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Renal Medicine / Nephrology – Dr Bibin George

Dr Bibin George is a renal / nephrology registrar at the Royal Hobart Hospital in Tasmania. He commenced his medical education in India and came to Australia to undertake further training. Dr George was kind of to share some of his experiences and advice with MSO.

Please tell us a little about your medical background
I completed my MBBS from Kottayam Medical College which is one of the 5 medical schools run by the Government of Kerala, one of the southern states of India. After completing my internship in 1999, I temporarily disconnected myself from work except for the occasional locum jobs, to study for entrance exams for postgraduate courses. These are highly competitive as the aspirants are many but positions few especially if you are interested in General Medicine and General Surgical courses. I was lucky in securing a position for MD in General Medicine in 2000 at the Kasturba Medical College, Manipal and completed it in 2003. This is similar in some ways to the Basic Physician Training of the RACP but the difference was that submitting a thesis was a requirement for completion and once you complete training you could practice as a consultant in General Medicine.

I worked as a Junior Consultant / Assistant Professor at KMC, Manipal for a year and then at the MOSC Medical College, Kolenchery, Kerala for a period of 3 years. Work was extremely satisfying as I was independently responsible for 20-30 inpatients, challenging on-call shifts, crowded outpatient departments where I could see up to 50 patients in a day but the part of my job that I enjoyed most was bedside teaching of medical students. In 2005, I decided that I had to train in a subspecialty and wanted to do this outside India. I applied for a few jobs in Australia and received an offer to join as a medical registrar at the Royal Hobart Hospital in 2006 which I accepted. I passed my FRACP in 2009 and also got my AMC certificate within this period by completing the written and clinical parts of the AMC. I also got general registration in 2009 which is the first goal for any IMG arriving in Australia. I was again lucky to land the registrar job in my specialty of choice, Nephrology, at the RHH.

How did you go about deciding on nephrology?
Given that I had done lots of General Medicine, nearly 10 years of it, Nephrology was an automatic choice simply because Nephrology involves a lot of General Medicine. 90% of kidney disorders arise from a systemic process and only a limited number of disorders arise denovo in the kidneys. Caring for CKD patients is again a lot about doing the General Medical stuff correctly such as fluid management, control of blood pressure and blood sugars, treating infections etc. I also enjoy managing extremely complicated patients and Nephrology provides plenty of such challenges. Renal Transplantation is again a field that I am extremely interested in as it provides the same set of challenges.

What do you enjoy most about nephrology?
What I enjoy most about Nephrology is the complexity of cases this specialty provides and the complex management decisions that need to be taken. Every patient draws on your medical knowledge and clinical skills as well as your management and planning skills. It necessitates keeping abreast with the latest evidence based medicine and hones your professional skills to achieve your objective of being a good physician.

What are your interests outside of medicine? Do you get time to pursue these activities?
My interests outside of medicine include listening to music, watching movies, spending time with my family, keeping in sync with the latest gadget news and following cricket. I do get a reasonable amount of time to balance work and leisure but work can be unpredictable at times but that is what makes this line of work enjoyable and why I chose Medicine in the first place. Unpredictability is the spice of life!

Do you have any advice for budding medical students / JMOs wanting to specialise in nephrology?
First you should decide what you want to specialise in, ideally in your first RMO year or at least the second. Then you should try and do something in your chosen field to make your CV stand out amongst the other applicants. You could attend conferences held by the specialist body or do an audit, make yourselves known to that particular unit in the hospital long before you even approach them for a job, attend their unit meetings etc. Presentation of case reports / studies in your chosen field at conferences is a big plus. All this shows your interest in the subject. Your competition could have the same eagerness to specialise in this area but you would have the evidence to back your interest and that’s what would make your claim more appealing to the Specialist Body.