In 1983, I suffered from a peculiar affliction common to young doctors: the “Alphabet Itch.” I already possessed an MD, but I was convinced that unless I could trail a few more capital letters behind my name—like the tail of a stubborn kite—I would remain a medical lightweight. And so, I set my sights on the MNAMS (now known as the DNB). I imagined my future visiting card becoming quite the heavy-hitter in academic circles.
The theory papers in Bhopal went off with the breezy ease of a Sunday brunch. I felt invincible. But then came the practicals at Maulana Azad Medical College in Delhi.
***
Delhi, as any provincial doctor will tell you, is where egos are polished more frequently than stethoscopes. My assigned patient was a textbook case of a cervical cord tumor—or so I thought. I poked, prodded, and questioned the poor man with the precision of a detective. When I faced the external examiner, I was armed with facts and a dangerous amount of youthful certainty.
The examiner, a gentleman whose seniority was matched only by the stiffness of his collar, frowned. “The plantar reflex isn’t up-going,” he declared, peering over his spectacles as if I’d suggested the earth was flat. “Therefore, no cervical cord lesion.”
Now, a sensible man would have nodded. He would have looked thoughtful, perhaps even slightly humbled, and made a strategic retreat. But I was intoxicated by clinical epidemiology. Instead of a graceful exit, I decided to “educate” him. I quoted literature. I stood my ground. I treated the viva like a debating society at Oxford rather than a high-stakes exam in a humid Delhi ward.
The examiner did not appreciate being “educated” by a candidate. He went silent. In a viva, silence isn’t golden; it’s the sound of a guillotine being sharpened.
Only four out of thirteen passed that day. I was, quite predictably, left in the cold.
***
A few months later, the very same examiner turned up at Sevagram for our MD exams. He spotted me immediately. “Weren’t you at MAMC recently?” he asked with a smile that was dangerously kind. “You were one of the best candidates,” he whispered, “but you made one fatal error. Never bruise the examiner’s ego. In an exam room, the examiner is God—even if his theology is a bit rusty.”
It was a delightful lesson in humility. I realized that medicine is fifty percent science and fifty percent reading the room. I didn’t cry into my tea. I didn’t declare it a tragedy. I simply filed the failure away like a misspelled lab report and went back to the wards.
In Sevagram, my patients were remarkably indifferent to my lack of a DNB tag. They didn’t care about the alphabets; they cared if I showed up when they couldn’t breathe, or if I could explain their heart failure in words that didn’t require a Latin dictionary.
***
There is, however, a delicious postscript. My senior, Dr. A.P. Jain—a man twelve years my senior and a formidable unit head—had also secretly sneaked off to Bengaluru to take the same exam. He told no one. He, too, wanted the extra alphabets. It was only when the results came out that the truth emerged: he had failed as well.
Dr. Jain passed away a year ago, and I think he’d enjoy me sharing this now. We both failed. We both lived perfectly distinguished lives without those extra letters. It confirms my long-held suspicion that exams don’t actually select the best doctors; they merely select the best exam-takers. The rest of us are too busy actually practicing medicine.