In a whirlwind of events, the 10-week internship at Aravind Eye Hospital has blown by. With our projects finished up, I can be proud in the work we managed to accomplish this summer. We simultaneously tackled three projects with three different supervisors.

Our first project was under Gnana Sir; we were responsible for standardizing performance evaluation parameters for each department across all of the Aravind branches. After weeks of phone calls, meetings with various department heads, and even a trip to Pondicherry to meet with additional supervisors, we managed to compile a packet of definitions for each parameter on the evaluation parameter sheets. In addition, we formatted the sheets so that the task of putting them together is as streamlined as possible. We hope that our work can be a stepping stone in realizing the eventual goal of having these parameter sheets be a completely automated process.

Our second project was with Dhivya Ma’am, and we were responsible for investigating the feasibility of incorporating Shared Medical Appointments (SMAs) into the Glaucoma Clinic. SMAs, as the name implies, is an appointment where patients are examined and spoken to in groups. Championed by the Cleveland Clinic, this innovative concept looks to enhance the patient experience by encouraging patient-patient interaction. After shadowing physicians and nurses in the Glaucoma Clinic and obtaining patient flow data, we modelled the current work-flow in the clinic and how a SMA could be incorporated. After analyzing the time efficiency of implementing a SMA and the strain it places on human resources, we concluded that there was much benefit in using SMAs. After presenting our findings to the doctors in the Glaucoma Clinic, we received the green light to do a pilot study. We were able to pilot various aspects of the model, and with the feedback found areas that required tweaking to be more efficient. In our final days at Aravind, we managed to run a full pilot and set up a plan for more pilots to be run in the following weeks. We hope that in the near future SMAs will be fully incorporated into the Glaucoma Clinic and that Aravind will look to expand this model to other clinics.

Our final project was with Dr. Avika and Dr. Pillai, with whom we planned a clinical Mitomycin C study. Mitomycin C is a drug used during trabeculectomies (Glaucoma surgery) to prevent scarring of the eye-tissue. While commonly applied using sponges soaked in the drug, recently there has been a trend towards injection application. Seeing the need for a full prospective study to compare the efficacy of the two methods, we did a literature search to compile the information necessary to plan one. Now, we are waiting for IRB approval; hopefully the study will soon be underway.

While there is feeling of accomplishment, there is still a sense of unfinished business. We are excited to see what all three projects will evolve into and are eager to help out in any way possible from the US. For me, working at Aravind has been an eye-opening experience to see how medicine can be taken to the doorstep of the community to make an impact in under-served areas. Apart from giving me exposure to Ophthalmology, this internship has gotten me further interested in healthcare management and global community health, interests that I plan to explore further in medical school.