…while mentoring young doctors as part of a succession plan
By Lakhram Bhagirat
Guyana has a long way to go in relation to the development of its medical services but there are several doctors within the healthcare system that are actively working to expand their knowledge and bring world-class services to the Guyanese people.
Notably, these doctors are performing procedures that one never knew that Guyana had the capability to offer.
Among those doctors that are actively working to improve the quality of care delivered in Guyana is Dr Shilindra Rajkumar – who has been working in plastic surgery for a number of years. He is currently heading the Georgetown Public Hospital’s Burns Unit and is the Chief Plastic Surgeon at the institution.
With the speciality comprising of three components – burns, reconstruction and alteration – Dr Rajkumar has been mostly focusing on the first two but recently began delving into the alteration aspect which is commonly referred to as cosmetic surgery.
Dr Rajkumar comes from humble beginnings and a family that has always been focused on attaining a high quality of education. Being the youngest child meant there was some amount of pressure placed on him to ensure that he lived up to the expectations of his parents and performed as well as his siblings.
His father always wanted a doctor in the family and he was the chosen one.
Hailing from the Essequibo Coast village of Johanna Cecelia, Rajkumar wrote the then Secondary School Entrance Examination (SSEE) and gained a place at President’s College but instead opted to attend Queen’s College. There he spent seven years and upon completion of his A-Levels, he began furthering his studies at the University of Guyana (UG).
He initially began studying biology but after the first year in University, he moved over to the Medicine Programme where he commenced his medical journey. He completed his medical studies at UG in 2002 and started his internship at the Georgetown Public Hospital Corporation (GPHC). There, he worked for a year and a half after which he decided to do a Diploma in General Surgery at the same hospital and through the University of Guyana.
He continued working at GPHC in general surgery and was then offered a scholarship to do plastic surgery with the University of Ottawa in Canada. He took up the offer and thus commenced his plastic surgery journey.
The focus there was burns, reconstructive surgery and cosmetic surgery with a little bit of pediatric plastic surgery. The idea, for the then young doctor, was to come back and work in Guyana with Georgetown Hospital and continue his quest to improve the medical sector by offering improved services in his field.
When he returned in 2010, he recommenced working with the GPHC in the hospital’s Burns Unit where there had been a great demand for burns and reconstructive surgeries and has been there ever since working in and heading that department.
“There was a lot of persons in need of cosmetic surgery but because of the demands for burns and reconstructive surgery over there, there wasn’t enough space to do cosmetic surgery on a regular basis at Georgetown Hospital,” he said.
Seeing the demand for the cosmetic aspect of plastic surgery, Dr Rajkumar once approached the hospital’s administration for them to commence offering that but there was some resistance and that never materialised. That, he explained, was due to the fact that there was the debate as to whether a public institution should offer cosmetic surgery at the expense of patients who are already admitted for reconstructive surgeries.
The debate stemmed from the fact that a single cosmetic procedure takes at least 2 1/2 hours and in that time two reconstructive surgeries could have been completed. So, the hospital thought the practical thing to do was to refrain from venturing into that field.
However, earlier in 2020 he received an offer from Surgical Associates based at the St Joseph Mercy Hospital for a partnership to extend his plastic surgery services and venture into the cosmetic aspect of it.
“Ever since then it has been slow at the start but we can see that the progress is steady and more and more people are getting to know about us and the services we offer and we are getting a steady flow of patients now,” Dr Rajkumar said.
For him, he never really thought much about getting into the cosmetic aspect of his speciality since he enjoyed dealing with burns and reconstruction. However, he is now beginning to like that aspect of his field and is seeking to expand that reach.
“The burn and reconstructive surgery – you don’t get to choose your patients. They are handed to you and sometimes they come in a very bad state and you have to think out of the box and it is challenging and fruitful and very satisfying to do reconstructive surgery. With cosmetic surgery you get to plan them better, you get to see your patients, you get to create the scars and surgery from inception and the patient satisfaction is better.
“With burns and reconstructive surgery, there is always the challenge of where these patients would have been severely burned. Physiologically they are not up to scratch. A lot of your surgeries you have to be a lot more cautious but in cosmetic, the majority are young healthy patients,” he explained.
Through Surgical Associates and the St Joseph Mercy Hospital, Dr Rajkumar is offering a series of cosmetic procedures. He is now able to offer liposuction to any part of the body, abdominoplasties (tummy tucks), breast reduction, breast lifts, wound reconstruction, fused finger separation and cleft palate procedures.
He explained that liposuction can be offered to any part of the body but the majority of the patients opt for liposuction to the abdomen. As it relates to abdominoplasties, most of the patients are women would have had multiple pregnancies which left them with an increase in abdominal fat and redundant skin around the abdomen coupled with stretchmarks. His job is to flatten the abdomen, fix the excess skin and remove the stretch marks.
“We see very enlarged breasts often and we call that mammary hyperplasia. For some reason, there are a lot of persons with very enlarged breasts and this has a significant impact on their shoulders in terms of the pain to carry heavy breasts around and we offer breast reduction surgeries. We do two to three breast reduction per month. We also do breast lifts because a lot of patients after breastfeeding would have long sagging breasts. So, we do breast lifts to kind of revert the breast to a more anatomical, more cosmetic position which a lot of patients are grateful.”
Dr Rajkumar is married with three children. His eldest child just sat the National Grade Six Assessment (NGSA) examination and secured a spot at Queen’s College. He thinks she is on the path of following in his footsteps. Both his daughter and son are avid chess players and are, in fact, junior chess champions.
Meanwhile, his youngest is in nursery school. He credited his ability to venture into plastic surgery on the sacrifices his wife made since they had a young child and she was pregnant at the time he was offered his plastic surgery scholarship. She allowed him to chase the opportunities for betterment while she held the fort down.
For him, balancing work and his personal life is not an easy task but over the years he has developed a hack that makes it manageable. While his work by itself is challenging, he has a capable team which he moulded and trained over the years so that they can function without him being present there.
Teaching is also a big part of what Dr Rajkumar does and for him, it is something he is passionate about. He is the principal tutor for general surgery at the University of Guyana, so he coordinates and teaches all of the third and final year medical students. He mentors and prepares them for their exams and has been doing that for about eight years now.
“Teaching is one of the things I have a passion for. Teaching and seeing your students develop gives you the drive to continue in this field, to continue reading and being abreast with medical knowledge. I don’t think I would have the drive to continue if it wasn’t for teaching,” the accomplished doctor stated.
Dr Rajkumar has very distinguished goals set for the long term and short term development of the plastic surgery services in Guyana and it begins with the imparting of the knowledge he has accumulated. He is open to sharing it with everyone who is willing and able to learn.
He is focused, at this time, on seeing his practice developing and receiving the recognition so that they are able to perform more advanced procedures. He has plans in the pipelines to do partnerships with overseas-based plastic surgeons who would come and assist with some of the more complicated patients, help with the teaching and with some of the training of persons as well.
“In the long term, I am looking at getting my staff trained and certified in this field so that they can actually take over and run with this field say 5-10 years from now. I am looking at having somewhat of a succession plan so that my younger, dedicated staff can take it over and develop it more.
“Over the last years I have been working on a curriculum so that we can start teaching, sharing this knowledge and skill. I am 40 (years old) and I see myself in retirement by 55 so I want to consider by that time that we should have a well-staffed and functioning department without me,” Dr Rajkumar noted.
He is continuing teaching and building his practice for now. He also said that the prices for cosmetic procedures are competitive and, in most cases, amounts to just a fraction of what one would expend to have the same procedures done overseas.