From Experience to Evidence

If the 1990s were about digitising hospital records, the early 2000s were about upgrading the software of our minds. In 2000, the Medico Friends Circle (MFC) held its annual meeting at Yatri Niwas in Sevagram—a modest guest house across the road from Gandhi’s Ashram. MFC meetings had their own flavour: simple arrangements, serious conversations, and a lot of idealism. Doctors sat cross-legged on the floor, arguing about social determinants of health over endless cups of tea, while ceiling fans pushed warm air from one corner to another.

That is where I met Dr Madhukar Pai—Madhu.

He was a young graduate from Madras Medical College, then doing his MD in Community Medicine at CMC Vellore. He spoke with an unusual clarity. Not loud, not dramatic—just sharp and well-structured, like a good clinical note. We began talking about medical research, and I told him about my growing fascination with Evidence-Based Medicine (EBM), which I had stumbled upon in 1996 through David Sackett’s writing.

Madhu’s eyes lit up. He was already conducting workshops on epidemiology and statistics on his own. In that small room, with the smell of chai in the air and the usual MFC buzz outside, we decided to work together. It was one of those casual decisions that quietly changes the direction of your life.

The workshop that made residents sit up

In February 2000, we organised a three-day workshop on Statistics and Study Designs at Sevagram. Thirty residents signed up—from Medicine, Paediatrics, Obstetrics and Gynaecology, and Surgery. Most of them arrived with the same expression I had seen many times before a thesis submission: polite interest mixed with dread. They expected the usual diet of p-values, t-tests, and boredom.

Madhu had other plans.

He didn’t teach statistics like a punishment. He taught it like a torch. He showed them how bias can bend the truth, why randomisation is simply fairness written into a study design, and how to read a paper without getting fooled by confident conclusions. He made confidence intervals feel less like a formula and more like common sense. Even chi-square tests stopped looking like Greek.

For eight hours a day, residents stayed awake—fully awake. That itself felt like a miracle.

By the end, the fear around “statistics” had softened. They began to see research not as mathematics, but as curiosity with discipline. Many of them wanted Madhu to join MGIMS full-time. I remember thinking: this is new for Sevagram. We were not only treating patients now. We were also learning to question our own habits.

That workshop was a small turning point—one of those quiet institutional moments that doesn’t make headlines but changes the culture.

McMaster: my first flight, my first mistake

Three years later, the pull of this new world took me to its birthplace—McMaster University in Hamilton, Canada, where EBM had been shaped into a method and a movement.

In June 2003, I was accepted for the workshop titled How to Teach Evidence-Based Clinical Practice. The Kasturba Health Society funded part of the cost, and Mr Dhirubhai Mehta helped arrange support for the rest. I booked an Air Canada ticket—my first international flight.

The route was Mumbai to London (Heathrow), then onward to Toronto, with a 90-minute layover in between.

I landed at Heathrow and did what a first-time international traveller does: I wandered. I stared at shops. I walked slowly, as if the airport itself was a tourist attraction. I forgot that 90 minutes in a giant terminal is not time—it is a warning.

When I finally reached the transfer desk, the staff looked at me with a mix of sympathy and disbelief.

“Sir, your flight has already departed.”

For a few seconds, I just stood there. My luggage was already on its way to Canada. I had little money. And I had no idea what to do next. I felt foolish, stranded, and very small in that enormous airport.

I went back to the Air Canada desk and told them the truth. I said I was a doctor from rural India, travelling on a grant to learn how to teach and practise better medicine. I said I couldn’t afford to buy another ticket.

The lady at the counter listened quietly. Then she typed rapidly, paused, and said, “Okay. We can put you on the next flight. It leaves in an hour.”

I didn’t ask questions. I didn’t celebrate. I simply ran.

That day I learnt a new clinical rule for travel: never underestimate the distance between gates.

Hamilton: evidence, ego, and role-play

McMaster was unlike anything I had experienced.

There were ninety participants from across the world, divided into small groups. We didn’t sit in a lecture hall. We sat in circles. The teaching method was simple, slightly uncomfortable, and very effective: role-play.

One person played the sceptical student. Another played the arrogant consultant. A third played the EBM advocate trying to introduce evidence without bruising egos. It was funny at times, but it was also painfully familiar. I realised something important: knowing the evidence is not enough. You have to learn how to carry it into real clinical life—into hierarchies, habits, and human pride.

A librarian sat with each group, calmly teaching us how to search PubMed and Cochrane. Watching her work was humbling. She could find answers in minutes that would have taken me hours. It also made me uneasy in a useful way. How much of my earlier practice had been built on expert opinion, and how little on hard evidence?

That question stayed with me long after the workshop ended.

A small alumni trail on the way back

On my return, I stopped in the UK to meet members of the MGIMS diaspora.

I stayed with Dr Monika Ahuja in London—now a young mother, juggling medicine and a new life. I visited Dr Vipin Zamvar in Edinburgh, Bhavana’s cousin, a cardiac surgeon who showed me his hospital with quiet pride. In Aberdeen, I spent time with Muthu Kumar and Sonali, and bought the Harry Potter audio series for Ashwini. I still remember carrying those tapes like precious contraband.

In Oxford, I met Dr Sadhana Bose. Through her husband, I was introduced to Dr David Warrell, the editor of the Oxford Textbook of Medicine. We spoke for two hours—about snakebites, of all things. It felt oddly perfect: a global expert discussing a problem that still walks into our Sevagram wards every monsoon.

I returned to India with a suitcase full of books, a few souvenirs for my children, and something far more valuable—a new lens.

The evidence revolution had already begun in Sevagram. For me, it was now leading to an even bigger adventure: a year at UC Berkeley.

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