I am very proud to call the Institute of Liver and Biliary Sciences, New Delhi my mother ship, that's what doctors call it - Dr. Cyriac Philips. 
DocScopy

The Liver Doctor on a Warpath to Bust Myths: Dr. Cyriac Abby Philips (Part-1)

An account of how Dr. Cyriac Abby Philips became The Liver Doctor, as he is popularly known on Twitter and Youtube.

Parul Soni

Welcome to another section of DocScopy, let us walk through the life and professional journey of Dr. Cyriac Abby Philips. MedBound Times (Parul Soni) was fortunate enough to get an opportunity to have a candid conversation with The Liver Doc as he is popularly known. His tweets are full of myth-busting education. Many of his latest tweets are viral around the world. Dr. Cyriac Philips did his MBBS from St. Johns Medical College Bangalore, his MD in Internal Medicine from Nilratan Sircar Medical College, Kolkata, India, and his DM in Hepatology and Transplant Medicine from the Institute of Liver and Biliary Sciences, New Delhi.

Dr. Cyriac Philips is a two-time American Association for the Study of Liver (AASLD) clinical hepatology plenary awardee (2015, 2017). Three-time AASLD Young Investigator Award winner (2015, 2016, 2017). A winner of the President of India Gold in Hepatology from Institute of Liver and Biliary Sciences, New Delhi in 2016.

Dr. Cyriac Philips is currently a senior consultant in the Department of clinical and translational hepatology at The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva, Kerala, India. He is also, Faculty Member of Guidelines Committee on Drug Induced Liver Injury, Asia-Pacific Association for Study of Liver (APASL). Dr. Cyriac Philips is also Clinical Advisor and Doctoral Advisory Committee Member at Department of Cell and Tissue Culture, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Government of India) at Trivandrum, Kerala.

Parul Soni: Please tell us about your professional journey and life in general, what are you doing now?

Dr. Philips: Currently I am a practicing hepatologist. I am a senior consulting hepatologist and physician at Rajagiri Hospital in a place called Aluva in Kochi in Kerala. We have a separate institute for liver disease and it’s management. It is called the Liver Institute it is under center of excellence in GI sciences so I am a senior consultant there.

I started my journey with my bachelor's degree in St. Johns Medical College Bangalore completed in 2007. While trying for MD I cleared the entrance examination on my 2nd attempt I got through for internal medicine at Nilratan Sircar medical college in Kolkata. So I already lost a year for MBBS and I lost a couple of years for doing MD, also I was an average student. I was not like a gold medalist, the only subject I won some laurels was forensic medicine. I have honors in Forensic Medicine but other subjects I have just scraped through, especially Anatomy.

After graduating from Nilratan Sircar College in Kolkata, I lost one more year there because I wanted to get into DM and then I prepared at home at that time but it was not good enough. I started working as a senior resident, and a non-academic resident at the Institute of Liver and Biliary Sciences in New Delhi. I wanted to do gastroenterology because my father Dr. Philip Augustine is a very senior gastroenterologist in India.

Parul Soni: Please tell us about your father, Dr. Philip Augustine.

Dr. Cyriac Philips: Dr. Philip Augustine is a very senior gastroenterologist in India. He’s been practicing for 4 decades now. I would call him one of the founding fathers of gastroenterology in India. Dr. Philip Augustine was the first person who actually did the ERCP (Endoscopic Retrograde Cholangiopancreatography) procedure in the country. Dr. Philip Augustine was the first person to report Crohn's Disease in the country. He is in a league of his own. Dr. Philip Augustine was actually a Padmashree award winner in 2010 by the government of India. So he has set up a lot of milestones in gastroenterology practice in south India so I was automatically attracted to gastro practice.

When it came to my turn to do super specialty, my dad himself said that gastroenterology will get saturated because it is more into skills. So a lot of endoscopies, new types, and techniques of endoscopic procedures will come up, so that’s how it’s going to be in the future. So the pure clinical practice in gastroenterology will come down. He told me this many years back when I was actually preparing for my DM exams.

Parul Soni: Sir, how was the Hepatology journey and when did you get your gold medal from the late President Pranab Mukherjee?

Dr. Phillips: I went and started my senior residency in hepatology at the Institute of Liver and Biliary Sciences, New Delhi Under Professor Dr. Shiv Kumar Sarin. Dr. Shiv Kumar Sarin said that hepatology is a sub-specialty in Gastroenterology and it has significantly more to offer because it has transplant hepatology as well as basic science hepatology. A lot of patients that we actually see even in Gastroenterology are from the liver.

In gastroenterology, patients in ICU, if you see a maximum number of patientsat a time. They are from the liver department because they are the ones who are really sick. Dr. Shiv Kumar Sarin said that try this once and see how you like it and then take it up. I had no idea about the liver, I didn’t even remember the segments of the liver when I entered in my DM course, I was that basic. During that small stint I had in the Institute of Liver and Biliary Sciences, New Delhi, my hepatology senior residency was a different journey on its own. I have never seen or felt that kind of clinical practice in my life. It was because the patients were so difficult to manage, everyone is so crude, and managing them is a hard protocol. If there was a patient who was out of the protocol then they would actually be doing some research protocol on such patients and finding out new things to do for those patients. So I found out, hepatology has not just simple clinical practice, but it is actually very protocol based. You can build on a successful protocol if you do hepatology and I fell in love with it.

I started reading more about Pathology and gastroenterology and in my first attempt after my first year of residency, I actually got into the Institute of Liver and Biliary Sciences through their own exam so they had separate exam at that time they used to have.

I gave the AIIMS entrance exam because everyone was giving the AIIMS exam because that was the first thing to do and then I actually studied hard for hepatology because a lot of questions at the Institute of Liver and Biliary Sciences included hepatology based on very little from gastroenterology.  I don’t believe in prayers and luck and all that, I believe if you actually work hard that is how you make your own luck. I worked very hard. I burnt the midnight oil. I struggled a lot studying at that time, then I got through and then I joined the program at the Institute of Liver and Biliary Sciences Delhi and that was life-changing for me.

After completing these, I was also the best student where I received the gold medal from the late President of India Sri Pranab Mukherjee. These were very important aspects in my life because I was always an average student and I never considered myself a brilliant student, I used to go with the flow. But then I understood that if you actually work hard, try to aim for improving yourself, and doing better things for your patients, colleagues and patient's families and everything it actually shines back on you.

This was something very interesting because through that it was kind of satisfactory clinical work because it was not like a 9 to 5 job. I understood that work satisfaction and action that you should have in life because without that your life is not satisfactory.

Parul Soni: After talking about protocols, I have a question. Did you get into Research?

Dr. Cyriac Phillips: Yeah exactly! This happened at the Institute of Liver and Biliary Sciences once I completed my course there and I could do a lot of new things. I did my first paper publication from there. I started to research. I know the importance of what you call statistics. Knowing statistics is something that I completely neglected during my MBBS time in community medicine. I was seeing 100 patients a day in the institute and I completely went into research methodology.

Once I was out of the Institute I felt empowered. I was not just treating patients but also actually trying to think out of the box, in that sense. Even doing research protocol methodology, every thing they taught me from the Institute as a whole package. That was such a good thing, I mean I was glad that I studied there. I am very proud to call that institute my mothers ship, that's what doctors call it.

I started working in Kochi, initially in a private hospital called CBS Hospital. I wanted to start a hepatology transplant unit, research unit, and more. We moved to another hospital called Medical center and from there currently we are now in Rajagiri Hospital. Here we have every infrastructure for the patients and I am working here. I am also doing research, specifically clinical research with my group of selected people who work with me so this is my whole journey.

Parul Soni: Sir has this become your passion, what drives you further?

Dr. Cyriac Philips: Yes it is now, because I am there at my research unit every day. I mean when we have colleagues who think at the same frequency that I have. For example, the clinical research team has had a homeopathy doctor and ayurveda practitioner and they are not practicing. They have joined me and we are doing a lot of good work. Looking into a novel way to work and approach difficult legal situations.

For instance, we are doing a lot of work on alcoholic hepatitis and we do a lot of on drug-induced liver injury. We do a lot of work on complement and alternative medicine-related injuries to the liver. So every day it’s not just clinical practice. It is a lot of discussion on how we look at things from another perspective. So this has become a passion. It’s not just a 9 to 5 job anymore. It becomes a part of your life. I am happy with it.

Parul Soni: That actually reflects the way you speak the way you reply to People the way you debunk the myth that is why everyone is going crazy about The Liver doc (Twitter handle name).

Parul Soni: Tell us more about the Twitter sensation you have become!

Dr. Cyriac Philips: I mean I am actually not at all like that in real life. The character you see on Twitter and in person is very different. What happens is that certain discussions actually do not require your time in it. I joined Twitter and debated whatever myths and pseudo-science or traditional medicines-related discussions are floating around in social media towards people. I think that part has become interesting for others because I just put in the facts and move on I don’t keep on debating.

Parul Soni: Sir what happens when people start trolling you all the knowledge you’re delivering is you know

Dr. Cyriac Philips: Trolls I completely ignore. Some trolls are funny because I can make some humor out of it so I go online and have a chat with them.

Stay tuned for more interesting conversations with Dr. Cyriac Philips.

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