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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Choosing the Right Surgical Training Institute: A Personal Guide

My Personal Journey & Lessons

Transitioning into a completely different field is never easy—and in my previous blog, I shared how I unexpectedly stepped into a job far from what I had originally trained for. If you haven’t read it yet, please check it out for the full background 

https://faithfatigueandthefuture.blogspot.com/2025/11/starting-over-in-pediatrics-learning-to.html


Adjusting to a New Job and a New Environment

The first one or two weeks were difficult. Everything felt new, different, and sometimes overwhelming. But slowly, things began to settle. I made new friends, my colleagues were supportive, and the overall work environment was friendly. I even started enjoying the work.

I was working evening shifts, which came with both benefits and drawbacks.

Benefit: waking up comfortably in the morning, no rush.

Drawback: the entire day practically disappeared. I used to leave home around 2 PM and return at 10:30 PM—exhausted. After that, I had no energy left for studying or anything else. My life started revolving only around the job.


Learning From Unexpected Opportunities

Despite the routine, I cannot deny how much I learned. I saw conditions I had never encountered before:

-Acute Lymphoblastic Leukemia (ALL)

-Thalassemia

-Sickle Cell Disease

-Chronic Myeloid Leukemia

These pediatric cases gave me exposure I never expected. I learned NICU care, how to receive newborns, assess them, and manage various emergencies. It made me realize something important:


Nothing in life ever goes to waste. Every experience adds value. 

We just need to stay open to new opportunities.


Six Months Passed Before I Realized It

Time flew, and suddenly six months were gone. The new induction session was approaching, and I had done zero preparation. That’s when it hit me again

I had passed FCPS Part 1 in Surgery, and now residency was the next step.

I had to decide which speciality I have to choose in my case it was FCPS for that we have to choose in start regarding the 2 year or 4 year program I had no any interest for the subspeciality so I chose 4 years program, I applied to several places, and calls started coming in. But even a day before the interview, my mind was full of negativity:

“Only one day left… I haven’t prepared anything.”

“This is too hard for me.”

“Maybe I don’t deserve this.”

I couldn’t understand what was going wrong or why I felt so stuck.


Trusting Allah and Moving Forward

I kept reminding myself to rely on Allah and keep going. I wanted a good institute—preferably government—with:

-A positive environment

-Strong hands-on surgical skills

-Good academic and research exposure

-Balanced workload

I applied everywhere. Some tests were online because of COVID, some were physical. Unfortunately, I did not get selected in the government hospital I wanted, and I was heartbroken.

Then a private but reputed institute called me for an interview. I got selected.

I was 30% happy and 70% sad—still confused, still unsure.


The Last-Minute Breakdown

Even a day before joining, my mind was full of doubts:

“I don’t feel like joining…”

“Will I adjust?”

“Surgical skills? I know nothing.”

“Calls every 4th day? How will I manage?”

“What if the supervisors are too strict?”

“I miss my previous workplace…”


But life doesn’t wait. And neither does opportunity.


Leaving My Medical Officer Job

I resigned from my Medical Officer job with a one-week notice period.

They didn’t give me any certificate because I left early—they wanted one more month, but I couldn’t manage.

And so I stepped into the next chapter of my life:

My surgical residency.


Tips for Choosing the Right Institute for Surgical Training

If you are applying for surgical residency or training, here are some important points to consider:

1. Choose an Institute With Strong Hands-On Exposure

Surgery is a skill-based field. Look for a place where you will get:

-Regular OT exposure

-Assistance and first-assist opportunities

-Emergency and trauma case handling

-Variety of surgical cases


2. Academic Environment Matters

A good surgical department should offer:

-Weekly academic sessions

-Journal clubs

-Mortality & morbidity meetings

-Regular teaching rounds


These shape your thinking and improve clinical judgment.


3. Supportive Senior and Faculty Behaviour

Your learning depends heavily on the environment. Choose an institute where:

-Seniors guide instead of intimidate 

-Consultants teach willingly

-Questions are welcomed

-Errors become learning opportunities


Get some knowledge about the enovironment before stepping into it.


4. Balanced Duty Hours

Surgery is demanding, but extremely toxic duty hours can burn you out. Consider institutes where:

-On-calls are manageable

-Post-call offs exist

-You get at least minimal rest between shifts


5. Research Opportunities

A strong research culture helps in:

-Publications

-Career advancement

-Better understanding of evidence-based surgery


6. Learning Culture in the OT

Observe how surgeons teach residents:

-Do they explain steps?

-Allow residents to perform under supervision?

-Give constructive feedback?


This makes a huge difference.


Final Thoughts

Life doesn’t always go as planned. Sometimes we start in a completely different direction, yet every experience prepares us for the next chapter. My journey from a random job to surgical residency taught me that:

Nothing is wasted. Everything becomes part of your growth.

If you are also struggling, confused, or starting over—trust the process, trust Allah, and keep moving.



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

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