Dr Mayank Vats

My interest in Respiratory Medicine aroused, when as a student of M.B.B.S. I was posted for orientation in the Department of Respiratory Medicine at J.L.N. Medical College & Asso. Group of hospitals, Ajmer and further as an intern in my hospital.

To fulfill this interest, I joined the postgraduate training in Respiratory Medicine in May 2003. J.L.N. Medical College & associated Group of hospitals, Ajmer is a teaching hospital specialized in tertiary level of medical care. The medical college has 4 civil hospitals with a total capacity of 1000 beds attached to it. It has a robust and dynamic Department of Respiratory Medicine which provides services to all other departments & accident emergency and ICU for specialist respiratory consult. During my postgraduate training, I had the opportunity to be exposed to critical patients in the ICU of our hospital. We used to attend calls for resuscitation from all over the hospital as well. Working in this hospital trained me in all aspects of Respiratory Medicine, Intensive care & sleep Medicine.

After this I worked as a Senior Resident in the Department of Neurology and critical care medicine in Jaipur Hospital, one of the premier super-specialty hospital of the state dedicated to neurology, neurosurgery & trauma. Here I have had the opportunity to work in Neurology, neurosurgery & accident & trauma ICU. Besides this I had to take care of ward patients & emergency cases and have been a part of the accident & emergency resuscitation team.

From March 2004 – July 2004 I worked as Visiting Bronchoscopist at North-Western Zonal Railway Hospital, Ajmer & Consultant Pulmonologist & Intensivist at Mayani Hospital & Research Centre Ajmer where worked independently in the field of respiratory, Intensive care & bronchoscopy which I have already explained.

I learnt the principles of management of critical patients during my M.D training period and my interest in the specialty grew. In August 2004 I was selected for Post Doctoral DNB Fellowship in Critical Care Medicine (2 Year Clinical and Academic Residency of National Board of Examination) at Escorts Heart Institute New Delhi & Escorts Hospital Faridabad. The ICU in this Institute is one of the best equipped and busy unit in the country. Here I had the opportunity to manage critical patients of both medical and surgical specialties and I had to supervise the ventilator, hemodynamic and general intensive care of such patients while working as registrar in-charge during my fellowship.

I dealt with a wide variety of critical patients with or without ventilatory support such as ARDS, Respiratory Failure, COPD, Acute Myocardial Infarction, Valvular Heart Disease, Cardiac Failure, Cardiomyopathy, Septicemia and Multiple Organ Failure, Acute Renal Failure, Acute Pancreatitis, Hepatobiliary disease, Stroke, Brain hemorrhage, GB syndrome, Myasthenia Gravis, Meningitis, Encephalitis, Seizure disorders, Poisonings, Trauma, Head/ spinal Injury, Obstetrics emergencies and Post Resuscitation patients etc. to name a few.

I got vast experience in the management of cardiac / post-cardiac surgery patients, accident & emergency, gastroenterology, pulmonary, cardiovascular, infectious diseases and all types of medical critically ill patients requiring aggressive monitoring & treatment.

This working has aroused in me special interest in the field of critical care and I wish to undergo further supervised and structured training in the field from recognized and specialist centers.

During my this 2 years training I also got ample experience in insertion of central venous lines at all sites (about 520), endotracheal intubations (about 230), Percutaneous tracheostomy (about 65), management of difficult airway, blind nasal intubations and the laryngeal mask airway, fiberoptic bronchoscopies (about 108), gastroendoscopy (about 19) haemodialysis & CRRT (about 105), Intercostal chest tube & pleural aspiration (about 175), Lumbar puncture (about 30), ascitic tap (about 45) & suprapubic cystostomy(5)etc. I was also an active member of the transport team of critically ill patients (including road & air ambulance)

After completion of my fellowship I joined Escorts Heart Institute & Research Centre as Consultant Pulmonologist, Intensivist & Sleep Physician with all the assigned responsibilities of an independent consultant including management of inpatients / OPD / Interventions related to respiratory medicine, critical care & sleep & to remain on calls 24 hrs × 7 days. I established a well equipped Bronchoscopy Lab, Sleep Lab and PFT lab for the advancement of Pulmonary medicine in this hospital.

As a coordinator & teacher of Pulmonary & Critical Care Medicine (CCM) Program I had the responsibilities of: a) Providing a supportive academic and clinical environment designed to facilitate the professional development of the fellows and assist them in achieving their academic goals. b) Assuring quality of the educational program & suggestions to improve the program after making consensus for the proposed changes. c) Assuring adequate records, log book and performance evaluation of all CCM trainees. d) Updating of information about the individuals appointed to the program and the impact of educational activities to the CCM Training Program Committee & to ensure appropriate communication between all. Assisting the CCM Fellow in obtaining all materials, research papers, guidance & motivation to carry out clinical research.

I left Escorts Heart Institute & Research Centre and joined Indraprastha Apollo Hospital, New Delhi with the team of about 200 doctors on the same post with similar responsibilities. While taking care of all clinical responsibilities as an independent consultant, I also played active role for the upgradation of the pre-existing CTVS ICU in the same hospital. From last 7 years actively gaining expertise in full spectrum of Interventional Bronchoscopy / Interventional Pulmonology & Sleep Medicine by training at state of the art Centers (in USA/ Europe/ Germany) for the same with the intentions to develop State of the art Interventional Pulmonology deptt in Rashid hospital.

1. Interventional pulmonology and bronchoscopy (complete spectrum viz EBUS, EBUS TBNA, TTNA, Valve placement, Stent insertion, TBLB, Cryo-biopsy TBLB, Electrocautery, debulking of central airway tumors, APC,)

2. Fibreoptic Bronchoscopy and Related Procedure e.g. Br. Biopsy, Br, Brushing, TBNA, TTNA and BAL.

3. Confident in Airway Management Including Difficult to Intubate Patients, Well Acquainted with Supra Glottic Devices (LMA, Combitube) Fibreoptic Intubations.

4. Expert in Percutaneous Tracheostomy, Cricothyrotomy and Difficult Airways.

5. Can Do Following Procedures Independently with Confidence: Biopsies (Lung, Pleura, Liver, Kidney, Bone Marrow, Excisional Lymph Node), Tube Thoracostomy, Thoracentesis, Pleurodesis, Abdominal Paracentesis, DPL, Pericardiocentesis, Lumbar Puncture, Supra Pubic Cystotomy, Percutaneous Endoscopic Gastrostomy (PEG), FNAC (Lymph Node/Lung etc), etc.

6. Allergy Testing (Skin Prick tests, Patch tests, Immunotherapy)

7. Have Adequate Experience in CT and USG Guided Diagnostic Procedures and Can Perform and Interpret USG, Transthoracic and Transesophageal ECHO.

8. Procedures Related to Critical Care (Central venous Lines, Arterial Lines, Pulmonary Artery Catheter, Intra-Aortic Balloon (IABP) Counter pulsation, Temporary Transcutaneous and Intravenous Cardiac Pacing.

9. Sleep Studies (Polysomnography- Diagnostic & Therapeutic)

10. Can Perform Upper GI Endoscopy and Related Procedures e.g. EVL, PEG, Biopsy

Pulmonary Medicine, Interventional pulmonology & Sleep Medicine:

1. Interventional pulmonology and bronchoscopy (complete spectrum including Bronchoscopy Biopsy, brush, BAL, TTNA, TBLB, EBUS TBNA, Electrocautery, APC, Cryobiopsy, Bronchial Thermoplasty, Stents& Valve placements, foreign body retrieval, debulking of central airway tumors etc )

2. Sleep Related Breathing disorders, Obstructive Sleep Apnoea and other sleep disorders.

3. Bronchial Asthma, COPD

4. Diagnosis & treatment of Respiratory Allergy

5. Bronchogenic Carcinoma and other lung malignancies

6. Pleural Diseases

7. Immunological, Multisystem & Occupational lung diseases

8. TB & MDR TB

Critical care Medicine:

1. Mechanical Ventilation (Invasive and Non-invasive).

2. Cardio-Pulmonary Emergencies.

3. Neurological, Endocrinal and Metabolic Emergencies.

4. Moral, Ethical and Legal Issues in ICU.

5. Sepsis and Acute Infectious Diseases in ICU.

6. Enteral and Total Parenteral Nutrition in ICU.

7. Invasive Diagnostic and Therapeutic Procedures related to critical care.

Clinico-Radiological presentation of Tuberculosis in elderly.

My work as a senior postgraduate trainee at J. L.N. Medical College involved the administrative responsibility of organizing the ward, inpatients, OPD, Minor OT & emergency services run by the department. I was involved in management of the day to day services provided by the department for the management of the medical ICU as well as procurement and checking of all the equipment and monitoring devices

As Consultant in Apollo hospital I contributed in the establishment of a new CTVS ICU (12 bedded) by directing & guiding about the Design, Equipments, Machines & other facilities for the ICU. I also played active role for the up gradation of the pre-existing CTVS ICU in the same hospital.

I also contributed to the organization, planning & development of multi specialty ICU’s (Medical, surgical, neuro, gastro, coronary care & so on) in an upcoming multi-specialty (1500 bedded) hospital in Gurgaon, India with the esteemed guidance of Director of my department.