needs to send the Blood to Lab for Investigations.


This is in a hospital where we have severe shortage of paramedical and nursing personnel
How much of time is spend in doing this
A staff nurse on average gets RS 30000 (Except for first two years)
Sees 22 to 23 duties per month (Reduce her five off per month plus CL etc)
We pay her RS 1500 per duty
That is RS 250 per hour
And make her do this

If we buy containers to collect blood, it costs much less

Many private hospitals use disposable paper bed sheet and OT dress and theatre linen
They found that

  1. Having a staff nurse spend time daily tallying number of bed sheets and number if towels send to laundry
  2. Maintaining two register
  3. Receiving from laundry
  4. Entering again
  5. Salary of laundry staff
  6. Salary of transport from ward to laundry

All costed more than disposable OT dress and scrub sheets

This Reinforces my pet theory

Of the 100 problems in a hospital
30 percent are due to ignorance
30 percent are due to stupidity
30 percent are due to laziness
10 percent is due to corruption or willful disregard of rules

Very few workers are bad, corrupt
Most workers are just ignorant or lazy


Let us analyze why it has happened and how to rectify it
Why vaccutainers are not used ?
The indent is not placed

Why it is not placed ?
The chief pharmacist does not know it exists
That it is available in TNMSC
Who should tell him ?
Professor of Micro Biology / Biochemistry
Professor of Medicine / Surgery

Why professor of Micro Biology / Biochemistry does not initiate ?
If he / she suggests this
The cost of this will be recovered from the budget of micro / biochem (our people are notoriously good at this ) and at the end of the year biochemistry department will run short of reagents needed to do tests

It usually happens
Test kits for some investigation. Like say amylase, lipase etc are not available in March
As far as biochem is concerned
They are not losing anything now (when staff nurses waste their time in making these bottles)
Why raise an issue and make buying reagents difficult
Who else can change ?
Staff nurse association can
They can protest
The administration will immediately buckle

But the question is
Why we need this to come at level of association
Once upon a time
Manual labour was cheaper and vaccutainers costly
This decision was taken
During the course of evolution
Labour has become costly and vaccutainers cheaper
But switch has not happened
We are waiting for the staff nurse association to raise the voice
We are waiting for the difference to increase and explode through some way

Rather than effect the switchover on the day “the descending limb of vaccutainer price met the ascending limb of labour cost”

We should have a mechanism through which We effect changeovers as and when needed For many of the protocols and procedures in a hospital

Disposable syringes and disposable gloves were used because of HIV

Else even in 2021

  1. we would have happily washed the gloves
  2. Hung them
  3. Powdered them
  4. Reused them

Shall I suggest something
We need to fix a cost for all activities in the hospital

Say blood test for sugar
What is the cost of it

For example

Cost of blood sugar test is

Cost of

  1. 1. One cotton swab
  2. 2. One two ml syringe
  3. 3. 1/1000 of tourniquet cost
  4. 4. Cost of bottle (ten minutes of staff nurse time to prepare the bottle)
  5. 5. Blood drawing and labelling (5 minutes of staff nurse time)
  6. 6. Transport (human or pipes)
  7. 7. Lab reagent

We need to ask hospital to report their cost
We need to see whether one hospital does at high cost and one at low cost
Learn from there

Ideally we should have switched long back and saver more money had we had due financial prudence into the system
Need to build these into HMIS
State health data resource center should track these
Those guys are putting charts for Total OP, Total IP, Total deliveries

Had we done this

We would have found that

PHCs using vaccutainers doing blood sugar at cheaper rate than Rajaji hospital

They use the technology available when the start
PHC gives Anti Rabies Vaccines 24x7x365

While MMC gives it
2 hours a day
Monday to Saturday

  • If you are bitten by a dog in valaparai, you can get vaccine in five minutes
  • If you are getting bitten in park town at 11 am Saturday, sorry gentleman, you need to wait till 8 am Monday

Coming to the main issue
We need

  1. 1. A cost for each procedure at each institution
  2. 2. Cost to be compared across institutions and outliers identified and reasons found out

The cost revised every year

Lab costs : at jan
Pharmacy : at feb
Vehicle : at March

My Scientific and Academic Publication

My Scientific and Academic Publication


List of Publications in Pubmed Indexed Journals

S.No Name of Journal Volume Pages Title Contribution Remarks Pubmed id
1 National Medical Journal of India VOLUME 25, NUMBER 2


109-111 Overcoming shortage of doctors in rural areas: Lessons from Tamil Nadu First Author as well as Corresponding Author Cited by 4 Papers PMID: 22816168
2 Neurology India Volume 65 | Issue 4 | July-August 2017 794-800 Microsurgical anatomy of the superior sagittal sinus and draining veins First Author as well as Corresponding Author Cited by 6 Papers PMID: 28681754
3 Emergency Medicine Australasia 2019 Oct;31(5): 882-885. The World Health Organization trauma checklist versus Trauma Team Time-out: A perspective Author Cited by 2 Papers PMID: 31081585

List of Publications in Journal Indexed in Index Copernicus

4 Indian Journal of Applied Research Volume-9 | Issue-3 | March-2019 | PRINT ISSN – 2249-555X 61-65 A STUDY OF INCIDENCE, MANAGEMENT, AND OUTCOME OF PAEDIATRIC EDH (EXTRADURAL HEMATOMA IN CHILDREN) Second Author as well as Corresponding Author    
5 International Journal of Scientific Research Volume – 10 | Issue – 07 | July – 2021 | PRINT ISSN No. 2277 – 8179 | DOI : 10.36106/ijsr   TREATABLE AND CURABLE CAUSES OF POOR ACADEMIC PERFORMANCE IN


First Author as well as Corresponding Author    
6 Global Journal for Research Analysis


VOLUME – 10, ISSUE – 07, JULY- 2021 • PRINT ISSN No. 2277 – 8160 • DOI : 10.36106/gjra





First Author as well as Corresponding Author    


Volume – 10 | Issue – 07 |July – 2021 | PRINT ISSN No. 2250 – 1991 | DOI : 10.36106/paripex






First Author as well as Corresponding Author