Solving India's Skilling Crisis

"India is projected to need over 1 crore healthcare workers by 2030, the challenge isn’t just the number of graduates entering the workforce. It’s whether they are truly prepared to step onto the hospital floor."

In the first episode of #TheExecutiveEdit led by Akash Kalp, CBO at Emversity, we explore one of the most pressing challenges surrounding India’s healthcare system: the growing gap between healthcare education and real-world hospital readiness.

Our guests Dr. Arvind Kasagod, Director Medical Services at Cloudnine Group of Hospitals, and Megha Lal, CHRO at Emversity, share insights from the hospital floor on what employers actually look for in young healthcare professionals and why many graduates struggle to transition from classroom learning to patient care.

More importantly, they discuss what it will take for India to not just supply healthcare talent to the world, but to set the global standard for it.

Transcript

SPEAKER_01 0:00

I actually don't really care about qualification based training.

SPEAKER_02 0:03

Exactly get the same questions around everyone. How do we address the skill gap that is existing in our market?

SPEAKER_00 0:09

By 2013, Lindia alone, we would be needing like one crore plus healthcare workers. The problem is not that there are not enough graduates who are entering the job market. The problem, as Dr. Alvin also mentioned, is predictability of the skills that you know the hospitals would get when they hire these graduates.

SPEAKER_01 0:25

One of us know that there is a gap between the training that you get and what actually happens again.

SPEAKER_02 0:32

Graduates you are in specifically for me being the size of a developer like it is. The biggest problem that you as an employer is getting these new graduates onto the hospital floor.

SPEAKER_01 0:41

Communicating. Really? And setting expectations very clear. Most of the problems that happen in healthcare are related to lack of communication. At the end of the day, you might be best qualified, and if you can't do the job you're expected to do, then it's of absolutely zero. Where the university comes from.

SPEAKER_02 1:01

What's the worst first problem that we are trying to solve at university?

SPEAKER_00 1:04

There are three major problems. One is the communication. The new graduates who come and join the hospitals are not able to talk to the patients, they're not able to address their queries, make them comfortable. The second problem is of discipline. Not coming on time, not adhering to the Google standards, not maintaining proper registers and documents. And third problem is their clinical readiness.

SPEAKER_02 1:25

What is the philosophy of caregiving at Cloud9 that makes it so distinctive?

SPEAKER_01 1:29

People go to McDonald's anywhere in the world, they expect the same food, same kind of service, right? Similarly, we want it to be in that kind of situation where literally we build a process that is cookie-cutter. So what we do is we train, train and train someone.

SPEAKER_00 1:49

So I think see the opportunity is massive. India can be the healthcare workforce capital of the world and in not just supplying the talent but actually setting standards as well. For that, I think hospitals, training institutions, and regulators, we need to invest in people like the mattress.

SPEAKER_02 2:09

So welcome to the executive edit. Today we are discussing about something which is very, very fundamental to Indian healthcare. The skill gap and the communication around how do we address that? And also a communication around how does empathy increase, how does bedside manner increase, and everything along with that. When we talk to hospitals across the country, we encounter these questions everywhere. Be it geriatric care, be it maternal care, be it super speciality hospitals or multi-speciality hospitals. We exactly get the same questions around everyone. Like how do we address this skill gap that is existing in our market? So, today to dive more into it, I'm joined by two people who are best fit for this discussion. Firstly, our guest, uh Dr. Irwin Kasagore. Uh, Dr. Irvine is a director of medical services at Cloud9, one of India's most respected names in maternal and child health. But let me give you a sense of his journey. He trained at Madras Medical College, then did his paediatric residency at Dr. Robert Wood Johnson Medical School in New Jersey, followed by a fellowship in pediatric critical care at Denver Children's Hospital. He holds an MRC PCH from the UK and MBA in health services. And at Cloud9 is responsible for quality across 29 facilities, which I think is increasing day by day. And in an environment where the stakes are very, very high, we are talking about bringing new life into the world.

unknown 3:51

Dr.

SPEAKER_02 3:51

Ambrudan, thank you for being here. Your introduction was rather long, so I had to slightly read it out of the books. Thank you, Doctor. And then I'll also introduce uh Mega. Uh Mega here comes and is recruiting and hiring and training people across 30 cities for us. We have over 700 uh people working for us, in which there are several healthcare professionals, specifically academicians, right? So Mega is also here. So I'd like Dr. Arvin to just throw some light uh on about the problems that we're talking about, how skilled manpower is an issue, how do you manage that at Cloud9 right now?

SPEAKER_01 4:32

Yeah. First off, uh, thank you all for having me here. Uh it's a pleasure. And the introduction sounded more fancy than it is. Uh thanks again for that. Um the reason I came back to India was to ensure that you know we're able to provide the kind of care that is available to patients across the world and in the best of the world, countries. So with having that in mind, uh we've been uh really lucky to be working having worked in two very good organizations, and both of them have given me an opportunity to implement what I have learned both in UK and in the US. Having said that, my core training was in India, and I think training here is as good as anywhere else. However, all of us know that there is a gap between the training that you get and what actually happens at work. And this is not unique to India. I mean, this is something that happens across the world. It's probably more pronounced here because of the very diverse nature of everything. Starting from the students, the kind of institutions we have, private, government, the regulatory mechanisms are different. So the fact is there's going to be a skill back skill gap everywhere. And the skill gap that is in healthcare is very important because we are dealing with life and death.

SPEAKER_03 6:29

Thank you.

SPEAKER_01 6:30

When we do that, we will need to come up with strategies to ensure that we cover that gap and provide the best care possible.

SPEAKER_02 6:38

Thank you, Dr. Miga. Um the perspective from where Miversity comes from, what's the workforce problem that we are trying to solve at Miversity?

SPEAKER_00 6:47

Uh so see, when we look at uh you know the demand for healthcare workers. So by 2030 in India alone, we would be needing around one crore plus healthcare workers, right? So the problem is not that there are not enough graduates who are entering the job market. The problem, as Dr. Arwin also mentioned, is in the quality, the predictability of the skills that you know the hospitals would get when they hire these graduates. So when I spoke with different uh CHROs of hospitals, they pointed out that there are three major problems. One is the communication, uh, which is very important, healthcare, uh, empathy. So they're not able to, you know, the new graduates who come and join the hospitals, they're not able to talk to the patients, they're not able to address their queries, make them comfortable. The second problem is of discipline. Uh, it could be you know not coming on time, not adhering to the grooming standards, uh, not maintaining proper registers and documents. And third problem is their clinical readiness, right? Uh uh so in fact, I was talking to a very senior uh nursing head from a very uh large hospital change. She said that once the nurses join, uh, you know, they're not able to, they're not allowed to interact with the patients for good six months. So for the initial six months, they just have to follow uh, you know, uh whatever the nurses are doing, they have to shadow them and you know they're learning on the job. So this is the problem that at university we are trying to uh you know address. How we can uh make these graduates, you know, train them so that there is a the skill gap which already exists, we can address that.

SPEAKER_02 8:19

Got so as we established, uh the problem statement is very, very large, and we talk about this throughout this episode. But first, coming uh Dr. Avin to Cloud9, how do you describe Cloud9? Uh the scale is as you said, scale is always increasing. What is the philosophy of caregiving at Cloud9 that makes it so distinctive?

SPEAKER_01 8:41

So when I joined Cloud9, we had nine hospitals. Today we have 43. So the reason I was brought on was precisely for the reason of standardizing care across all hospitals, all geographies, and as we scale up, because when we scale something up, consistency is key in any industry. People go to McDonald's anywhere in the world, they expect the same food or the same kind of service, right? Similarly, uh in healthcare it's no different. We uh want it to be in that kind of situation where literally we build a process that is cookie cutter. Sounds very boring, but I t let me tell you in healthcare, boring is good because we don't want to be firefighting. Yeah, that's not something you want to do because at the end of the day, patients are what matters. And if the patient needs firefighting, then something is seriously wrong with the system. We don't want that to happen. So what we did was we start put all the building blocks together. It took us a good two, three years. So from between I would say 9th hospital to the 16th hospital, we were just putting all the building blocks in place. Once we got our first NAVH accreditation, after that, in fact, in a 12-month period, we got about 11 hospitals accredited in a 12-month period. I don't think NBA has done that for anybody. That was purely because we were able to standardize care across different geographies. And in India, it's not easy because you have you know there are language issues, there are skill gap issues, and everything else. So once we did that, every year we've been able to open eight to ten hospitals. And that's because we were able to standardize everything. And people who walk into any cloud nine will get the same kind of treatment both medically and in allied services and the whole customer experience part as well.

SPEAKER_02 11:07

Just a follow-up question to that, specifically adding maternal and unital care, right? Which Cloud9 specializes in. Is it more complex when it comes to this? Or uh because we talk about standardization across the board, right? But very few hospitals have been able to standardize the way Cloud9 has been able to do. So is is the category unique or is the pro are the processes unique?

SPEAKER_01 11:29

No, I see the thing is category is unique in one way. Uh there's a huge difference between maternal care, especially you know, going in for a delivery, and rest of health care. Yeah, but the key difference is this everywhere else in healthcare, you go to a hospital because you have to go.

SPEAKER_03 11:50

Yeah.

SPEAKER_01 11:51

Deliveries are the only time when you actually want to go.

SPEAKER_03 11:54

Yeah.

SPEAKER_01 11:55

That makes a huge difference. Having said that, expectations are very high.

SPEAKER_02 12:01

Yeah.

SPEAKER_01 12:01

Right? It is supposed to be a normal process. You know, pregnancy, our tagline is pregnancy, a wellness, not an illness. However, all of us know that it's at the end of the day medical care, it's health care. It's not a perfect science, and there are you know complications that are going to happen, and we will need to deal with that. So, expectation setting becomes very, very critical. Once you do that, then the process becomes easy. So, one of the key things that we talk to our doctors about and everyone else who's involved is about communicating really well and clearly and setting expectations very clearly. Because most of the problems that happen in healthcare are related to a lack of communication or miscommunication. Sure.

SPEAKER_02 12:56

So, next question, uh, and we'll quickly dive into the elephant in the room, right? Or the problem in the hand. When uh, because we are dealing with a lot of fresh graduates, right? When fresh graduates join in, specifically cloud nine being the size of employer that it is, right? What is uh the biggest problem that you as an employer face, right? What do you think can change and what do you what is the kind of problem that you're facing today? Uh training and getting these new graduates uh onto the hospital floor.

SPEAKER_01 13:26

So this is an issue that I'm glad that no everybody is talking about, right? I mean, there is a huge difference between uh qualification-based hiring and skill-based hiring. I actually don't really care about qualification-based hiring anymore. At the end of the day, you might be the best qualified, and if you can't do the job you're expected to do, then it's of absolutely zero value. Whereas if there's somebody who actually can do the job and is not qualified, I would pick that person anytime. And I think world over now, that's what's happened. I mean, one of the companies in the US actually has hired 22 kids straight out of school. Right? And there were 500 applicants, and you know, they've taken people on. And we people are talking about that. We've already done that in cloud. Yeah. So we've opened up areas of education for girls who are straight out of high school. And we teach them everything, starting from English or the local language. And along with that, any other areas where we think we can hire them back. So we are we we do that, and that is something that we are very, very clear about, right? For us, skill-based is more important than qualification cost.

SPEAKER_02 14:50

Got it. I think that's a dialogue across the world that skills have become more important. And uh to a large extent, education system, our education system has not been very successful in imparting the right skills to the people. Uh, want to come to you. Uh, at university, how are we looking to solve these last mile gaps? As Dr. Irvins said, when these new graduates are coming in, they still have to train them for everything. How do you think we are addressing the right?

SPEAKER_00 15:19

So, see, to begin with, the current set of nursing colleges or their light healthcare colleges, they're not they're not doing a bad job in the sense they are doing whatever the decades old academia told them to do, right? The problem is that the world has changed. Hospitals have changed, the expectations from the patients have changed. So, somewhere, uh, like Dr. Arwin also is facing uh on a day-to-day basis, the the graduates they are not trained to sort of uh you know undergo the 12-hour shift in the hospitals when they join. So, what adversity is doing that we are helping them transition from, you know, we have studied this, you know, from saying what we have studied this to actually uh saying that we can do this. So, how we are doing it is that first is we create a curriculum which is co-created with the employers. So we sit with the CHROs, medical directors, and we create a curriculum so that we are not left at the end of the day guessing what is it that the what are the skills that the hospitals need. So this curriculum design happens with the employers themselves. The second is that in our curriculum, 70% of the curriculum is uh you know on the job training. So the students they get to understand the hospital setup, they are able to look how the labs you know would look like, and they are also getting an exposure to the shift timings. So this is how we are trying to give them the right exposure while they are studying in cell. And then we have a lot of simulations uh which enables them to practice before they actually get to touch the first patient. So these are some of the things that we are uh you know bringing in new inversity. We are also focusing a lot on uh communication because in medical profession, you know, communication can actually save lives of uh the patient. So communication, uh patient empathy, these are some of the things that we are focusing on when when they are training with inversity. So uh, you know, we are saying to the hospitals when you go to them that you know you don't have to do, you don't have to do the training, we will do it for you.

SPEAKER_02 17:17

Bridging this question to you, sir, right? Do you see when uh students come with better preparation, when freshers come with better preparation, more practical training? Do you see that evident difference in them when they join and and do they do they succeed earlier? Do they have a longer career path? How do you see that?

SPEAKER_01 17:37

So, like I said, we have not um actively engaged with somebody like M varcity, but we have built our own. Yeah, and that has worked really well for us. Yeah, so we take on students in the six months of final six months of their training, whatever it is, yeah, and then you know, filter them out, take the good ones from there, and then give them an offer letter, again train them for six months and then bring them back. When they do that, uh a lot of skeptics, you know, doctors are extremely skeptical and all are you know used to say uh you know we want experienced nurses, qualified nurses. So we tell them that we will create the experience before they hit the floor, right? So that is actually very, very important. Unfortunately, the same thing doesn't translate among medical students. Yeah, so far there hasn't been anything that is really focused on getting doctors job ready. And that's an area which uh clearly requires focus. And uh we I'm I mean, yeah, my son is a is a medical student too, right? I mean, recently graduated, he's not done his postgraduation. Uh I I think he would need training before he starts working. So that's yeah that's how it is, and no shame in that.

SPEAKER_03 19:05

Yeah.

SPEAKER_01 19:05

Uh I mean, if you were to take a sports analogy, I mean, at every stage, everybody needs additional training. I mean, I'm sure Michael Jordan, when he graduated from high high school to college, he needed training. And then again, from training to the pros, retraining, and probably training every day of his career as well. So no harm in doing that, no shame in doing that. And I can tell you when I joined in the US as a resident, they said, we won't assume you know nothing. And our job is to train you. So don't feel bad. I tried telling this to some of the people I hired. I almost almost got beat up. They say, you know, the immediate reaction was, oh, you're from the US, you think you know everything, uh, you're putting Indians down. No, it's not. I mean, the question was if a training system is good, doesn't matter where it is from, yeah, please follow it. I mean, you know, at the end of the day, you want to get yourself record.

SPEAKER_02 20:03

So I also come from the eastern part of India. Uh a very unique thing that I've seen with specifically with Cloud9 is you have certain teams going to villages, working with the tribal population out there, training them, and then getting them into workforce, right? Um, I've seen uh some volunteer organizations doing that for you. Uh quickly, would you like to touch a minute on that, how you are scaling that? Because I think that uh as a part of social responsibility is also big for Cloud9.

unknown 20:31

Yeah.

SPEAKER_01 20:32

So what what we have done I hope becomes a model for everybody else. And it's not because you know we did it first kind of thing, but I think it's something that is required. Yeah. And at the end of the day, we need to identify where the problem is. Yeah. And I I'm a true believer that we need to hire people from that local area to do the jobs there.

SPEAKER_03 21:02

Yeah.

SPEAKER_01 21:03

Forcing MVBS students to go to rural areas or postgraduate students to go to rural areas and you know, sit in a PhC. That is not going to work. What will really work is somebody who's trained from that area and say that you sit in that PhC and provide care for your people, that will definitely sell better than anything else. Right? So, what we want to do is we want to empower people in different geographies. We've started off from where we started, but you know, it's because we got an opportunity, we work with Parfi, we were able to get in there. But we are open to any part of the country. We have absolutely no problem. And I know that we've, you know, even one of my maid's daughters is now working uh in uh in one of our hospitals. And she didn't even have a 12th standard certificate because somebody had, you know, kept it hostage, literally. But we took her on, trained her. And now she's you know happy to be working independent and you know you know it and she's from rural Tamil Nadu. So for us, we truly believe that we need to empower people in local areas and enhance the care provided in areas where uh trained people are not going.

SPEAKER_02 22:19

No, this is inspirational. I think to do uh specifically for other merchants who are doing this, this is very inspirational. I think a lot more people need to start doing this. Coming to the next question. Uh so Cloud9 is known for consistent as well as high-touch experiences, right? Because the kind of services that you are in. What workforce practices have you developed that has been able to give you consistent experience to your customers across these 43 uh hospitals that you built?

unknown 22:51

Yeah.

SPEAKER_01 22:52

So what uh we we do is we train, train, and train some more. This is something that is happening nonstop. And very recently we hired one doctor into our fold, and he came in for a visit to one of our hospitals, um, actually, more than one of our hospitals, and the first thing he said was everywhere I went, the nurses were being trained. They were in some training session or the other. That's the secret sauce. Training on a daily basis. And I mean, I I can't even tell you the kind of commitment that you know, mostly we have young girls who have come from various parts of the country. I I just love the kind of enthusiasm, the curiosity and energy that they have. Uh, and attending all these training sessions. I mean, yeah, I'm sh I know for a fact I didn't attend many many of the classes I was supposed to in college. So when I see these girls doing it, I'm I'm absolutely thrilled.

SPEAKER_02 24:04

No, and I think ownership is a big part of it, and I think that's uh rightly touches the right chords that hiring young women who are taking a lot of ownership, and that is also I think driven by that repeated training, right? Because it becomes a part of your DNA. Understood. Mega, coming to you, uh, you have built a team of 700 people across 22 states, uh, right from Kashmir to Kerala, right? And uh, what have you learned about building consistent behavior at scale, specifically across geographies?

SPEAKER_00 24:34

Right. So, very similar to what Dr. Ramvin said, uh, training and communication, uh, creating daily rituals, right? We cannot really depend on the motivation of people to actually follow the systems and processes. So we have daily huddles, we have uh playbooks, we have guidelines, you know, it could be grooming guidelines, it could be how the hygiene standard across the centers need to be maintained. And so we we communicate a lot on a daily basis so that there is a muscle memory built in the system, uh, built in the people. And uh, you know, that is that sort of takes care of uh you know the consistency and the standardization across the location.

SPEAKER_02 25:12

I also think uh to add to it, I think I think both places, adapting to geography also becomes a big part of it, right? As was telling that how the people from that place, because they understand the local nuances better. Got it. Got it. So another question, and very important one of that. Healthcare as an industry is known for high burnout rates. Uh we meet a lot of students, we also meet a lot of guest lectures coming to us, and everybody is emphasizing about long work hours, right? And everything around that. Young talent, as seen in healthcare, is moving really fast, sometimes for a very small amount of remuneration and different levels of motivation, right? According to you, what keeps them engaged and how have you been able to kind of inculcate that across the country?

SPEAKER_01 26:01

So, attrition is a real thing, and it happens across all industries, and in healthcare, it is definitely very high. So it helped that you know our CEO is also from a non-healthcare industry, and he wants us to get to the attrition rate of non-healthcare industry, which is what is driving us a lot. And um what we usually see for people to stay with you and enjoy what they do is to ensure that they're taken care of well, yeah, they have a career path and they need to have fun. More than half our awake time is spent at work.

SPEAKER_03 26:50

Yeah, right.

SPEAKER_01 26:53

So if your workplace is not fun, yeah, you're having a miserable life. Right? And not only that, you take it back home, yeah, and your family doesn't have a great life either. True. Right? So what we go out of the way and make sure is that they are professionally getting better, they're financially compensated better, they're emotionally better. When we put all these together, then people tend to stay back. And our attrition rates have come down even in high attrition areas like doctors, registrars or duty doctors, or you know, whatever different people call it differently. Um, but we hire specialists. We typically have postgraduate training doctors who are taking care of patients. So we really don't have duty doctors. So we have proper specialists taking, even amongst them, we have a high attrition rate. But we have now narrowed it down to where they're leaving because of totally extraneous, uncontrollable reasons. Whatever we can control, we've tried to get a handle around that. And uh people leaving for the small amounts of remuneration, like that you mentioned, that is no longer there because we have provided them a career path, um, unlike any other place. We take them on, we make them consultants, we don't wait for this because they're already well trained.

SPEAKER_03 28:30

Yeah.

SPEAKER_01 28:31

Right? And they can go ahead and start their own clinic outside. So coming, bringing them into an organization and saying you have to spend five years with us, seven years with us, ten years before you can become a consultant doesn't work at it anymore. Nobody's that patient. And this generation is very different than the generation that I grew up in, and you know, I'm of course I'm a dinosaur, but uh the Gen Z are not going to wait that long. So if we find somebody who is really good, we definitely promote them to the next level. And we also have the fortune of being here, you know, expanding so fast. So we are able to absorb all of them into our own system. Yeah. And to fast track them, we give them opportunity of going to our tier two city hospitals where they, you know, where they can go and start off at a different level. So we use multiple different strategies for both doctors and nurses. Uh our you know uh internal recruiting is now almost we, you know, we're getting it to a point where half of them come from within us. Yeah. But we also want to bring people from outside because you know, just expanding. Inbreeding is not a good thing. You need to get ideas from outside, and you know, some cross-pollination needs to happen. Yeah. So we we think that you know we have a good mix in place right now.

SPEAKER_02 29:57

Somebody I met uh was telling about the induction program at Cloud9, and also that specifically for allied healthcare and nursing professional, the mentorship program. Uh, you want to throw some light on that? How is induction and mentorship in Cloud9 helped you sustain this? Yeah.

SPEAKER_01 30:11

So, I mean, not having an induction program is like driving blind. Yeah. So for us, that is very, very key. We make sure that people know what they're supposed to do. And to know how to do it right, you need somebody to mentor who's already been in the system. Yeah. Because you know, you sit for induction for three days, uh, show some PowerPoint slides, talk about it, half the people are sleeping. That makes no sense. Very little difference. Right? I mean, maybe helps you give an outline, but on the job induction, that is something that we are very, very focused on. So for us, when we say induction, it's not a classroom session alone, it's mostly in on the job, you know, see how people are doing it, and that's the way you you know you you get better, and that's the way people stay back. Because the reason why people don't perform is not because they know or don't know. It's the fear of doing something wrong.

SPEAKER_03 31:22

Yeah.

SPEAKER_01 31:23

If you are able to get them to the point where that can be allied, and they're comfortable doing a procedure or you know, talking to somebody, then they're not going to be fearful of their jobs and they're going to enjoy their job that much more. And that makes them stay back.

SPEAKER_02 31:42

Very valid point. Now you've been talking to various healthcare employers, a lot of CHROs. What trends are you seeing when you talk to them about the retention patterns in the healthcare industry, specifically in the nursing allied healthcare industry?

SPEAKER_00 31:57

So I think uh uh see retention is rarely about money. Uh it is more about you know, for it starts with actually onboarding, you know, whether you were onboarded, right? And uh I think uh Dr. Alvin is also uh already addressing that in cloud nine when they have this uh very exhaustive orientation induction process. So it starts from there. Uh then of course um it's a it's about giving proper feedback, right? So uh, you know, uh when when whenever organizations depend upon say an annual appraisal to give in feedback, of course, there are instances where the employees are very confused, right? They thought they were doing a very good job the whole year, but suddenly the rating is not reflecting that. So it's very important to have a you know a closer uh feedback loop with them so that you know they can also correct or bring in the behavioral uh you know changes that is required for them to do their job better. And um, like Dr. Arwin already said, that mentoring becomes very important. Uh, you know, otherwise, when these new graduates they join the hospital, you know, they are left if if they're if they're left without any mentoring or training, then they wouldn't be able to understand what is required of them and they wouldn't be productive, right? So the messages from the CHRO and to the CHRO is clear that uh, you know, you have to stop treating the talent as resources to be deployed. You have to look at them as uh a talent to be groomed. You know, they want to see how they're going to grow in the organization that keeps them motivated. And at MOCD also, we you know we try to uh uh you know promote people in internally in the team so that the others can also look at them and understand that you know there's a clear card career path if they, you know, if they stay with us.

SPEAKER_02 33:42

So I'll like to come to one very, very important question. As a lot of people watching this uh or listening to this episode will be young nurses or young allied healthcare professionals. If I'm a nurse today joining Cloud9, what would be my career trajectory? How will I grow? How many years will I reach to a position which is deemed respectable and a managerial position, maybe?

SPEAKER_01 34:07

So we have very clear-cut uh career paths for our nursing staff, and we take them on, start them at a you know, position which is easily manageable and what they're trained for during the training. We identify uh what they're good at and give them that role, and then from there we expect them to grow. Uh, for example, if they were to join the OPD department, we don't want them to retire in as an OPD nurse because it's not fair to them or the organization, because you can either get complacent or you can get both and leave. So we don't want that to happen. So we want them to move to the next level, whether it is inpatient care or you know labor and delivery, and then move on to high equity places like NICU, PICU, uh, OT, uh, and of course uh fertility as well. So we have a very clear patch charted out for the nurses, and once they get to that position, then you know we have along the manager roles, we have they become uh in charges of a particular area, a particular department like NICU in charge or OT in charge. And then they can become, you know, they absolutely have the ability to um become a regional manager uh and you know for the roles that can uh help them grow in their professional life.

SPEAKER_02 35:39

Also, maybe the new units that you are kind of coming up with. Correct.

SPEAKER_01 35:42

And when they when we expand more, uh which we have been doing, we they become the nursing head for that unit as well. Uh so and we are actually you know very, very open. In fact, um everyone in top management would love it if one of our nurses ends up um becoming uh business head or a COO. True. Um, you know, or uh if they're good enough, I don't see why they can't be a medical director as well. True. I'm quite happy to give my job to them.

SPEAKER_02 36:16

But I think predictability in career part definitely helps. Coming to you, uh we've been talking to a lot of young professionals across the industry, be it academics, be it salespeople and and various others, right? What do you think this young generation wants in terms of career progression clarity and what makes them stay?

SPEAKER_00 36:35

I think yeah, they want to understand, like after, and especially in a startup kind of a setup, you know, they want to see what they're going to do, you know, when are they going to reach the next level? What is it that their responsibility will change, how it will change. So they want absolutely, even if they have the five-year uh mindset uh, you know, uh to stay with the organization, then they would want to understand each year what is it new that they are going to do, how they're going to grow in the organization.

SPEAKER_02 37:05

Got it. So coming to our next question, and uh these are some hard questions. So, what is the hardest part of managing healthcare talent that uh outsiders, let's say different industries do not see, right? Uh what do you think are those two, three key pointers which are different in this industry?

SPEAKER_01 37:31

So the healthcare industry is not just technical, right? I mean, it has a huge human element. And along with that comes kindness, caring, empathy, things that are not taught in public college. And not everybody is born with these things.

SPEAKER_03 37:53

Yeah. Right?

SPEAKER_01 37:55

So while it may seem that these are things that are people people are either born with or not born with, if you're in healthcare, you have to figure a way out to inculcate. That is, if you don't have any of these, at least don't join healthcare. As simple as that. Because at the end of the day, you literally need to put yourself in the shoes of education or the customer.

SPEAKER_02 38:26

So do you think people learn this over time at the job, or is it involved?

SPEAKER_01 38:31

So you have a Sachantendalkar and you have me, right? I can play cricket too. And he was born to play cricket, a natural cricketer, born to play cricket. So that's a difference. Yeah. But can I hold my own? Yes. Yeah. And the world is not made of superstars. So there is room for people to learn and do things that in general people think cannot be done.

SPEAKER_03 39:03

Yeah.

SPEAKER_01 39:04

So at the end of the day, tell me a person who doesn't have kindness or empathy to their kids. If you have your own kids, why can't you work in club? Yeah. You just need to flip a little bit and say, treat that patient like your child, like your sister, like your mother. Then the solution is right there. It's very simple, it's not that difficult. So that's the care part of it. The other part is a big part of our job is working with probably the most egoistic group in the world. Right? Who do you think that is? I'll not like to say, but I can. I'll spare you the trouble. Anyway, uh doctors, of course. I mean, we've usually top of the class, tough exams, near whatever you want to call it. You know, you spend a lot of time studying, working hard, you get to where you are. You feel entitled.

unknown 40:10

Yeah. Right.

SPEAKER_02 40:12

And I actually the word makes you feel also entitled at times.

SPEAKER_01 40:18

Okay. True, true, and this is something I I probably said it in any of my previous talks. Even today, people in India think doctors are gods. Yes. Unfortunately, many doctors believe it's true. Right? That's where the problem is. I see. We are not. We are not gods. We are not practicing a perfect science. We are making mistakes. We will make mistakes. We have done it in the past, we're going to do it. The fact is, how do you deal with it?

SPEAKER_02 40:52

Discipline also is ever evolving, I suppose.

SPEAKER_01 40:55

See, discipline is required in anything.

unknown 40:59

Right?

SPEAKER_01 40:59

I mean, tell me a person who's not disciplined at hard work.

SPEAKER_03 41:02

Yeah.

SPEAKER_01 41:03

Everybody is, right? And I do clearly tell my kids also, I said, even a terrorist is hard work. Yeah. Without hard work, you can't accomplish anything.

SPEAKER_03 41:12

Yeah.

SPEAKER_01 41:12

That's that's the way it is. You need to put in the hours to be good at whatever you are. So that part is a given, irrespective of profession. So doctors do, I don't give a free ride on that to doctors, right? Where they actually can make a difference is communication, empathy. And today, of course, you need documentation as well. Yeah. Just in case the first two doesn't work, then at least the third one, your lawyer has something to work.

SPEAKER_00 41:42

The sense of entitlement is not limited to doctors, no?

SPEAKER_01 41:46

No, it's not big cruel. It's not. It's not entirely the doctor. Like what he said, people around doctors have made doctors feel entitled. Feel entitled.

SPEAKER_02 42:00

When we talk about a lot of healthcare professionals, I think the generation Gap is also pretty evident. A lot of people say that generationally it has been working like this, right? The new generation necessarily cannot conform to that. And that's what you've seen. You young professionals going to the hospital and they see there's some practices which are slightly archaic, right? Which enhances burnout, I would say. What is your view on that? Is it is the spectrum changing? Or do you still think a lot of these generational practices are still there in a lot of places which needs to be changed?

SPEAKER_01 42:33

Which generation do you think I am? You sure you are the right generation. No, so yeah, very valid question. And uh uh and this is an absolute fact. Again, it's the same thing. Not everybody is the same.

SPEAKER_03 42:52

Yeah.

SPEAKER_01 42:52

I have seen very young old people and very old young people. So it is not about which generation you are, it is about adaptability. Yeah. Are you willing to adapt? You can be Gen Z not willing to adapt and you will perish. Or you can be an optogene and be totally adaptable and be fine. Right? And adaptability doesn't mean doing the same thing that you're doing when you are 40. Yeah. You can change your role. Yeah. You can go into mentoring, you can, you know, MS Dhoni is not the same that he was many years ago, but he's not, is he not contributing to CSK? True. 100% yeah. So the fact is, you need to be able to adapt and contribute to the cause, whatever that may be. So for me, a good mix of the right people of different generations adds more meaning than trying to focus on any one particular generation. And again, it'll come down. To talking to people, training them, identifying their strengths, identifying the weakness, and slotting each person in the right place.

SPEAKER_02 44:10

No, I asked this question because uh a lot of times what we hear is that healthcare practices and scalability across is always difficult. Everyone comes and says, while say industries like retail, hospitality, entertainment, events, they've been able to scale up across, right? So that is where I was coming from that this repeatability, right? How does that come in? I'll like to secular to Mega also. Uh, you've been uh talking to again a lot of people. What do you think as a as an HR professional, what systemic issues make uh healthcare workforce development uh such a big challenge that everyone talks about?

SPEAKER_00 44:48

So primarily I think two major problems we have. One is that it's highly regulated sector, right? We have when I talk about uh you know the allied healthcare, there is UGC, there is NCBT, then there is um NCHP now, NCHP and all of that, and they have their own sets of regulations. So it becomes very confusing for the institutes also to what to focus on, how to design a curriculum wherein they're meeting the academic standards, they are meeting the skills standards, then all the regulation which is required. So that is one major challenge. The second challenge is career counseling is not uh as uh you know uh I mean it's not there in in many places. So many students they don't even know that you know aligned healthcare is a career option. Or if they know, then it is definitely not their first choice, right? So I think uh these are two major challenges, and we need to, but but of course, we are optimistic because uh on one side we have hospitals like uh Cloud9 who uh really care about the people on training and grooming them, and also a lot of investment is coming in the sector, which which gives us hope.

SPEAKER_02 45:54

I also have traveled across country meeting young professionals, and you'll be surprised to see these tier two, tier three cities, the amount of excitement they have to come into healthcare workforce is is amazing. As recently in Kashmir, and uh you'd not believe the number of people looking to get into healthcare as a profession is just is very, very high. So I think if uh everybody is able to solve that for flexibility, there's a huge, huge influx of talent that can come in.

SPEAKER_03 46:24

Yeah.

SPEAKER_02 46:25

Uh the last my final question to you. What is the one message that you will get give to anyone young who's entering healthcare into profession while you've already told that you should have certain traits? But what is that one message? Let's say if somebody who's today, 16, 17, right, or 18, who's looking at this and he or she wants to enter into healthcare space, what is that one message?

SPEAKER_01 46:50

The key message is don't get into healthcare unless you absolutely love it. Because I'll qualify this, but I think it makes life a lot easier. If you like helping people and you know you're willing to swallow your ego a little bit, it you need to do all of that. And the reason I say that is when it's not something you that you automatically like and love, it's a lot of work. And the prime example is I never wanted to be a dog. I joined College of Engineering Indy, left that and then joined medicine. Uh, probably the only reason I've listened to my parents. Uh having said that, I had to completely change my attitude and say now that I'm in it, I need to play the game it is supposed to be like. So I have completely changed the way my brain thinks got a lot easier after I had kids. Uh the whole part of kindness, empathy, and all literally came in as a second nature then. But you know, even today my engineering traits show up, and my CEO always keeps telling me, Doc, I like you because you think like an engineer. And it helps with the problem-solving part. So um I think at the end of the day, people have to realize that uh healthcare, um, doctors or otherwise, is a lot of hard work. Yeah. Uh but it is definitely worthwhile if you're that kind of person who loves to help people. And even if not, you can if you can at some point in time move to a role where you can solve the problems within the system and help the entire system and have a better reach of what you do, then that's another way of looking at it.

SPEAKER_02 49:02

And one message to healthcare leaders on how do you manage this workforce as a strategic?

SPEAKER_01 49:08

Um, I I I really think it's a lot of common sense. Yeah. And do unto others what you want done auntie. Yeah. Basically, just say that if I were in that person's place, how would I like to be there?

SPEAKER_02 49:30

Yeah. Empathy also begins at home.

SPEAKER_01 49:32

Everything. I mean, every part of it. I mean, respect, uh, you know, uh uh integrity, trustworthiness, honesty, everything comes into play and and it doesn't matter whom you're dealing with. Don't let the position of a person dictate how you treat them. A top-earning doctor should mean no, nothing more different than the housekeeping stuff. At the end of the day, both of them are contributing to the organization in some way or the other, which is very meaningful for a patient. The patient who needs to go to the restroom and needs help from the housekeeping person, for them, the housekeeping person is much more important than the doctor who did the surgery. So remember to treat everybody equally and be honest and straightforward with every person who's working in your orientation.

SPEAKER_02 50:30

Great. Mega, uh, for closing remarks, what are your thoughts? Uh as you as you see in various industries, right? Like from banking to startups to education to now healthcare. Uh, very entirely different industries. But what are your closing statements on the same? As Dr. Alin has already summarized quite a lot for it.

SPEAKER_00 50:49

So I think, see, the opportunity is massive. Uh, India can be the healthcare workforce uh capital of the world and in not just supplying the talent but actually setting standards as well. But for that, I think hospitals, uh, training institutions and regulators, we need to invest in people uh like they matter because they Yeah.

SPEAKER_01 51:10

Yeah. And I'd like to say that you know, I'm uh really in awe of all you guys who are similar to Mbassity and anyone similar to this, because this is something that was non-traditional. You guys have really come and disrupted uh training and education. And I think this is something seriously required, and medical education in the country requires serious disruption. Today it is archaic, arcane, um, absolutely outdated. Um, you know, some changes, you know, brand-aid solutions have been made. Uh completely, we need to revamp the way medical education is provided. We need to shorten the courses, yeah. We need to make it extremely practical, skill-based, and get out students within four to five years. And every doctor who comes out of training should be a specialist assortment. Yeah. Right now, our shortage is not doctors, it is specialists. We don't have enough specialists in the right locations. So we need to get people from those locations, put them through an abbreviated course, and make them job ready to that geographic location, give them limited licenses, and ensure that they provide care for the people who need it where they need.

SPEAKER_02 52:32

I think specialization and vocational, right, both both go hand in hand today because as much practice that you do, right, uh you'll be better at it. I think that has been our motto also at MSV, that we are looking to do that specialization with vocation right in place. Uh, and and that's that's the idea.

SPEAKER_00 52:49

That's the combination of art and science of medicine that you have always spoken about.

unknown 52:53

Yeah.

SPEAKER_02 52:54

Good enough. Thanks a lot, Dr. Arwin. Thanks a lot, Mega. Thank you. Um, I think that chat has been really insightful, and our listeners, viewers will be really interested in following up with this. Thanks a lot for your time. Thank you, sir. Thank you.

SPEAKER_03 53:06

Thank you.