The Leap of Faith

(Credit: Central idea inspired by this article)

A short while back, I wrote about the spark early in a relationship, and how I thought it was not nearly as important as people usually believe. I did not mean to suggest that its presence is always misleading, or its absence completely immaterial. I just meant that one should give things time to become clearer and only then can they be sure whether or not something is meant to be.

The reverse problem is people waiting forever to be 'sure' and never quite getting there. In relationships, as in many other things in life, one can never be 100% sure they're making the right decision about the future because it is - and always will be - the great unknown. Getting to know another person is a life-long process and it can't be completed before you make a commitment. That's actually a good thing, because it leaves you a lot to look forward to later. But at some point, you just have to trust you know enough about the other person, and take a leap of faith!

While in college, I was in a great relationship with an extraordinary girl that lasted many years. When I graduated and had to leave for another city, we had known each other long enough and well enough to be as sure as was possible - that if we decided to be together, things would work out well. Unfortunately, we were both very young and just couldn't take that leap and commit to a future together. Things fizzled out, we moved on and grew up to become very different people. Today, I hope I will have a better future than I could have had, but the odds appear long.

After finishing B-School, I didn't like the first job I got. The company was great (both reputation and reality), the money was very good and I did fairly well, even achieving some records, but it was a manufacturing operations role which I just didn't enjoy and wanted to do something else. I resigned after ~10 months, without another job offer in hand. I was offered several tempting options by my manager who was desperate to retain me, and I wasn't having much luck with my first few job applications elsewhere. But I stuck to my decision, and took a leap of faith. Nearly 3 painful months later, I landed a job with a start-up in Bangalore and everything worked out brilliantly after that. I loved my new job, new company, new city, new life - everything!

It doesn't always work out, otherwise it'd be a walk in the park and not a leap. I recently took another one and ended up bruising my knees. That's a story for another time. But even when things don't work out, you just have to pick yourself up and motor on.

The simple truth is - if you want to achieve something great, you will at some point have to take some risks. Playing safe, having backup plans etc. can provide you security, but will also lull you into mediocrity and irrelevance.

To land on one's feet and not in the abyss, one must know the difference between irresponsible, mindless punts and well-informed, calculated risks. Faith must never be blind. This is the secret of successful businessmen like Richard Branson. They take many risks and not all of them pay off. What they ensure is that the potential downside of any risky venture is limited. When they fail, you don't really notice it because the loss is small. When they succeed, it makes the headlines. The mistake most unsuccessful gamblers make is getting carried away with the potential size of the bonanza, but not covering their backs for the scenario when things go wrong.

When you're standing at the edge of the cliff, you must be able to see where you want to land. You must have good reason to believe you can cross the chasm, preferably from your own history. When in doubt, it's often helpful to seek the opinion of a good friend who knows you well because it's easier for them to be objective in their assessment.

But there will come a point at which no more information will be available. You could be reasonably confident but not certain, and you'll find yourself standing at the edge with a choice. You could stand there forever and let life pass you by. Or you could turn away, and always keep wondering about what might have been. The best thing to do is to just jump and pray...

Questioning our medical education setup

Last year, Satyamev Jayate devoted an episode to the issue of generic drugs and doctors being motivated by commissions and profits to mislead their patients at times. Through acquaintances and Facebook etc., most of us would have heard tales of hospitals trying to rip people off by making patients undergo unnecessary tests and treatments. I've felt, for a while, that the root cause of these problems is something else.

Think about this. A typical engineer finishes college by the age of 22 and starts earning decently. S/he doesn't usually have a large loan to pay off. Adding on a masters degree is relatively easy and tends to add very significantly to their career prospects and earning potential. By age 30, most engineer-MBAs have a comfortable lifestyle and are able to afford a car and are on the verge of buying a house.

Doctors, on the other hand, generally don't finish their MBBS course before 23. Add a year of internship and preparation for MD entrance exams. 2 more years of MD, and then typically another year or two of further study or residency. Doctors are a few years older when they start their first jobs which typically pay peanuts. By the time they start earning a good amount, they're generally close to the age of 30. Unlike the engineer-MBAs, they don't already have big savings, instead they have huge loans to pay back.

Also, the medical education system in India is ridiculously corrupt. There are few 'merit' seats available. The majority of students have to make 'donations' to get in, and the amounts payable for more popular courses (specialties) are extortionate. This is true at every stage - bachelors, masters, fellowship, and sometimes even for getting passing grades, especially for final year courses.

By their early 30s, most doctors - who started with good intentions and a desire to do good and help others - give in to the temptation of dirty money. If you were earning less than your peers from school, and had already borne an additional cost of ~50 lakhs to reach this point - wouldn't you be tempted to compromise some of your values? Most people's conscience carries a price-tag, and it's usually lower.

What created this sorry situation in the first place? A simple mismatch between demand and supply. When I attended school in the 90s, the number of engineering and medical aspirants was roughly equal. I doubt if the scale has tilted too far since then. Last year, India produced 1.5 million engineers and 300,000 MBAs - that is more than USA and China combined in each case. Doctors? 33,000. That's about fifty engineers to each doctor. The number of seats available in medical colleges is several orders of magnitude lower than other streams, and with this kind of scarcity, corruption creeping into the system was quite inevitable.

There are also some other unfortunate consequences of this, which it isn't politically correct to mention, but I will do so here. Many failed MBBS aspirants now end up joining BDS, BHMS, BAMS or other such courses. I guess this helps them meet their own aspirations of becoming 'doctors', but judging by their employment trends, I'm not sure this serves a much bigger purpose for anyone.

Also, now that nearly half the medical college seats are reserved for 'quota' students, and many of the others are purchased by students with the most resourceful parents and not necessarily the most merit, the quality of the output is dubious. I, for one, avoid doctors with anything less than a solid reputation built over more than a decade. Most people don't have this luxury, and by lowering standards in medical education, their lives are being put at risk.

What makes this all the more appalling is that we need many more and better doctors, especially for primary care. We have the second (not for much longer) largest population in the world, and many national health indicators are among the worst in the world. The government's budgetary allocation for healthcare is also among the lowest in the world in percentage terms. They just don't seem to care. The situation desperately calls for more medical colleges to be set up and the whole system being cleansed and re-vitalized. I can't imagine voters being unhappy about the government setting up more teaching hospitals and/or medical colleges, so I don't understand why it isn't happening.

If the government can't handle this, they should encourage the private sector to do so. Why can't the kind of incentives that were offered to IT companies and BPOs be offered to private teaching hospitals now? Why can't PPP models be explored like they are for other kinds of infrastructure? Shouldn't this be a higher priority than messing around with the IIT JEE exam pattern every few years?

Caveats: This post makes several generalizations and no reader should take it personally. Also, I'm no policy expert and this is my opinion, based on common knowledge and common-sense rather than thorough research - please bear that in mind when you comment. If you agree that some of the issues and questions raised are valid, please share it forward because we need to push for things to change.

Tough. 6.

Really? Another test? Now?

Ok. I've faced many longer, tougher ordeals. Personal, professional, academic, romantic... and I have prevailed every single time.

Bring it on.