drmarvel

Residency can feel overwhelming. You constantly think about the “future you” the doctor who must know everything, do every procedure perfectly, and never make mistakes. And when reality doesn’t match that expectation, it’s easy to feel like you’re falling behind. But here’s the truth: You are in a learning phase. You are supposed to struggle. You are supposed to take time. You are supposed to get things wrong before you get them right. It’s normal to feel like your seniors are faster, sharper, and more confident. It’s normal to wonder, “When will I reach that level?” But pause for a moment. Don’t carry the weight of residency back home with you every single day. You cannot run this marathon if you never allow yourself to recover. You need time to reset, recharge, and come back stronger the next day. Because the ones who truly make it through aren’t the ones who chase perfection every day, they are the ones who stay consistent, trust the process, and keep showing up. Every senior or consultant you admire today once stood exactly where you are right now, unsure, slow, and learning. The only difference is that they didn’t quit on the process. So take a breath. Keep going. And trust that, one day, you’ll become the doctor you’re working so hard to be.

Your batchmate who seems to know everything? They don't. They're just better at sounding confident when they guess. Medicine rewards people who admit "I don't know" more than people who pretend they do. The consultant who says "Let me check and get back to you">>> the one who makes up an answer on the spot. Your honesty is a clinical skill. Not a weakness.

Years of ignorance when a section of professionals was targeted and exploited. Suddenly, when a different incident occurred, everyone started talking. Irony.

@_Arcturus_13_ Congrats doc ❤️

" Be HUMBLE enough to know that you're replaceable. But be CONFIDENT enough to know that it'll take 4 people to replace you. " ----@drdilipsmms Thank you for guiding me throughout the PG prep, Sir. And thank you for giving a roadmap for the PG itself.

You begin your career wanting to prove you’re capable. Then one day, you just want to be useful. That shift from validation to purpose changes everything.

Well done, India and Jemimah! If you’ve been following women’s cricket, you know how monumental this achievement is. The Australian women’s team right now is as dominant as their male counterparts were in the 2000s, simply invincible. They entered this match with an unbelievable 70-5 win-loss record in ODIs since 2018 and hadn’t lost a World Cup match since 2017 (that loss too was against India, when Harmanpreet scored a scintillating 171). Today, it was Jemimah’s turn, leading India to their highest successful chase, against the mighty Aussies, and in a World Cup semi-final no less. However, one area that badly needs improvement is fielding. The standards today were unacceptable, at least 25-30 runs were lost in the field. Hopefully, they’ll tighten up and cross that final hurdle against South Africa. For now, congratulations on slaying the Goliath!

Dr. Sivaranjani has taught us something truly profound, that standing up for what is right may take time, may even feel lonely, but in the end, it brings peace to the soul and good to society. There are moments when no one stands beside you, when silence feels heavier than support. But if your heart tells you it’s the right path, you must stay the course. Because truth and integrity always find their way.. slowly, but surely. Today, almost every parent, every doctor, and even a common man in our country knows what ORS is, and more importantly, what it is not. That awareness didn’t happen overnight.. it came through years of her quiet endurance, selfless sacrifice, and unwavering commitment. Thanks to her, people like me have begun to believe that it is possible to fight the wrongs, possible to hold on to what’s right, and possible to make a difference to humanity.

@FreddieQue96120 Yes. Previously it was achievable only with Bariatric. But not it’s possible with these. With peak doses of Tirzepatide there’s a 20% chance of achieving remission though it’s based on the starting weight, other comorbids and age.

@drdilipsmms Sir what do you mean by remission of t2dm? Patient will be off med?

Been prescribing the incredible incretin molecules for nearly a decade now - from Victoza, Trulicity to Rybelsus, and now Mounjaro. It's been quite a journey. Since 2016, I've used them in dozens upon dozens of patients, and the results have been nothing short of transformative. Watching patients achieve what we once thought impossible, even remission of type 2 diabetes, has been deeply rewarding. This time, the experience came full circle at the Railways Hospital, Ayanavaram, in a program sponsored by Ell Lilly. It's moments like these that remind me why medicine is both a science and a story of hope. Waiting for the future.

Make this your must read for the day. We need to celebrate doctors like her. This is the story of Dr. Sivaranjani Santosh, a paediatrician from Hyderabad, who fought for 8 years against sugar-rich drinks falsely marketed as ORS. Her persistence led to FSSAI’s landmark order, protecting children and patients from misleading claims. “These drinks had 10x the sugar WHO recommends, worsening diarrhoea and complications in millions of kids,” she explains. Her 8-year battle changed the game for public health and children across India. What is sad is that it took 8 years for the government and regulator to understand that these so-called ORS drinks were harmful to children. We need to have quicker public health reforms.

@ignitionvester For your kind info I’m practising for last 15 years and I’m the head of the department of internal medicine in a corporate hospital.

@drdilipsmms I guess this is the difference between a full fledged academic physician vs a experienced practising person

H/O: Self-fall One of my patients went to a local hospital after a simple fall, just a scalp swelling, nothing major. She wasn’t on any medicines, completely fine otherwise. And she has already received TT three times in the last two years. I mean, why TT again? Why an injection painkiller for a minor fall? Why an antibiotic when there’s no wound? Why a PPI? Why a CT scan? And why in the world, a B-complex? Still this was the prescription. Not even one in the prescription is justified, given the presentation. And atrocious - that it was written that the ‘patient is not willing for further investigations’. Seriously? This is the kind of thing that makes you shake your head. I see this almost every single day - and it’s frustrating. Whenever you talk about this, there are usually two responses from my colleagues: 1.“Patients demand it.” Many say, “They won’t go unless we give something.” I don’t agree. What they really need is someone to explain, to reassure. That’s part of treatment too. 2.“Don’t post such things.” I’ve spoken about this so many times - about the overuse of medicines and tests, but it feels like nobody wants to talk about it seriously. We have to admit - these kinds of prescriptions hurt everyone. Patients lose faith. And the image of our whole profession takes a hit. Sometimes, doing less is actually the best form of care.

Nope. It was for a UTI. They have injection ceftriaxone that was given in the ER. The law suit was why an injection? As per the documents patient did not have any urgent indication for an IV. So the court declared it’s unnecessary and got the compensation. I don’t think anyone even gets the essence of the post that overdoing can lead to issues as well. A well aware patient might easily bring a doctor down with such a prescription.

@drdilipsmms @NN1603928623983 It's a catch 22 situation I agree. At least you can use some obscure guideline to say you're in the clear for first line antibiotics. Antibiotics are never an emergency, tell that to the judge.

@CynFarmGirl If that’s the case - you need to do a 1000+ CTs every single day in a hospital in India. There are risk factors for a reason. I’d agree if the patient had danger/warning signs or if the age is < 2 or > 50.

@drdilipsmms Swelling of the head. You call it minor? No head swelling is minor after hitting your head. Shameful post.

@chiranjeebk Not at all.

@drdilipsmms The point I made was clear. If there was no localising signs, we could have waited for 24-48 hours before asking for a CT scan. Do you wish to refute that too?

@DocR_B There are so many rules. Canadian CT head rules would be ok to begin with. It has a sensitivity of more than 99%.

@drdilipsmms Could you please post the protocols ?

That’s what exactly I’m trying to say. Why not reassure or observe the patient for a few hours if there are no danger signs - follow up in OPD the next day and decide. I don’t even understand why people are getting triggered. Except for the CT (which maybe agreed to some extent) - none of the things in the prescription makes sense.

@drdilipsmms Leave it !! It will only raise counter argument. Observation and a fundus . May be a painkiller for day or two . But there are times wn medicine is not science anymore

@Kibe_Alpha I’m not saying it shouldn’t be evaluated. The whole argument is on why the unnecessary stuff

@drdilipsmms Self fall should be investigated, otherwise, everyone would have been falling.

@laralara571 I have been practicing for 15 years now. I have worked in government and been in corporate for a decade. I have seen as many MLCs or more than what you have seen. This post is for a healthy argument - not to undermine each other.

@drdilipsmms U can be a good “online lecturer” but man never thought you would be so out of touch . 1 MLC and my yrs of hardwork gone , just like that

@kekhaunter @NN1603928623983 Neither is the prescription. If you go by the laws - the same prescription m can bring you down. Recently a similar incident ended up in a patient winning 87 laks law suit for an unnecessary antibiotic in the ER. It’s a double edged sword. People can only believe what they know.

@drdilipsmms @NN1603928623983 With all the lawsuits that can pile up who will want to practice this way? Everyone will prefer defensive practice. Including writing patient didn't want more reports. Your post can't be used as evidence in a court of law na?

@aditya_gan3500 @_shreyanshgoyal Possible Iron deficiency. She is having a Hb of 8.1 and an MCV of 70. Have asked for the iron profile.

@drdilipsmms @_shreyanshgoyal What was the underlying cause of orthostasis?