My Journey of Becoming a Refractive Surgeon
I’m Dr. Ridhima Bhagali, a Cataract and Refractive surgeon, practising in Pune and this is my journey of becoming a Refractive Eye Surgeon.
I come from a family of doctors– my father, Dr. Nitin Bhagali, is a renowned orthopaedic surgeon and my mother, Dr. Meenakshi Bhagali, an ophthalmologist, both run a private nursing home, Bhagali Hospital in South Pune. I was raised to become a doctor, since as long as I can remember. I had all the necessary qualities since an early age – sincerity, dedication and a love for academics. I excelled in school and topped every exam through school, college, entrance tests and medical college.
After completing by MBBS from BJ Medical college, Pune, I desired an Obgyn (Obstetrics-Gynaecology) seat since I enjoyed it the most during internship. My parents tried dissuading me from taking up an emergency, hectic branch but I didn’t want to just continue in my mother’s footsteps and work under her forever (though ophthalmology seemed like a logical option!). So I took an Obstetrics seat in Bombay Hospital and finally moved out of home. But alas! I was posted for 3 months in general surgery as there was no vacancy in Obstetrics and I absolutely hated the private hospital rounds and assisting hernias and hydrocoeles, in addition to adjusting to a new place.
In the second round of counselling, better sense prevailed and I chose to take M.S. Ophthalmology at my Alma mater, B.J. medical college and moved back home, all delighted! I enjoyed Ophthalmology wholly, doing cataract surgeries, reading Albert & Jakobiec; my teacher’s at B.J.M.C, Pune were & still are my extended family. I had good surgical training (SICS- Small Incision Cataract Surgery) at the end of my post graduation, but was now confused as to what fellowship I should take up.
Between my M.S exam and my scheduled wedding, I had 4 months time during which I did a week long Phaco training course at Solapur. My sister was in Delhi at the time & I planned a visit to AIIMS and Gangaram Hospital to look for inspiration with big names in squint and oculoplasty. At the end of my quest, I settled on a Cornea & External Disease fellowship and decided to apply to L.V. Prasad eye institute, Hyderabad. They scheduled my interview on the day of my wedding and I had to let go of that chance then (& decided to reapply in the next opening in March).
After my wedding, I moved to Bangalore as my husband was working at St. John’s Hospital at the time. I decided to apply for Cornea fellowships in atleast 2-3 institutes in Bangalore, but the first one I visited happened to be Narayana Nethralaya (NN), Rajajinagar and my life changed then! I met Dr. Rohit Shetty, the Vice Chairman and he advised me to consider doing a Phaco- refractive fellowship ( I wasn’t aware that such a fellowship was offered) rather than a cornea- refractive one. I was secretly very excited with his suggestion as I loved Cataract & Refractive surgery but didn’t know that it could be a super speciality. I grabbed the chance and had the best training in the cataract department at NN for the next year.
We did regular Cataracts, complex cataracts, Phakic IOLs, Lasik, learnt to manage our own complications and those of visiting trainees, used hooks and rings, did scleral fixated IOLs and learnt to operate our own long OT lists. We learnt to write research papers , publish articles in international journals, present in and attend international conferences. It was hard work for sure. long hours, making mistakes, falling down, getting up again, making lifelong friends and having the best generous mentors. NN taught me more than eye surgery – it taught me how to become a good doctor, a good friend, how to speak Kannada, how to salvage a difficult situation. It opened up my world to so many new avenues.
Before my 15 month fellowship could end, Dr. Rohit offered me a Consultant post at their upcoming centre- NN3 on castle street, Bangalore. This opportunity of working independently in a tertiary institute as their sole cataract surgeon gave me immense surgical and administrative experience. I did difficult, complex surgeries with no safety-net to fall back on, operated on many VIP patients, performed large numbers of Femto-assisted robotic cataract surgery and premium IOLs but my refractive appetite was yet to be satisfied. I worked with my NN3 family for 5 long years before deciding to move to UK.
Yes, London was calling ! My husband, Dr Arun Tirlapur, after completing his DM Nephrology had got a fellowship in London and I, of course, wanted to accompany him along with my daughter. I applied online for fellowships too (nhsjobs portal), and landed a job pretty easily with my previous work experience. The fellowship interview had practical questions like “How to train residents for cataract surgery?”, “Tell us one difficult situation which you handled confidently in your career so far?” and “Another in which you could’ve done better?” I aced my interview with honest answers but then began the 5 month long process of securing by GMC registration through the Royal college’s Double Sponsorship scheme. In the meanwhile, I observed and learnt from Dr Sheraz Daya’s fantastic work at Centre for Sight in London & East Grinstead.
I then went on do an Anterior segment and Trauma Fellowship at King’s college Hospital, London where I worked in the Cornea department with Dr. Emma Hollick. I got to treat corneal infections, assist corneal transplants- very advanced DSAEKs (Descemet’s stripping automated endothelial keratoplasty) & DMEKs (Descemet’s membrane endothelial keratoplasty), perform Pterygium excisions & Cataract surgeries. NHS taught me new systems and practices, the importance of safety checklists & how to be a good general ophthalmologist – not just a super specialised one.
I learnt to do a LOT of admin work, wheeling patients in and out and learnt to appreciate our talent as Indian surgeons and the ease of the health system back home. Once the year in UK was up, we wanted to move back, as it was tough life there with both of us juggling on- calls, weekends, meal prep and a child in daycare. Our purpose of doing a fellowship abroad, living and working in a new country and travelling through UK and Europe was served.
The next choice was going back to our jobs in Bangalore (husband’s choice) or starting our own practice in Pune ( my choice as my parents are established doctors here). After 7 years of marriage, I managed to convince my husband to give Pune a chance. He joined a medical college and took up a few attachments as a Nephrologist, whereas, I started operating cases at my mother’s hospital.
Dr. Udayan Dixit, a renowned senior Ophthalmologist from the city and my parent’s friend, encouraged me to start my practice at his then- shut clinic as he was winding down his work. My sister, Ritika, an architect, helped me renovate his spacious clinic; I went ahead and bought all the latest equipment to start my own practice at Nayanjyot Eye Clinic, Bhandarkar Road. Dr. Dixit supported and mentored me through all the nuances of running a private practice.
6 months later, we learned of the sad sudden demise of Dr. Sanjay Sawarkar, a pioneer in the field of refractive surgery in the city. His practice ‘Medilaser‘ with state of the art refractive surgery equipment, was the next stepping stone to establishing my identity in Pune city. My refractive surgery dream was finally fulfilled! Doing ReLex Smile procedures, the beauty of the surgery and the joy its brings to patient’s lives has added a new sense of fulfilment to my work.
Typically my everyday starts with a few cataract surgeries at Nayanjyot eye clinic followed by seeing outpatients there; I then come to Medilaser mid-day, perform laser refractive procedures like SMILE/LASIK, Phakic IOLs, cataracts, cross-linking procedures for Keratoconus followed by OPD patients. Refractive surgery has now come up in a big way with quick, safe, fuss-free, advanced procedures. Patients are more aware and accepting of going the spectacle-free way with these new refractive laser options. I’m glad to be able to ride this wave and help so many achieve this vision and freedom!