We are often asked by medical students and parents as to what is the scope of private practice in Mumbai. My answer is “tremendous”. But one must know how to go about it. Mumbai is a metropolitan city and has an ever increasing population. To find gainful employment is not difficult. Infact the totally free patient rarely exists. This knowledge has encouraged the Municipal Corporation and the Government Hospitals to charge for OPD attendance as well as operations; though nominally. It was thought that by levying a charge the large queues for OPD papers and the waiting lists for operations will reduce. It hasn’t. Being a commercial city people want value for money. So qualification, competence, and reasonably clean set up is a must.

For those who wish to settle down after MBBS into family practice are better off to do some posts in medicine, paediatrics and for ladies-gynaecology. With this grounding one is apt to give competent advice to patients. Mumbai is a city where every Medical Association holds regular CME’s. These CME’s are very useful and helps the practitioner to learn about advances in medicine without going to libraries or conferences. The family physician would be well advised to pick up a diploma in child health (DCH) or dermatology (DVD), because 30-40% of his practice will involve children and/or skin. That will give him an advantage over his peers. Enterprising doctors could collect extra income through attachments to pharmaceuticals companies, diagnostic centres, school health service, corporations or ICU’s.

The specialist has to gain a footing through other means, in order to practice a speciality in Mumbai. He is better off to be a super or super super specialist e.g. gastroenterology has already been segmented into medical and surgical, endoscopic and non-endoscopic, invasive and non-invasive, and upper GI and lower GI. Single-organ specialist like hepatology can also do well provided they have spent some time in good centres. Although many 5 star and 7 star hospitals have flourished in this town attachment to them is easier if you are a super specialist and competent in your work. Other attributes like marketing techniques, sociability and computer literacy also helps. With coming in of newer technologies, newer specialist will be required. So the consultant must remember that learning is a continuous process. He must stay abreast with all advances.

Mumbai is a cosmopolitan town with ever increasing population and ever increasing demands. If one can establish himself as a specialist or as a super super specialist maintain his competence level, be good at public relations, his scope is tremendous. Newer and previously unheard of specialities like Cosmetology, Biomedical Engineering and Hospital Administration have also come up. Thus increasing the scope of practice.

People with weaker financial backgrounds or liking for academics can join medical colleges as professors and lecturers. Most medical colleges now allow private practice. Some even provide accommodation. For those who are unable to maintain a high pressure life, there is a chance of making a decent living in middle class areas and at district level. As the Chinese proverb says there is always room at the top provided you can climb long enough.

Ex-hon Paediatric Surgeon, Bai Jerbai Wadia Paediatric Hospital, Parel, Mumbai 400 012.