Twenty years ago, on September 16, 2005, I left India with one suitcase and a head full of dreams. Heathrow, London, was my entry point to the Western world, a land I had never seen and a culture I barely understood. I was a young immigrant surgeon, fresh out of MS surgery, with little real-world knowledge. I wanted to learn more about surgery as I had always loved the liver and pancreas and wanted to improve my skills. The aspiration to learn more kept me excited, but it was sprinkled with anxiety and fear of the unknown.
The only country I had visited before was Nepal with my family when I was 8. Even then, my parents encouraged me to venture out and explore the world, even though my mom was more worried about what I was going to eat. The man behind it all was Dr. Subodh Varshney, who trusted in me.
I believed that without moving out of your comfort zone, you don’t reach your potential. In those days, the internet was at its infancy and making distant phone calls was not easy. In my first week in England, I bought a £25 calling card with 45 minutes of talk time, my lifeline back home. I didn’t even know the geography of England and had to get a map from the British Council. My journey as an IMG surgeon had begun in earnest.
Finding My Footing in the UK
I landed in the beautiful Isle of Wight, one of the most stunning places on the planet. Three weeks later, I was struck down with chickenpox, locked away in my room. I wasn’t able to use the common kitchen area, had no TV or internet, and not enough credit on my calling card. I had no friends. It was lonely, but it toughened me.
Over the next few years, I navigated the UK NHS surgical training system, learning from legendary mentors. I must mention Mr. Walsh, who saw my potential and fought for me to get the best placements during my RITA/ARCP evaluations. I trained across the Wessex and Severn regions, where I had the opportunity to work with many leading surgeons and trainees, including Mo Abu Hilal, the world leader in laparoscopic liver and pancreas surgery, Prof Primrose at Southampton, Kit Armstrong and Chris Wong at Frenchay Bristol, Mark Vipond and Prof Barr in Gloucester, Ameet Patel and Mohd Rela at King’s College, London, and Derek Manas at Freeman in Newcastle. It’s hard to name everyone.
Why Surgery, Why Transplant?
The first time I saw a liver transplant, I was captivated. The sheer impact on a patient’s life was unmatched. That’s when I decided: this is what I want to do.
The Leap to America
The surgical training in the UK is different and longer. Sam had secured a national training Number (residency in ophthalmology) in Scotland and was excelling in her own career. By most measures, I could have stayed in the UK and done well. But I heard about the Nebraska transplant program, one of the best in the world. I didn’t want that opportunity to go away. So, I curtailed my British career and moved to the USA. Landing in America with that same one suitcase, I was so excited I used to go to my rented apartment only once a week. I will need a separate blog to talk about how this affected my family and Sam’s career.
From day one, I felt welcomed. I was an Indian surgeon in the USA, and the training was intense but rewarding. My trainers, Dr. Mike Morris, Dr. Langnas, Dr. Grant, Mercer, and Vargas were a dream team. My senior and junior Fellows, Amneh and Duncan, were partners in crime. In Nebraska, I learned what a real surgical training should be like. Every case was a Fellow case in the OR. Many times, I was operating independently. There were no clinics or rounds if they overlapped with the OR. It was surgery every day and almost every night, non-stop.
The American Dream, Nine Years On
During these years, life moved on. Sam moved to the USA, Ronnie was just born, Rhea grew up, and I lost an uncle and a grandmom. So much had happened in the world that I didn’t see. The world kept spinning while we worked around the clock. Still, I was grateful. Program directors Dr. Are and Dr. Thompson supported me all the way. Eventually, I earned board certification and completed my Fellowship.
For the past nine years, I have been on staff in the US. No doubt, the American dream is not a myth. It’s a land of opportunities, where hard work is recognized, patients are appreciative, and trainers push you to be your best. When I look back, I see how I evolved from a young, uncertain doctor to a surgeon entrusted with programs.
What Kept Me Going?
I often ask myself why I kept pushing. Was I super ambitious? I don’t think so. Maybe it was something inbuilt. Maybe it was Sam and parent’s unwavering support. Maybe it was simply an attitude of never giving up. Three things, I know, kept me going:
- An unrelenting thirst to learn new techniques
- Hard work and loyalty
- A supportive family who stood by me
Gratitude and Perspective
Now, twenty years later, I feel blessed and grateful. Training across three continents has given me not only skills but perspective. I hope to use it to help more people, train the next generation, and perhaps inspire others who are standing today where I stood in 2005: uncertain, but ready to take the leap.
Recently, I even published an article comparing surgical training across three continents: a reflection of the global perspective my journey has given me. Those interested can find the article here: “General surgery training in the USA, UK, and India: a scrutiny of strength and challenges.’