By Dr. Shibinath Velutha-Mannil
The decision to pursue cross-cultural experiences in one’s medical career takes courage and an eagerness to explore new frontiers. I write this blog in hopes that some of you reading this are international medical graduates who are considering this option and will derive some inspiration from my experience. My desire to do a residency in the United States ignited as I was finishing medical school in India. The infrastructure and advancement of modern medicine in the United States and the opportunities for career development and research intrigued me.
Due to personal reasons, I had to set aside my preparation for the USMLE Steps for a little while. I started working as a medical registrar in India, still with my dream of doing my Steps and matching into a residency in the United States on the back burner. But God had different plans for me. I got into an anesthesiology residency in India and completed it in 2018. In 2020, in the midst of Covid-19, I got the opportunity to do surgery and anesthesia rotations in Florida. At this time, I also applied for training positions in the United States. I got a few interviews and ultimately matched into an obstetric anesthesia fellowship in New York. Going to the United States for my fellowship presented its own set of challenges, both professionally and personally; adapting to a new healthcare system, understanding different guidelines and protocols, and assimilating into a diverse cultural environment required a lot of resilience and open-mindedness. However, the difficulty of these challenges did not outweigh the rewards of personal and professional growth, the opportunity to learn from diverse patient populations, and the satisfaction of positively impacting patients’ lives.
During my training in India, I developed a passion for obstetric anesthesia. I realized the importance of providing safe and effective pain relief during childbirth. This foundation laid the groundwork for me to choose obstetric anesthesia as a subspecialty. During my fellowship training in New York, I had the opportunity to handle various cases, from routine deliveries to high-risk, complex situations. I honed my skills in pain management, labor analgesia, and anesthesia administration, working closely with my attendees and obstetricians to ensure safe and comfortable experiences for expectant mothers. I was able to extend my roots into a whole new community. It was multicultural in all aspects and everyone was very welcoming.
During my training, I soon realized that a huge portion of the population I was working with suffered from substance abuse and its complications. The use of substances was something that we were supposed to carefully consider when deciding on safe patient anesthetic management. This made me realize that I needed to do an addiction medicine fellowship to be able to truly do justice to this subset of patients. I applied again for an addiction medicine fellowship, and to my amazement, I matched into a program in Tennessee. This fellowship has given me a unique perspective on managing pain in patients with substance use disorders. I have acquired skills in multimodal pain management, including using non-opioid analgesics and advanced regional anesthesia techniques to minimize opioid exposure and enhance patient recovery. This training has fostered my ability to address the complex needs of patients struggling with addiction while ensuring their safety and pain control. In a culmination of all my hard work, I was recognized as an outstanding fellow in addiction medicine with an annual award that is organized by the Tennessee Society of Addiction Medicine.
My specialized focus on obstetric anesthesia and the profound understanding of addiction medicine has shaped me into a well-rounded physician. Through the cultural immersion I’ve experienced in the United States, I have developed a broader perspective on patient care and have recognized the importance of tailoring my treatments to individual patient needs. As I continue on this path, I remain committed to delivering exceptional care, advocating for patient well-being, and advancing the field of anesthesiology in both obstetric and addiction medicine.