From Dentistry to Public Health: Dr. Mahalakshmi Shares Her Career Transition and Future Aspirations
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: What is the correct age for an infant or for anyone to start visiting a dentist for a regular health checkup? Now even if you want to get admission to school, you have to know to give your whole body checkup so, what is your take on this? How many times in a year or what's the correct age to start visiting a dentist?
Dr. Mahalakshmi Sivashankaran: So as soon as a baby starts getting teeth like their first milk teeth around the age of like five or six years. I think they should start going to the dentist because that's the age when kids. They are more prone to eating sweets and everything. So, a regular dental checkup once a year like in the beginning before they develop a disease like from five to six years, or a yearly checkup is good enough. I would suggest if a child has cavities developing or something like that, they should visit every six months, but otherwise, there is no problem as such. I think a yearly visit is enough. I feel that there is a huge gap between them. Patients and doctors don't understand that kids require a lot of dental attention because it's that age where your milk teeth fall off and like your adult teeth come in it's a period of change and they are more prone to diseases at that time. So, like there is that gap that is between the general public and doctors and it's very common in India as well. There is no knowledge of a dentist, especially for children there is no knowledge that there is a dentist who specializes in children's teeth. So, I mean knowledge that children should be taken to a dentist is lacking in India and there needs to be more awareness in that area.
Himani Negi: So, another question is that in India there is a system of private hospitals and government hospitals. So, you have private doctors you who can say you go, you pay your fees, and get treated. But as you have worked in a government organization, I have this query: is it possible for me to go to a private hospital and ask a doctor that I want to have my oral health checkup? But, is it also possible to do the same in a Government Hospital? There are severe cases and people may need a doctor more than a normal person who's not facing so many problems. So, is there a concept of regular health checkups for patients who go to Government Hospitals?
Dr. Mahalakshmi Sivashankaran: People do come for regular checkups because I mean the OPD is available like doctors are sitting in the OPD and they're regularly just checking mouths just to see. And there are people. There are a lot of people who just come for a regular dental checkup. They don't have any pain as such and they just want to see the doctor to see if everything's all right. I have seen patients like that come with no problem and then we see that breath then we're like "Okay no, no." This is like having a cavity forming but it's in the first stage so you can get it treated there won't be any pain so it is common. But then some people come in the exact opposite place and like their entire face is swollen and they won't. They put off going to the doctor until the last moment and they come and there's uncontrollable pain. So, there are both types of patients and I mean it's genuinely like about your personal choice and how you respond to doctors.
Himani Negi: So it's better to at least visit once a year?
Dr. Mahalakshmi Sivashankaran: Definitely. It’s better to come at the first stage because the treatment is going to be small. The pain level is going to be very low and the treatment that you're going to do is not going to be very invasive. It's going to be very conservative. You're just going to drill a hole in your mouth and just put medicated medication and you're going to put it like your cement or your fillings. So, definitely come to the first stage. But then, there is again there is like a gap between the general population and like doctors, there's that lack of communication that happens.
Himani Negi: So, this is a very controversial question. So generally, the patient load is very high in government hospitals and I have worked in a pharmacy at Sanjay Gandhi Hospital in Delhi. So, I have two questions, one question is that they gave some medication XYZ and then there were a lot of problems related to medication like every second day the medication was out of stock and patients were shouting at us like you are not giving medications so we can buy the medications from outside. Then we are asking your doctor to give you some other medication as a substitute. We will dispense medication, but we don't have any specific role in that. So, have you faced any such problem where the patient is blaming you for any such thing that is not in your hands or you are not responsible for?
Dr. Mahalakshmi Sivashankaran: I mean it always happens especially with antibiotics because there's like so many brands and there are I mean you prescribe. I mean in Government Hospitals there is a rule to not prescribe brand names so we just write the co-opposition and we send the patient you buy whatever brand name you can find and I mean we usually refer them to like the hospital pharmacy and there are times when there is like the shortage of like that particular like the free one. But the expensive brand name is usually available and it usually comes on us. But honestly, we can't do anything. We’re writing like the composition and sending them to the pharmacist. So, I mean there's obviously a supply chain problem in that aspect. But I mean it's difficult you can't judge. I mean people. Usually in India, they would prefer getting the free stuff rather than having to pay for it. So, I mean, you can't take it personally like it's genuinely not your fault.
Himani Negi: Yeah, because it happened a lot of times the patients were blaming us. Another thing is that even as a pharmacist when I joined, I tried to keep my calm and I would explain each and everyone with love and all the general. But then the patient load increases which eventually leads to the question of how much time you can devote to every individual. So, then there is a perception that government doctors are rude or government pharmacists are rude. So, what do you take on this? Because it's not like we don't want to explain everything briefly, we want to do that but then the other patient will start fighting. This thing happens very commonly in government hospitals. So, what's your take on this thing? Is it like this? Are we rude or are doctors rude? What do you think?
Dr. Mahalakshmi Sivashankaran: See with the amount of time you spend at a government hospital you end up developing a tough exterior like that. You can move from one patient to the next so that they don't end up asking you a lot of questions and just go or we just tell them to go and read the pamphlet. But I mean with patients who come to a government hospital, there's always a literacy gap. So, it’s best to advise them with words coming from the doctor's mouth instead of telling them to go and read it. But then that happens because even though we're human, we're just like them, but as patients keep increasing, we get tired and like there is no time to go and eat lunch, all those frustrations. Usually, they end up coming out on the patient, so I mean I would say that we should learn to like, keep our cool in a better way. But then sometimes it gets difficult. We are human at the end of the day.
Himani Negi: Because they also don't try to understand it most of the time.
Dr. Mahalakshmi Sivashankaran: Yeah, exactly and they start arguing with us. Also like in a healthcare setting, people are already coming there with stress, they're already coming there with pain. So, you should just try to keep your cool. But sometimes it becomes a little difficult. You end up arguing with them.
Himani Negi: Yeah, because I was a very calm person. So, I was spending like let's say if I am spending like five to ten minutes on explaining a person because the thing is that I have to explain to them as you highlighted that there is a literacy gap so it is very important to make them understand each. I was making pamphlets and mentioning with a pen on dosage. Then what happened was the people behind the row started fighting.
Dr. Mahalakshmi Sivashankaran: Yeah, like after extraction of teeth you have to give certain instructions to the patient. Let's see you can't do this; you have to like it. Take your spit in, you can't spit it out, you can't eat this, you have to eat this, you have to eat an ice cream after extraction, all of that and they will listen to us. They will listen to the entire instruction and then they'll come back again and then they'll keep asking us while we are doing a patient so that becomes a little annoying.
Himani Negi: That is the problem. I think it will improve in time. I hope so.
Dr. Mahalakshmi Sivashankaran: Yeah, I mean we could probably involve some other person because see, once the doctor is doing treatment, he or she needs to focus on that particular treatment right? They can't focus on like two or three things together to probably train like the nurse or like the hospital staff to give the advice that we're supposed to give like after the extraction or any particular procedure. So yeah, we could improve on things like that.
Priya: What are your long-term career goals in the dental field and how do you plan to achieve them?
Dr. Mahalakshmi Sivashankaran: Since I'm making a career shift. I don't plan on continuing as a dentist. And even I can't practice in the United States without studying DDS (Doctor of Dental Surgery) and taking their licensing exams. So, I'm just a dentist here in India. So probably if I come back here to India. If I have the opportunity to start a hospital where I would be able to manage all these services. But in the long run, I am completely trying to shift from a clinical career approach to a more non-clinical profession.
Himani Negi: So, I was reading your DentiSight and there was like one question if you have any alternate career options you could have selected Biotechnology and Microbiology. Any specific reason for selecting dentistry over biotechnology and microbiology? However, you are currently pricing in Public Administration, Master's in Health Service and Administration to be particular. Any specific reason for choosing that as an alternate career choices?
Dr. Mahalakshmi Sivashankaran: While studying the dentistry itself we had like microbiology as a subject and I was very fascinated by the whole subject and how little nanometre organisms could affect us and how they could change our entire being and how they could cause diseases and how they can actually be a form of like a vaccine or they can treat us as well. They have both pros and cons. So, I found that very fascinating and biotechnology probably because I like the whole amalgamation of technology being used for biological diseases and problems. I mean from everything from your shampoos to your conditioners to any skin product you need a biotechnologist to make that particular machine so that you can fabricate those products. So, I mean both these fields have. I mean I found them fascinating but probably just a hobby like I probably just read articles about them. That's all.
Himani Negi: Great. So, anything else that you want to share? Because we have asked a lot of questions and all the queries have been cleared. But still, if anything is remaining that you want to share?
Dr. Mahalakshmi Sivashankaran: The health industry; it's ever-changing and it's developing at a very fast rate now because of the pandemic and the fact that we lack crisis management strategies we lack in all of those areas. So, I mean there are a lot of technological advancements happening, so be updated, get yourself updated, read articles, read researches that are happening in your field and other corresponding fields. So, knowledge of what is happening in your field is very important to be successful and make a career out of it.
Himani Negi: Yeah. For sure. Ma'am, so there are a few more questions I have regarding the GRE. Let's say, I want to take the GRE next year or this year. How many years of preparation does it require?
Dr. Mahalakshmi Sivashankaran: It won't take years to prepare. It'll just take you like a couple of months, like four or five months maximum.
Himani Negi: Hw many hours did you study per day?
Dr. Mahalakshmi Sivashankaran: Since I had classes they used to give me homework, so I used to do it with that. So, the classes were for three months and then after that, I practiced for like two months and I gave both my GRE and TOEFL in the same month. So, GRE and TOEFL are happening every alternate day throughout, like from January to December. These exams are happening all the time so you can take them any time you want. And these scores will be valid for the next two years. You can take the exam whenever you want whenever you feel you're ready to give the exam because I mean it is an expensive exam. So, you should know that you are ready for it. It depends on the person like their own goals and standards of perfection. For me by five months I was like "Okay, fine, I can take the GRE because by then the deadline was also coming near for applying for a Master's." I decided to be done by September.
Himani Negi: Did you also take the help of any consultant like we have Leap Scholar or any other agencies? There are so many like they're calling so did you take the help of any of those agencies or is it like all your hard work like you were working on your own?
Dr. Mahalakshmi Sivashankaran: No. I did take the help of an agency called IDP for help with resume prepping and my SOPs by a statement of purpose that you have to submit, edit, and apply sending in all your applications and the visa process everything they help you throughout all of this.
Himani Negi: Would you like to disclose your GRE marks or rank or anything?
Dr. Mahalakshmi Sivashankaran: I scored 301 andnd in the essay, I got 5 or 4.5, I don't remember. I didn't have to submit my GRE score. I just had to submit my TOEFL score.
Himani Negi: Which coaching did you take? Would you like to reveal the name?
Dr. Mahalakshmi Sivashankaran: I took coaching from Mania.
Himani Negi: So, is it like online coaching?
Dr. Mahalakshmi Sivashankaran: They have in-class and online as well. But I was working so I chose to take the online one.
Himani Negi: So, like you give a whole care to liking coaching right, you believe that coaching helps you a lot in cracking the exam?
Dr. Mahalakshmi Sivashankaran: I wouldn't have done it alone.
Himani Negi: Do you think is coaching necessary for cracking this exam?
Dr. Mahalakshmi Sivashankaran: If you are a medico, yeah sure you will definitely need it. Without coaching if you are in touch with mathematics till tenth class like the math we used to have like in school. If you are in touch with those concepts then I am sure you will be able to crack it. But, I did need a little bit of help with geometry and permutations and combinations and all those concepts that I had like literally forgotten by then.
Himani Negi: For sure because when we prepare for the medical exams, the biology that they teach at the coaching institute is way higher than we studied at our graduation level. So, for coaching, I'd like to ask, is it like they teach you the same level of exam? Or is it something extra knowledge as well?
Dr. Mahalakshmi Sivashankaran: No, they taught me at the exact level that the exam required nothing extra and I mean it was basic concepts like 10th level, geometry, and arithmetic, algebra all of those concepts, and simple interest, compound interest all of that.
Himani Negi: So, any final message that you would like to give to upcoming aspirants who are preparing for this exam or do you want to pursue a Master's in Health Administration?
Dr. Mahalakshmi Sivashankaran: You have to be updated with all of the things that are happening in the management world and how you can interpret data. You should probably do a course in statistics so that you have a rudimentary understanding of statistics. Just like I mean you have to make sure if you choose this path, you have to take the required steps to get there so like prepare for like I mean find out which exams you need because right now in the US they have GRE for MHSA, but you do need GRE for like MBA and all of those degrees you do need GRE or a GMAT score. So, I mean do your research well and read about universities, what they offer, what they don't offer, and all of that.
