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Table of Contents
Year : 2020  |  Volume : 3  |  Issue : 4  |  Page : 785-786

The grand finale

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India

Date of Submission29-Jul-2020
Date of Decision11-Aug-2020
Date of Acceptance11-Aug-2020
Date of Web Publication25-Dec-2020

Correspondence Address:
Satvik Khaddar
Department of Medical Oncology, Tata Memorial Hospital, Mumbai - 400 012, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/CRST.CRST_259_20

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How to cite this article:
Khaddar S. The grand finale. Cancer Res Stat Treat 2020;3:785-6

How to cite this URL:
Khaddar S. The grand finale. Cancer Res Stat Treat [serial online] 2020 [cited 2021 Jan 25];3:785-6. Available from: https://www.crstonline.com/text.asp?2020/3/4/785/304957

The final examinations were just a couple of months away. It was important that I prepare and do well. Therefore, I needed to study and revise all that I had learned during the three years of my residency. The thought of appearing for an examination always sends chills down a student's spine. Hence, despite having appeared for examinations several times in the past 12 years of my medical training, I was no exception to this. Moreover, the fact that this would probably be the last time I was going to appear for a university examination made me jittery.

Three years ago, I had joined the Tata Memorial Hospital(TMH), Mumbai, India, to pursue DM in Medical Oncology, and I knew what I was signing up for. Given the busy schedules of the outpatient departments (OPDs), ward duties, night calls, and emergencies, one rarely gets enough time to read thoroughly, except during the last few months of residency. It is mainly from the interaction with patients in everyday clinic that we learn the tips and tricks of oncology practice, which, although important, is certainly not sufficient to get a firm grasp of the subject.

Just as I was approaching the final few months of residency and had started to prepare for the final examination with a hope that I would be relieved from emergencies and busy night calls, a new calamity struck the world. The coronavirus disease 2019 (COVID-19), which is probably the biggest pandemic in human history, rapidly spread across the globe and in India. Mumbai being the epicenter of COVID-19 in India was the worst hit. Most of the hospitals in India were temporarily shut, but TMH being the apex oncology care center was functioning throughout the pandemic, for the risk of patients dying from untreated cancer was much higher than that of them dying from COVID-19. With it came the extra workload, and academics took a backseat. Apart from the regular OPD and ward duties, we were assigned duties at the screening booths for identifying patients with symptoms suggestive of COVID-19, in the fever OPDs dedicated to suspected COVID-19 patients, and isolation wards to look after patients diagnosed with COVID-19. The regular OPDs were not easy either. All the doctors and hospital staff began taking the utmost precautions as per the protocol. N95 respirators, surgical masks, gloves, and face shields became our routine attire. Obsessive repeated handwashing and sanitization of personal belongings became standard.

While the pandemic was still picking up pace, my examination dates were gradually coming closer. I had almost forgotten about the examinations while trying to adjust to the “new normal.” My primary fear was that of contracting the disease and missing the examinations; death was secondary. Daily news of medical personnel getting infected and succumbing to the virus added to the worries. Social media were brimming with news about resident doctors being treated poorly at their institutes, lack of proper personal protective equipment, and poor quarantine facilities for the exposed individuals. Having heard about so many unfortunate incidents from across the country, everyone was worried about their fate in these demanding times. At this juncture, I felt really blessed to be a part of an institute that took care of us in the best possible way. All necessary protective gears were made available to all the staff, weekly meetings were held to ensure that we are safe and following the protocols, and even the smallest of concerns were duly addressed among several others.

Amidst this chaos, I tried to take out time to study the gargantuan syllabus of oncology. The problem was how to go about it. Reading only textbooks meant losing out on the recent advances. On the other hand, reading only guidelines meant not having a stronghold on the basic concepts. So, I took help from my seniors, focused on the important topics, and decided to stick to Devita (“The Holy Grail”) along with updates from recent guidelines, as and when required. Remembering all the evidence, guidelines, and criteria was an arduous task but was made simpler during group discussions with my batchmates.

With the theory examinations being only three weeks away, we were granted the much-needed preparation leave. This was the time when the Gompertzian curve of our knowledge was expected to reach the log phase. Paradoxically, the progression-free survival and overall survival started to jumble together, all molecular pathways appeared similar, and the toxicities of every drug became nausea, vomiting, neutropenia, and fatigue. Amidst all this, the fear of contracting COVID-19 was still lurking in the background. Yet again, at this point, I felt immensely proud of being a part of the TMH family, where each one of us residents was given personal attention by our consultants. Even with their busy schedules, they would call and message us to inquire about our health and whether we were eating adequate meals and taking appropriate rest. This gave us immense psychological support and strength to cope up with the examination stress.

Finally, I appeared for my theory examinations, and they went well with the blessings and support I had from the people around me. However, the battle was only half won. Viva voce, which is considered even more decisive than the written examinations, was about two weeks away. This required a different approach of preparation altogether. Fortunately, I had an outstanding group of people around me. We discussed the nitty-gritty details of all the topics, from hematoxylin and eosin stains to genomics and proteomics of diseases. Classes were conducted by consultants from other departments for teaching us the basics of ancillary subjects such as radiology and pathology, in addition to the case presentations in our department.

With plenteous knowledge at its Bragg peak (or so I wrongly presumed), I appeared for my practical examinations. Being the first candidate on the very 1st day, I apprehensively entered the examination hall, imagining all sorts of questions that could be asked with the fear of going blank in front of the examiners. To my surprise, the viva went pretty well too. I was able to answer most of the questions with minimal blunders. All of this would not have been possible without the countless days of studying, tough times with sleepless nights, help from the batchmates who have now become friends for life, and most importantly, my teachers, who supported me throughout my residency, especially during the last few months. Their constant psychological support helped me maintain my calm and not lose my confidence.

The results came out on the last day of the viva voce, and all of us cleared the examination with flying colors. I felt the relief of having completed almost a decade of training. Having made some wonderful memories over the past three years and with a cupful of knowledge that I have acquired from the ocean of medical oncology, I look forward to starting a new journey with the zeal of attaining more knowledge in the years to come.

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Conflicts of interest

There are no conflicts of interest.


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