ther you have done it or you haven’t.
All the reading of the books won’t
help you!
VP: So after that, you had gone
to the US. So was it like a norm,
that everyone used to go?
AA: Well, at least half of the batch
used to plan to. My trip there was
a bit different. My plan was to do a
Ph.D. As it turned out that the per-
son to whom I spoke earlier, who was
one of the biggest guys in the world
on lung physiology, he actually knew
my father and he pointed out to me
that he thought that my father had
mentioned that I was a doctor. I
said yes. In that case, he said, why
don’t you come for a residency pro-
gram? And in that program, based
on meeting certain criteria, there is
a track where you can do research
side by side while doing a residen-
cy. And you get paid more. Well,
who turns down the opportunity
to get paid more! Then my plans
changed slightly and I shifted to a
residency-cum-research track which
used to be called the CIP, the clin-
ical-investigator-pathway and now
called MeRIT in America, I guess,
the medical researcher investigator
track. The names keep on chang-
ing, but fundamentally the system
remains that you have to do at least
2 years of core medicine, then you
substitute two years of medicine
with 2+2 in which you do mostly
outpatient plus research. What typi-
cally takes 5 years now takes 7 years,
but you come out with the experi-
ence equivalent to a Ph.D. but you
also end up getting multiple board
certifications in the process.
So that’s how I left for the US. The
original plan was a Ph.D. then it be-
came this. And then I spent my time,
at the end of which I decided I like
research more than clinical and I
became a faculty over there. There,
they had this system, three months
of clinical pays your salary. The
remaining nine months you do not
have anything except OPD that too
once in a week. So you are really free
to do a lot of research. Those kinds
of things do not exist in India, as far
as I know. If you are clinical you are
clinical the entire year. And that is I
think one of the things that we have
to learn from outside. Because there
is simply no way a person can really
be a researcher in the clinical sci-
ences without having dedicated time
for research in which you are not
supposed to also see patients. One
can do descriptive clinical research,
in terms of what happens mostly in
AIIMS, you do x,y or z and in the
end you either compare or describe,
but you do not really do that much
of fundamental or path-breaking re-
search where you discover things ad
initium, simply because those things
take a huge amount of time. So I re-
ally respect people like Dr. Acharya
and Dr. Makharia. So GI and Peds
are some of the departments that do
really well. You look at the faculty,
they are really dedicated. Week-
ends are when they do the research.
That’s not the way you must force
people to choose. You must not force
them to be clinical on a working day
and being a researcher in vacations.
Except for a few people, you will
lose most of the highly talented peo-
ple who could’ve potentially added
things.
I once got called to Pulse a few years
back, to speak on translational re-
search. Me and Dr. Paul had the
same topic. So he went before me
and he was describing how AIIMS
is really nice for doing research and
so on. My opening slide was a frog
sitting inside a well. The point was
that in AIIMS you do not realize
how much research is being done
outside by clinicians. You ultimately
are looking at people who get Nobel
prizes in stem cells. They’re physi-
cians by training.
VP: Yamanaka was an ortho-
pedic surgeon!
AA: Yeah. See! But when you go
outside, and see these people, you re-
alize, they do a lot of research. They
are clinical faculties, professors and
HOD in the departments of med-
icine, and others, but they spend
most of their time in labs. Their
colleagues who do not want to work
in labs, they see the patients, these
people will see patients once in a
while when it is really a special case.
So for instance, if you had a medical
doctor with a very high level of in-
terest in stem cells, and you give him
a lot of time to work on stem cells,
and he is a part of the medicine
unit. If one day you want to start a
stem cell unit, you would have a re-
ally really competent person, to do
it. So now if you make everybody,
see all kinds of patients every day,
and tell the person who is interested
in stem cells, to read up about stem
cells on weekends, one day you want
to start a stem cell therapy unit, you
won’t have anyone good. That has
been a tragedy of our system. We
do not really create hardcore clini-
cal-researching interface specialist.
We create clinical specialists, who
are academically inclined, who like
to do research, or at least read up
about research, and would like to
implement it in a few pieces. But I
think things are changing. There is
a department of research here at
AIIMS. I heard from somewhere,
they actually have a formal depart-
ment.