2020—the Year That Was!

It has well and truly been a god-given opportunity, a great honour and an incredible privilege to serve our esteemed Association. Over the past 24 months, both in my role as Vice President and President ASI, I have been working to the best of my abilities to ensure “Creative Leadership & Accountable Governance”, which has been my “mantra” right from day 1.

My vision for 2020 published in the February 2020 issue of the Indian Journal of Surgery [1] has attracted the highest number of accesses ever for an Editorial published by the Journal. I have therefore been acutely conscious of the enormous responsibility. The expectations and views of “grass root” members have been uppermost in my mind, all along. As I come to the end of my tenure, I would like to express my profound gratitude to the Membership for electing me to the apex position with an unprecedented victory margin, never before witnessed in ASI’s 82-year history.

Whilst reflecting upon my presidential term, I am writing to share with you some of the major events that shaped “The Year That Was!”

The Pandemic—Interaction with Hon’ble Prime Minister of India and Life-Transforming Philanthropy

“A leader is someone who has insight into the situation in which he exists.”

This has been a year like no other. With considerable foresight, well before the national lockdown was announced in India, I had alerted the Chapter and Sectional Representatives in the first week of March 2020 about the urgent need to defer all the onsite academic activates. In fact, in early March 2020, ASI was the very first pan-India-based Medical Organisation to issue directives to cancel all the onsite Workshops, CME Programmes and annual State Chapter/Sectional Conferences that were scheduled to be held all across the Country. I had highlighted this point during my virtual video interaction with Mr Narendra Modi, Hon’ble Prime Minister of India, in the third week of March 2020. Some of the suggestions that I had made during this virtual interaction found place in the Prime Minister’s address to the nation on the same evening. Within minutes, this video interaction became incredibly popular on social media and was shared by many people across India and abroad, both within and outside of the Medical fraternity (Figure 1).

Fig. 1

Virtual interaction with Hon’ble Prime Minister of India (March 2020)

ASI has spearheaded a never before–witnessed life-transforming philanthropic drive during this unprecedented pandemic. There was acute shortage of life-saving personal protection equipment (PPE) between the months of March and June 2020 as there were very few government-approved PPE manufacturers in India at that time. Having identified a reliable government-approved manufacturer, I personally coordinated the procurement and delivery of the PPEs during the nationwide lockdown at a time when Road, Rail and Air services were totally disrupted. That this exercise was not easy and challenging would be an understatement, and I must confess that this was the most stressful period of my Presidential term. I ensured that these life-saving PPEs were sent directly from the manufacturer to the ASI State Chapter/Sectional Chairmen & Secretaries, and through them, the PPEs were hand delivered to frontline healthcare workers that needed them the most in COVID-designated hospitals in most of the states across India. Well over Rs 1, 00, 00, 000 (Rs. 1 Crore) was raised within a short span of time to procure and deliver these PPEs. I have no words to thank the representatives of Chapters and Sections of ASI, who stood ‘shoulder to shoulder’ with the parent body in implementing this landmark initiative.

AMASI (The Association of Minimal Access Surgeons of India), a Section of ASI, and some of our Members joined me in making a generous contribution (Rs 25, 00, 000) (Rs. 25 Lakhs) to the PM CARES Fund as well. Furthermore, in June 2020, ASI in partnership with Amway India distributed 12,000 hand sanitizers to frontline healthcare workers in 56 COVID-designated government hospitals in 12 states. Rock-solid determination, focussed efforts and perseverance have enabled me to undertake and accomplish the major philanthropic assignments during these most trying times (Figure 2).

Fig. 2

Life transforming philanthropy - Personal Protection Equipment (PPEs) & Hand Sanitizers delivered to ASI Chapter/Sectional Chairmen & Secretaries all over India (March – June 2020)

Reaching out to Staff at ASI Headquarters

One must never forget to help grass root personnel who have been actively assisting the Association for a number of years. I have pledged to provide a robust comprehensive Health Insurance Cover for the ASI Staff members and their immediate families through my own resources for the next five years until 2025.

Academics

“Leadership means, once you sit on a perch, you better see clearer than others, otherwise you will make a ridiculous fool of yourself.”

To me personally, implementing VISION 2020 during the unprecedented COVID 19 pandemic has been life’s powerful learning lesson. Education and training have been my top priorities [1]. At any given time in India, there are some 15,000 surgical trainees in the system, who are indeed the future of ASI. Meticulous planning during my term as Vice President has ensured that the various Courses for trainees that were outlined in Vision 2020 [1] kick-started soon after assuming Office as President ASI. Between January and March 2020, fifteen courses were held in various parts of India, which aimed to improve the knowledge and skills of trainees. I am ever grateful to Dr. Pawanindra Lal, National Executive Committee member of ASI & Dr. MBV Prasad, Consultant Surgeon at KIMSHospitals, Hyderabad for co-ordinating these Courses.

The courses introduced for surgical trainees in the year 2020 include (Figure 3)

• ASI Basic Surgical Skills Course (3 days)

• ASI Critical Care Course (2 days)

• ASI Basic Laparoscopic Skills Course (2 days)

• ASI Anastomosis Skills Course (1 day)

• ASI Communication Skills Course (1 day)

  Fig. 3

  

  ASI Basic Laparoscopic Skills Courses, ASI Anastomosis Skills Courses, ASI Critical Care Courses & ASI Communication Skills Courses (January – March 2020)

However, the onset of the COVID 19 pandemic in India during the month of March 2020 put an abrupt brake to these onsite courses that were scheduled to be held all through the year. Having adjusted to the “new normal” and quickly adapting to the change, starting from June 2020, ASI resumed its academic activity which got disrupted in March due to the pandemic.

Between the months of June and October 2020, two major intense online academic training initiatives were implemented under the auspices of ASI

National Online Skills Enhancement programme 2020 (NSEP)

(Target audience: trainees and practicing surgeons)

ABCs of basic surgical procedures, which are often not formally taught neither in the regular teaching sessions nor at major conferences, were showcased by experts from across the country through short crisp videos, which was followed by an interactive discussion. One procedure per week was discussed online from June to August 2020. A never before–undertaken social media campaign was launched, and ASI’s Facebook page was activated, which resulted in the very first NSEP held on 10 June 2020 attracting a record of 10,845 page views, 1006 likes and 1221 new followers. There was no looking back after this hugely successful first online academic initiative, and the number of trainees and members watching the weekly NSEP online increased manifold week on week over the next 10 weeks.

This landmark online ASI’s e-learning initiative ushered in a new era in ASI’s academic schedule.

Annual online Regional Refresher Courses 2020

(Target audience: trainees and trainers)

The online NSEP seamlessly transitioned to ASI’s flagship annual Regional Refresher Courses (RRCs), which were also held for the first time ever on a virtual platform. RRC 2020 started off with an initial pan-India screening round—an MCQ Test—30 questions to be answered in 30 min. This included six levels of difficulty with five questions in each level of difficulty (6 × 5 = 30 questions) and five OSCEs. The country was divided into six zones—six zonal RRCs were held between 10 August to 26 September 2020. Each zonal RRC was held over a 6-day period with case presentations made by 18 trainees assessed by 72 carefully chosen examiners from the region.

Moving away from the tradition of just having clinical cases for the final round, for the first time ever since the RRCs were introduced, the final round in RRC 2020 had assessment based upon a combination of clinical cases, radiological images and virtual ward rounds. This has ensured a 360° assessment of the twelve trainees who were selected for the final round examined by fifteen examiners and three independent judges.

Some 5000 trainees have watched RRCs on a daily basis on ASI’s Facebook page, which speaks volumes about ASI’s successful online academic initiative. The six zonal RRCs including the final round held over one and half months had participation from 120 surgical trainees, 447 examiners and 21 judges. And so, one can imagine the meticulous planning and the extraordinary efforts invested in making this flagship ASI Programme a stupendous success story. My heartfelt gratitude to Dr. Santhosh John Abraham, Director, Academic Council ASI , who has been the chief architect of the NSEP & RRCs and to Dr. Abhay Dalvi, Vice President ASI for their tremendous efforts in spearheading ASI’s online academic activities.

Integrity, Transparency and “No Nonsense” Approach (Accountable Governance)

There have been several landmark decisions taken during my presidential term that I am proud of. Keeping with what is expected of a president, I have distanced myself from “personal likes/dislikes” and “friendships” in taking these decisions, always keeping the greater good of the Association as my highest priority.

“Good leaders take a stand.”

ASI Awards

An award must be bestowed upon deserving members based upon merit and merit alone. Only then would the award bring honour to the awardee and indeed, ASI. A number of palpable changes have been introduced to streamline the selection process for all ASI awards.

The ASI Lifetime Achievement Award is the highest recognition that can be achieved by an ASI member for his/her lifetime contribution to the art and science of surgery. For a number of years, ASI has been conferring these awards annually to senior members of ASI. However, there have been no formal guidelines in selecting the awardees. The membership must be involved and be given an opportunity to submit nominations for this most prestigious honour (“people’s nominee”). And therefore, for the first time in ASI’s history, robust criteria were introduced and a formal selection process was implemented in choosing the Lifetime Achievement awardees for 2020.

Personal decisions...

At a personal level, I have declined to be conferred ASI Lifetime Achievement Award for the year 2020. Clearly, I have not made a Lifetime Contribution to ASI. Also, I am of the firm opinion that it is not right and proper for a serving President to be conferred Lifetime Achievement award during his/her tenure.

I have also declined to deliver the presidential oration at the Annual Conference of ASI (ASICON 2020). Having delivered Col Pandalai Oration just a couple of years ago, which is the highest academic honour that can be achieved by a surgeon practicing in India, I felt that there would not be much point in my taking up 45 min of prime time during the annual conference just to satisfy my “ego” that I have delivered yet another prestigious oration. Whatever I wish to convey as the president, I have done so, regularly every month both on social media and through emails. Whatever else needs to be conveyed towards the end of my tenure would be taken care of during the conference inauguration. And furthermore, this editorial piece also summarises most of the activities undertaken in 2020.

Instead, I thought it would be prudent to break the monotony and utilise this prime time engaging delegates through an inspiring discussion with a world renowned distinguished personality from outside the fraternity.

Finally...

There have been many a nostalgic moments throughout the year—it has well and truly been a delightful pleasure participating at most of the ASI State Chapter/Sectional “virtual Conferences during the course of this year. Despite all the odds, great care was taken by the chapter and sectional representatives in preparing the academic programme in all the conferences, which showcased best practices related to the art and science of surgery in addition to laying emphasis on what one can learn over the weekend that can be applied in clinical practice on the Monday morning.

The life-transforming major philanthropic drive championed by the Association coupled with an intense and vibrant academic activity have been the highlights of the year. I have no doubt whatsoever that ASI’s flagship annual congress later this year (VIRTUAL ASICON 2020) would be a fitting grand finale to “The Year that was!”

Nothing gives me more pleasure than to share a letter of appreciation from Prof. Tehemton Udwadia, a revered former President of The Association of Surgeons of India, who is widely considered to be the “god father” of Laparoscopic Surgery in India. It leaves me with a great sense of satisfaction that I treaded the path “not taken”, boldly and fearlessly...

Insight, integrity and inspiration have been the three pillars of reference to my leadership journey. I would like to end with a quote that just about sums up many of my thoughts for “The Year that was”…

“When you have an important responsibility, you must have an inner strength that will not be changed or threatened by external situations.”