In this interview series, Part 2, we engage in meaningful conversations with Peddaputha Akbar Basha who generously shares their experiences at the Kurnool Medical College, Kurnool, Andhra Pradesh, India.

Priya: What are the challenges faced during academic and clinical rotations?

Akbar : What we learn in exams is to secure good marks or at least pass. Nowadays, the introduction of different rules and regulations has made it more challenging for students to pass or succeed. In the field of medical studies, for example, there used to be no limitations on the number of years one could attempt to pass. However, now students are given only four chances to pass.

Previously, if a student failed in a regular examination, they could take a supplementary exam. If they did not clear the supplementary exam, they could proceed with backlogs. But now the situation has changed, and students are only allowed to attempt supplementary exams in subsequent years. This causes a significant waste of time for students.

There can be various reasons for a student's failure, such as health issues, family circumstances, or lack of focus on the subject. Many aspects contribute to the challenges students face. As a student myself, I find it difficult to navigate through this ambiguous system.

Priya: Was there any patient case that had a significant impact on you during your clinical rotations? How did that experience influence your understanding of medicine?

Akbar : Exposure to patients and the results we achieve provide valuable insight into selecting our future branch in medicine. If, during clinical rotations, we find it challenging to connect with patients or struggle to retain and effectively communicate information, it may indicate a different suitability for us in the future. Each of us has unique mindsets and attitudes that influence our career choices. Therefore, it is essential to select a branch based on our interests and strengths.

In the future, our branch selection should not be solely influenced by the number of patients encounters we have had. Instead, it should be a thoughtful decision based on our passion and compatibility with the branch. Clinical exposure from the second year onwards helps students gain clarity about which branch is most suitable for them. If you were to ask our friends about their branch preferences, they might say that a particular branch is their first priority while another is their second priority. When asked why, their responses often revolve around feeling a sense of fulfillment and satisfaction when treating patients in those branches. This deep understanding of personal preference is a significant advantage of clinical exposure.

Priya: There are instances when patients' family members do not cooperate with interns, doctors, and other healthcare professionals. In such situations, how you ensuring effective communication with the patients and their families?

Akbar : We often use the local language, and we may encounter medical and legal cases where others may not accept our treatment and seek alternatives. Communicating effectively in such situations is challenging. We are currently focusing on observing how to communicate with patients. After a few days of observation, we hope to gain clarity on how to effectively communicate with patients, gather information about their condition, and inquire about their medical history. We are in the process of designing communication classes based on our findings and tailored to different subjects and colleges. These classes will teach us how to ask questions, respect patients' privacy, and handle confidential information. However, sometimes patients may not disclose their complete treatment history. In such cases, we need to find ways to gather that information without violating their consent. This type of communication can be complex, especially when patients delay sharing information.

We acknowledge that not receiving complete information from patients can create difficulties for us in reaching a diagnosis. However, we remain committed to finding the necessary details about their medical history during any point of treatment or communication. In some cases, there might be biological variations in the system that we can identify through medical examinations. Additionally, when conducting studies or reviewing surgical cases, we can gather information from biological markers and patients' accounts, which will enhance our understanding of effective communication strategies. We are aware that obtaining comprehensive information may present challenges, but we are dedicated to adapting our approach to overcome these obstacles.

Priya: How do you stay updated with the latest medical research and advancement in your profession?

Akbar : As a current student, my learning process is continuously evolving. Whenever new updates or advancements in the medical field occur, our instructors inform us about the latest machines and drugs entering the market. They provide us with chemical exposure and explain the features and benefits of these new drugs. Occasionally, marketing teams from pharmaceutical companies visit us to present their products, and we carefully observe their explanations. Our instructors emphasize the importance of ensuring that the drugs we choose have a positive impact on patients, considering factors such as our climate and the patients' specific situations. They encourage us to stay updated on any new developments in the medical field.

In addition, we also obtain information through social media platforms. Many of us have Instagram, Facebook, or other social media accounts where students share relevant updates within our groups or through WhatsApp. This allows us to stay informed about the latest developments and share valuable information with one another. Social media serves as a useful tool for exchanging knowledge and staying up to date in our field.

Priya: Tell us something about the campus/college.

Akbar : Our campus, Kurnool Medical College, is a prestigious government college established in 1965. With a history of approximately 65 to 67 years, it is considered one of the top undergraduate colleges locally. Being a student here feels like a privilege to me as I pursue my MBBS degree. Many graduates from this college have achieved great success and become renowned physicians and doctors worldwide. It's not uncommon to come across graduates from this college, such as the famous Dr. Dattatreyudu Nori who is a well-known medical professional and researcher in our country and beyond.

Moving on to my hostel life, our hostel is located in the heart of our city. It is well-maintained and takes care of essentials such as meals and dining arrangements through contracted services. We are divided into different batches, and each batch gets a chance to supervise the overall management of the hostel. We ensure the workers prepare different menus and deliver meals on time, maintaining good quality. Of course, this service comes at a cost, as we pay a considerable fee for these arrangements, similar to some medical policies.

Fortunately, our hospital facilities are excellent, and we have comfortable accommodations. We also have free time and the opportunity to enjoy pleasant outings whenever we want. Although studying for MBBS can be demanding, we have the option to take a break from our studies by going outside at night and experiencing the city's ambiance. It provides us with a chance to unwind and relax.

Priya: How is the study, and what about the practical?

Akbar : Our daily schedule consists of classes from 8 to 9 in the morning, followed by clinical exposure from 9 to 12. During this time, we go to the hospital for our assigned postings. Afterward, we have a one-hour break. From 4 to 5 in the evening, we have a sports period where our physical director assists us with various sports activities and yoga exercises. Following this hour, we continue with our studies in the classrooms.

We are fortunate to have good accommodation with proper air conditioning and ventilation. Our professors deliver lectures in English, although at times, Northeast students also use different languages to help everyone understand, such as Hindi or Telugu. Practical sessions are supervised by our own professionals, who provide guidance and personal instruction on conducting experiments and procedures. We are encouraged to ask them any questions or seek clarification whenever needed.

Practical assessments carry a weightage of 100 marks, with 80 marks allocated for our performance in the practical tasks and 20 marks for the viva voce. The viva voce is conducted in four sections, with two sections evaluated internally and the others externally. External examiners from different states, such as Tamil Nadu or North India, ensure that marks are awarded based on our presentations and responses during the viva voce, as well as our performance in procedural tasks during practical sessions.

Priya: What skills have you developed during your third year that you believe are essential for successful medical career? 

Akbar : A crucial aspect I have learned throughout my clinical journey, starting from the second year, is the significance of effective communication with patients. It has become clear to me that establishing a strong bond and actively listening to their concerns and pain is vital. Our future practice relies on this skill, as it forms the foundation for providing patients with good treatment. I have also gained a deeper understanding of the importance of ethics and moral values in our profession.

Regarding research projects, during my third year, I had the opportunity to participate in an academic presentation. I was involved in a research study focused on the quality of life of chemotherapy patients. Given the significant number of cancer patients in India, we aimed to explore how they cope with anticancer drugs, including chemotherapy and radiotherapy. We examined the functioning of their organs and different systems and identified any challenges they faced due to the drugs. This ongoing research project has involved collecting approximately 200 patient reports. Through interviews and surveys, we aim to gain insights into their experiences, difficulties in using the drugs, and lifestyle implications. Under the guidance of our H.O. resource, we are working towards presenting this research as a clinical paper, offering valuable insights to the medical community.

Priya: You had mentioned that you are writing a book. Could you tell us a bit about it?
Akbar : I mentioned earlier that I wrote a book on histology based on my learning. It's worth noting that textbooks in our field undergo frequent updates. The books we currently use are typically in their 39th or 29th editions, reflecting the continuous evolution and improvements in medical knowledge and understanding.

Nearly 39 years have passed since the book was first published, and there have been drastic changes in the field of medical education. Presently, students struggle to find sufficient time to read these comprehensive books and identify the key points that are essential for their studies. It becomes challenging for students to navigate through the extensive content, resulting in a lack of retention. This has led to a realization that the high-quality information provided in these books is not effectively utilized by students due to time constraints.

I personally experienced this when I purchased a book worth Rs900. After going through a brief revision, I realized that I hadn't retained much information. However, I managed to clear the exam somehow. This situation highlights the business aspect of publishing these books, where students are unable to allocate proper time to complete them. In the past, students had more dedicated reading time, and social media wasn't as prevalent. But now, every student has a mobile phone, which often distracts them.

This led me to a thought that focusing on important points and creating concise notes that can be shared among students would be beneficial for their future preparations. Anatomy is a major subject in the first year, and students face difficulty in memorizing details such as nerve names, muscle names, bone names, and arterial supply. It becomes a significant challenge. Additionally, many students tend to relax after clearing exams, but they are faced with the demanding subject of anatomy, which holds a 40% weightage in practical exams. Simplifying the study material can help students easily grasp the subject and allow them to allocate time to other subjects.

I discussed this idea with our professors, and they offered their guidance and support. With their coordination, I managed to write and publish the book. Within two years of its publication, the response among students has been positive, with approximately 120 copies sold. As a student, this is quite an impressive number for me. Even professors from other medical colleges have provided positive reviews. Currently, the book serves as a simplified and effective resource that students prefer.

Priya:  What do you find most rewarding about being a third year Medical student?

Akbar : We are currently in a situation where we are being exposed to the experiences of our pioneer students, our seniors, who guide us through the clinical process. Despite being just one step away from the final year, we often struggle to remember the subjects we learned in the first and second years. We try to revise those earlier subjects while also tackling the major subjects of medicine in the fourth year. The third year itself proves to be a challenging and demanding period for us, as we navigate through a hectic schedule. It can be overwhelming for third-year students, in my opinion.

Priya: What do you love to do in your leisure time?

Akbar : Outside of medicine, my passion lies in photography. I enjoy directing and editing videos, and I am a core member and editor for Know Your Calling, an initiative led by some residents. I am also involved in YouTube and enjoy being a YouTuber.

Priya: If given a choice, what alternate career would you have opted for?

Akbar : If I were not a doctor, I would have pursued a career in teaching. If I had not been able to secure admission to MBBS, I might have attempted other options before deciding on a path that resonated with my passions, such as becoming a teacher.

Priya: Any final message for upcoming juniors?

Akbar : Are you pursuing MBBS because it is your personal choice or because your parents want you to, or perhaps because you have a fear of mathematics? It is important to have clarity in these three points because there may be difficulties for doctors in the future in terms of job availability and career prospects. The schedule and examination patterns have changed significantly compared to previous years, with the National Medical Commission (NMC) implementing a unified schedule and exams throughout India. It is advisable to seek guidance from experts and have a clear understanding of the subjects you wish to specialize in from the beginning of your first year. Familiarize yourself with the examination patterns conducted by the NMC and prepare accordingly for both the board exams and the Meet PG examination.

Becoming a doctor is a goal for many individuals, and once you embark on the journey as an MBBS student, you will face the consequences and responsibilities independently. There will be limited parental assistance or follow-up from the early stages of your medical education. The decisions and actions you take during your medical college years will shape your future. I wish all fellow junior students the best of luck in their endeavors.