Progressive Rise of Smokeless Tobacco (Paan, Chalia, Gutka, Mawa) in South Asia And The Risks and Solutions

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World No Tobacco Day Message As a doctor, I regularly see the harmful effects of tobacco aswell as smokeless tobacco products such as gutka , mawa , naswar , paan , and chalia . These products may seem harmless, but they can cause addiction, oral cancer, gum disease, and permanent damage to the mouth. On this World No Tobacco Day , let us raise awareness about the dangers of smokeless tobacco and encourage healthier choices. Quitting today can protect your health and save lives tomorrow. Say no to smokeless tobacco—protect your smile, your health, and your future . Why Paan, Chalia, Gutka and Mawa Use Is Increasing Rapidly Paan, chalia, gutka, mawa, and other smokeless tobacco products have become increasingly common across South Asia, particularly in Pakistan and India .  What was once an occasional cultural practice has, for many people, evolved into a daily habit. Today, these products are consumed in an abusive way  by people from various age groups and socioeconomic bac...
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Life After FCPS Part 1, MD, MS, PLAB or USMLE: A Doctor’s Reality

My Struggle With Residency, MOSHIP, and the Fear of Falling Behind

I opted for FCPS Part 1 in surgery but alot of students who have given MD MS PLAB USMLE exams and not securing a training position anywhere, can relate to my story.

 

Clearing FCPS Part 1 in Surgery in my first attempt—after just 1.5 months of preparation—should have felt like the biggest breakthrough of my career. And it did…  for a moment. But what came after was something NO ONE warns you about:

the silent gap, the waiting, the rejections, and the fear of falling behind while everyone else seems to be moving forward.

I applied to all the major teaching hospitals and well-known institutes in my city. I walked into every induction test with hope, confidence, and my freshly passed FCPS exam. But the result was the same everywhere—

I didn’t get selected for residency training in surgery.


And that’s when the panic began.

Sometimes the gap isn’t empty; it’s where growth quietly happens.


-The Confusion That Followed: Surgery VS Medicine?

I didn’t want a break in my CV. I needed to stay financially independent. So I decided to look for RMOSHIPs that were related to surgery—something that kept me in touch with my field and strengthened my future application.

But reality hit again.

Wherever I applied, the only RMOSHIPs available were in:

-Medicine

-Pediatrics

-Gynae/Obs


Not a single surgical MOSHIP.

And that put me in a cycle of confusion:

-Should I continue searching for a surgery moship, even if it takes more time?

-Should I join medicine or paeds related jobs , just to prevent a career gap?

-Should I switch completely and prepare for FCPS Part 1 in Medicine as well?


Every option felt right and wrong at the same time and there was no one to guide anything.


---The Pressure of Time 

I kept thinking: I have six months—maybe I can do another Part 1? But deep down, I knew I wouldn’t enjoy medicine. I don’t feel connected to it. Surgery feels like passion, pace, movement, life. Medicine feels slow. Time doesn’t pass.


And then Ramadan period was around the corner—a month where duties are easy, but studying? Nearly impossible.

So preparing another Part 1 didn’t make sense.

What did make sense was simple:


I need surgical exposure. Even if it’s a small MOSHIP. Even if the hospital is not famous. Even if the pay isn’t high. I just need something that keeps me connected to surgery.


Because losing an entire year before the next residency cycle would push me far behind. 

I tried everywhere to get it but got failed so i joined my MOSHIP in paeds related setup instead of wasting my time.


---If You Don’t Get Residency Immediately: What You Should Do in a 6-Month Gap

I didn’t lose time—I gained perspective, strength, and clarity about what I truly want.

Many doctors face this exact situation—passed, qualified, motivated, but unable to secure training due to seats, competition, or timing.

These 6 months can either break your confidence…

or they can build your CV.

Here’s how to make the best use of this gap:


1. Join Any Surgical MOSHIP You Can Find—Even Small Hospitals Count

Don’t wait for a “big name” institution

Even district hospitals or private setups matter

Hands-on experience (OT, ward rounds, minor procedures) adds weight during residency interviews


2. Take Short Surgical Skills Courses

(If available in your city)

Examples:

-Basic surgical skills workshops

-Suturing, knot-tying courses

-Laparoscopic simulation training

-ATLS (highly valuable for surgery applicants)


These certificates make your CV stronger.


3. Start a Medical Blog or YouTube Channel

You already have high-yield exam experience. Share it.


Topics such as:

-FCPS Part 1 preparation guide

-Daily surgical life

-Study schedules

-Mistakes to avoid

-Mental health during gap periods


This builds your professional presence and keeps you mentally engaged.



4. Research & Audit Work

Even small clinical audits or case reports help your residency application.

Find a consultant willing to supervise your write-up.


5. Prepare for the Next Residency Cycle Strategically

-Keep a list of hospitals and their announcement dates

-Improve your CV

-Focus on recommendation letters

-Don’t rely on only top institutes—apply widely



6. Maintain Your Theoretical Knowledge

Just 1–2 hours/day revision is enough:

-Baileys

-SRB basics

This ensures you won’t feel rusty when residency starts.


Final Thoughts: Your Journey Is Not Delayed

Failing to get training immediately doesn’t mean you failed.

It means your timing didn’t match the system.

Thousands of brilliant doctors have been through this exact phase.

The journey pauses not to stop you, but to prepare you.

What matters is:

- You keep moving

- You stay connected to surgery

-You use your gap wisely

- You don’t let fear stop you from trying again


Your FCPS journey is not a race—it’s a path.

Sometimes the path slows down to prepare you for something bigger.


And trust me—no experience, no rejection, and no gap ever goes to waste.


“If you’re going through the same transition, you’re not alone. Comment below and share your experience!”

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