Balancing Dentistry and Healthcare Administration: A Conversation with Dr. Mahalakshmi (Part-1)
Dr. Mahalakshmi Sivashankaran is a BDS graduate from Manipal College of Dental Sciences, Mangalore, Karnataka, India (Graduation Year - 2022), and worked as a Junior Resident at VMMC & Safdarjung Hospital at the Department of Dental Surgery till January, 2023. She has completed a Diploma in Executive Healthcare Management from the Loyola Institute of Business Administration. She is currently an Administrative Intern at Michigan Medicine, USA.
Himani Negi: I would like you to introduce yourself to everyone who will be reading the interview.
Dr. Mahalakshmi Sivashankaran: I'm a general dentist and I've been practicing for a year. I graduated in 2022 from Manipal College of Dental Sciences in Mangalore and I've been working at VMMC and Safdarjung Hospital for around eight months then I shifted my role to as a medical content writer at Medical Dialogues, which is also in New Delhi. I've had a varied profile as I've indulged in the clinical services as well as the non-clinical site. But now I'm going to pursue my Master's in Health Services Administration and shift to a more managerial role like in the future.
Himani Negi: So, I have a few questions before Priya takes over. I was going through your profile. We had a lot of interns with dentistry background in our internships as well as the writing internship. I have met a lot of dentists, so I have seen that most of the dentists are switching from clinical to non-clinical backgrounds and most of them are going through public health programs. For example, one of my seniors was also working as a content writer at MedBound Times. She is right now in Britain and she's pursuing her Master's in Public Health from there. So, is there a reason why dentists are not going through MDS or they are more majorly switching to writing or public health? What is your reason for switching from BDS to Master's in Health Services Administration.
Dr. Mahalakshmi Sivashankaran: So, I feel like after COVID there's been a huge switch from just practicing medicine and more focus on public health. I mean it's become more of a trend right now because of the pandemic Plus, the dental industry is pretty saturated at least on the clinical side because there are so many dental graduates coming out each year. So, that is one of the major reasons why a lot of people are shifting towards a more public health kind of career approach. More importantly, I switched to a management role because I figured out that there are a lot of problems and a lot of things that can be solved in terms of service delivery like the healthcare industry. There are so many issues about the cost of healthcare, there are insurance problems and healthcare delivery for people who are in rural backgrounds. So, to develop that side more. I decided to switch to a more public health kind of scenario.
Himani Negi: Great so my next question is that there is a standard for doing MBBS in India. The first preference of any aspirant is to do MBBS only if they don't get into MBBS then they switch to BDS or BAMS or another field. So, was BDS your first choice, or was it because of other factors that were there behind choosing BDS?
Dr. Mahalakshmi Sivashankaran: See honestly when I was giving NEET, I was pretty naive about what I was going to choose and I did not make a choice that I would choose medical or I would choose dental. I was open to both options but when like after giving me and when the counseling and all started, I started talking to a lot of seniors who were already enrolled in colleges, and like when I talk to dental students I figured out that there is more of like, a combination of different aspects of like life like there's art, there's science, there's technology, everything is mixed in dentistry so that's why I chose to go into a dental field instead of choosing medical.
Himani Negi: After your college, you got into Safdarjung Hospital. You were a junior resident so I would like you to share your experience. How was your experience working there?
Dr. Mahalakshmi Sivashankaran: I was looking for jobs and I was going through LinkedIn. I was giving interviews and I was submitting my resume to different places. I got selected for the interview and I gave my interview. I started working at Safdarjung. It was a different experience altogether because I got to experience a huge flow of patients and there was so much there was such a dearth. The availability of doctors was limited. It was difficult to handle the patients that were coming in. The entire attraction with a governmental hospital is the fact that there's plea treatment there. So, there were so many patients. The doctors that I worked with found it difficult to handle the patient flow.
Himani Negi: So, is this scenario the same, or has it improved now?
Dr. Mahalakshmi Sivashankaran: I worked there for eight months. Junior Residency is usually like a year but then I had to cut it short because I was also going to the United States as well. The ratio of doctors to patients is still a problem. The ratio is still not great out there but I think things are improving and eventually I think they will catch up.
Himani Negi: You decided to pursue Master's in Health Administration. What was the main reason? And when did you start preparing for this?
Dr. Mahalakshmi Sivashankaran: So, I started around 2021 in September. I started giving my exams like my TOEFL and GRE and I started preparing my SOPs and everything so I had planned to give my applications to the early deadline. So, the early deadline starts from like you have to start your application process from September and you start getting in your decisions from like December-January. Those three months are deadlines, so I was planning to complete the application process by then. I started with my competitive exams and then my SOPs then the resume then getting your letter of recommendation from faculty members so I wanted to finish all of that before. I started very early.
Himani Negi: So, ma’am along with the TOEFL exam you also took the GRE, right?
Dr. Mahalakshmi Sivashankaran: Yeah. I have taken the GRE.
Himani Negi: So, can you please talk briefly about your preparation plan. How did you prepare? Were taking a break, or was it in along with your job or the internship that you were doing?
Dr. Mahalakshmi Sivashankaran: So, I prepared for it along with my junior residency that I was doing at Safdarjung. I joined classes like online classes because I mean it's been a long time since I did math or anything so I genuinely needed help with math. So, like for the quantitative section, it was a little difficult to cope with the concepts because for the past five years, I've just been doing medical subjects and so catching up like the quantity to part was a little difficult. But other than that, the verbal part is, it's manageable, but it's a little complex like some concepts are not taught in school, so we have to grasp those concepts for the GRE at least.
Himani Negi: So, how much time do you know one should require you know you think it will take for one to prepare for this exam? And along with what tips and tricks you would like to give to the aspiring candidates regarding how they can prepare along with you knowing their studies or their jobs?
Dr. Mahalakshmi Sivashankaran: So, GRE is like an MCQ-based exam and there's a time limit as well that you have to finish it within. So, I would suggest taking practice test papers and getting familiarized with the whole user interface because it's an online exam. You have to be sure that you are okay with operating a computer, you're fast with it and you know how to use the calculator on the exam portal. The practice of all of that along with that just continuous practice of MCQs helped me out and I was going for coaching. Whenever I had doubts, I used to just call up my teacher and ask her. You should be free and you should ask questions. I feel that if you're from a medical background, getting to the quantitative part of the exam is something that makes it's a little difficult to catch up with those years of not doing mathematics.
Himani Negi: Yeah, as a Medico we know this very well. So, like you were saying that you took coaching, was it like the study material? Everything was prepared by coaching itself or you referred to some other books or sample papers.
Dr. Mahalakshmi Sivashankaran: No, I only used my coaching material. It was pretty. It was very sufficient because they had like material from like a lot of years from around 10-15 years. They had like past question papers and everything. So, it was very easy. I did not have to go outside as such, but for TOEFL I didn't take any coaching as such and I prepared on my own. I just bought a book from Amazon for TOEFL like the General TOEFL exam book and I visited their website. I saw what competencies they are looking for in terms of speaking, writing, and reading. For TOEFL it was pretty easy. It's not that difficult as compared to the GRE. Even in terms of the English level, TOEFL English is comparatively easier than GRE English.
Himani Negi: So, when your result was out you qualified for your GRE, how did you start applying for the universities. I would also like to know if instead of pursuing your Master's from India, whether you preferred to pursue from abroad. Any specific reason?
Dr. Mahalakshmi Sivashankaran: Once I got all my documents ready, for the US, there is a portal called Sofar, you have to apply to all the universities. So, for me, I made the selection using ranking across my course and just asking around people and if the college is good enough. Doing my research and reading their websites about their courses. So, I mean doing research is of utmost importance. You need to know how your university is, what they teach, and what the faculty is. All of those things are very important like pursuing a Master's in the United States. The research really helps you through the interviews and it helps you communicate with the faculty further. Once everything was done. I shortlisted a list of like ten universities and I had applied for these ten universities through the portal. So, you have to upload all your documents there and all your transcripts and everything. Once they started calling me for interviews and after the interviews they told me the decision. So basically, like for the US, it's not one thing that they judge. It's like ten different things they judge and they use a cumulative like a report. They make a cumulative report of the student and then they select them for the university. So, for me, I chose Michigan because it has a good ranking and I was in support of all the core competencies they were training the students with. I had talked to a couple of seniors before applying as well. That's why I did not think twice before choosing the University of Michigan for my Master's program.
Himani Negi: You talked about your focus on networking and getting to know about the university, and doing your research, so how did you start? What is the best way to research? Let's say I want to. Which platform was it that helped you to do research and get to know about the university on a personal level like it was LinkedIn or connecting to professors or students? How did you exactly do your research? I would like to know that and how other people can follow this. Because it's very important when you are going to an alien country or anywhere basically away from your home. So, it's not just a day's decision, it's a decision of many days of hard work. How can we research when we are selecting any university?
Dr. Mahalakshmi Sivashankaran: So, I used LinkedIn and my college alumni network to connect with seniors because a lot of my seniors were already settled in the US and they were studying and they were about to finish their Master's. So, they helped me with how to talk to professors and how to mail them, how you should always send thank you emails after the interview and how you should keep talking to them, and how you should not leave the conversation to drive. It was one thing that my alumni really helped me out with and they also told me about how to prepare for exams and everything. I received advice on which university is better from them. Other than that, I talked to faculty through LinkedIn. Networking on LinkedIn is of utmost importance because it's a great platform for you to like, find people, and engage with them. Talk about problems happening within the healthcare community. So, both these things help me out.
Himani Negi: Great Ma’am. So, what's your plan you know after getting into this college like what you're thinking?
Dr. Mahalakshmi Sivashankaran: I want to shift to a hospital administrator or a healthcare consultant. I can go into insurance and or a pharmacological company. So, like with a public health degree, I feel like there are a lot more opportunities that open up because with a medical or a dental degree you just have one option. You have to do MDS or you have to do an MD and you have to just keep moving up that ladder. You have to do residencies, you have to do internships, you have to keep updating yourself within healthcare. But an MPH or a management degree, it opens up too many ways for you to choose from. So, you can explore and you can see what you like. It could be pharmacology, it could be insurance, it could be just working at a hospital like the accounting department or the HR department.
Himani Negi: Great. Ma'am, we would like to conduct your interview again when you go to the university for your experience there. Do you want to stay abroad or you want to come to India work on the ground level?
Dr. Mahalakshmi Sivashankaran: I want to keep traveling. I don't want to come back to India for now. I will come back to India eventually but then I don't want to settle in the US, I want to travel, and places to get a sense of healthcare in each country so that I can use the best parts of everything from each country and make a better healthcare system globally. So, there is a lot to learn about healthcare in different countries. Some countries are doing some things right. Countries are doing some things wrong. So, you can always learn a lot from that and I mean an amalgamation of all those things would help us make a better healthcare delivery system.
Priya Bairagi: Could you share an example or challenging case of a situation you encountered during your residency and how you handled it?
Dr. Mahalakshmi Sivashankaran: As a junior resident you're at the bottom of the food chain. So, like any mistake you make, you have to own up to any challenge or any mistake that you make while treating a patient. The most important thing is to own up to it and tell your seniors so that they can help you out. Hiding facts and hiding anything is only going to jeopardize the patient's health and the patient's comfort in the future. So, at any moment, you will feel that you have made a mistake. But, you should go and tell your seniors you, accept your mistake and learn from them. Learn on how you can treat them better and how you can do that particular treatment better in the best way possible basically.
Priya Bairagi: I have been reading your profile. I saw you have a Diploma in Executive Healthcare Management. How does a degree help you to enhance your understanding of the dental field and enhance your dental practice?
Dr. Mahalakshmi Sivashankaran: So, this executive diploma was like two forms of a base for preparing for my Master's. The diploma was in Healthcare Management but from the perspective of India's healthcare. So, the subjects that they taught me helped me develop a deeper understanding of financial finances, quality control, the economics of healthcare, healthcare marketing, and those concepts that were alien to me because like my dental degree only taught me how to deliver. But they didn't teach me what was behind the delivery of those services. So, that degree helped me understand how to calculate the storage and how to be accredited by a good NABH or JCI. So, all those concepts I learned from that diploma will help me for the Master's. I think I would be able to enhance those concepts even more and have a better understanding.
Priya Bairagi: According to you what are the challenges faced by dental healthcare today?
Dr. Mahalakshmi Sivashankaran: Honestly. I feel that there is a huge pay gap and like once you finish your BDS, it's quite difficult to find a job. There are so many dentists and dental graduates that are graduating every year that there are not enough jobs to cover that gap. On the other hand, we are still facing a very disturbing doctor-patient ratio and there needs to be more recruitment of doctors so that they can train well and can help patients more.
Stay tuned for Part 2 of this interview!
