Dr Balaji Bikshandi is a member of the College of Intensive Care Medicine in Australia. His interests include Surgical Critical Care and Trauma Critical Care and he has worked in Queensland, New South Wales and overseas in Chicago, USA during his fellowship training.He is an Associate Lecturer with the University of Queensland. He runs the website Creativity Based Medicine
Please tell us a little about your medical background
I did my medical school at the prestigious Madras Medical College, India – A college established during the British era with strong links to elite institutions of UK and USA. I did my internship year at the same institution. I left for the USA for my post-graduation in General Surgery at the University of Illinois, Chicago, USA.
How did you go about deciding on your speciality?
It was during my training in General Surgery at the Univ. of Illinois that I came to realise the impact of critical care in Surgical outcomes. The complexity of the critical illness, the challenge they posed and the rewarding outcomes attracted me to pursue a specialisation in this area.
What do you enjoy most about your specialty?
Being ultimately responsible for the care of the whole patient and the uniqueness of every complex situation that I face in daily practice – Nothing can be predicted with certainty in Intensive care!
Many students don’t know what know what is involved with your specialty in terms of day to day work? Can you tell us what you do in a normal day? How much is spent with patients, procedures, paperwork etc?
A day involves assessment and treatment of critically ill patients, providing consultation to patients under the care of various other specialists and attending emergency calls and resuscitations.
Significant procedural skills required are related to Airway establishments, Central venous cannulations, Intercostal drains placements, pacemakers etc. Organ support systems need to be reviewed everyday which include Ventilators, Dialysis Machines, ECMO Machines and Ventricular assist devices. There is a growing need for ultrasound and echocardiography skills to establish central venous lines and assess the heart by the bedside.
Also, there is a great deal of interaction with other specialists, nurses, dietitians, pharmacists and administration staff. It is a multi-disciplinary team approach that is involved in caring for the critically ill. Family conferences are a big part of the day. There is a considerable amount of on-call work involved in this specialty.
What are the some of the challenges associated with your specialty how do you go about overcoming them?
As with any field involving multi-disciplinary care, there exists a
challenge in co-ordinating the various aspects of care in addition to
providing our own expertise. Better communication solves most issues!
What are your interests outside of medicine? Do you get time to pursue these activities?
Time management is essential in this Specialty. With good time management, it is very possible to have time outside of Medicine. I am a person of diverse interests ranging from Medicine to Computers and electronics. I like to travel and spend time with my family when I am not rostered on!
Do you have any advice for budding medical students / JMOs wanting to specialise in this area?
It is a challenging and very rewarding specialty at the same time. It would be nice for Medical students and JMOs to have elective rotations in tertiary level ICUs to understand the nature of the Specialty. Also, the College of Intensive Care Medicine has a website which is very comprehensive : http://www.cicm.org.au/