We spoke to Dr Yogen Deo about training at the Citizens Specialty Hospital in Hyderabad
What is your name, fellowship title and which country are you pursuing your fellowship in?
My name is Yogen Deo. I am currently pursuing Pain Management Fellowship at Citizens Specialty Hospital in Hyderabad, India. I am sponsored by the World Federation of Societies of Anesthesiologists (WFSA).
Where are you from, and what work were you doing back home?
I am from Fiji Islands, a country situated in Oceania and is commonly referred to as the heart of Pacific Ocean. I work for Health Care (Fiji) Pte Limited at Lautoka Hospital, a tertiary facility in Fiji’s Western Division.
I work as an anaesthesiologist, administering anesthesia in surgery, managing critically ill patients in the ICU, and leading the clinical team in acute and chronic pain care in wards and the pain clinic.
Why were you interested in anaesthesia as a career?
To answer this, I’ll take you back to my 2013 internship at Colonial War Memorial Hospital in Suva. Internship is a doctor’s most challenging year – our first hands-on experience. I completed four 13-week rotations in Internal Medicine, Surgery, Paediatrics, and Obstetrics & Gynecology.
My rotations didn’t include anesthesia, but I quickly noticed that in any emergency or difficult situation, the go-to phrase was always, “Call the Anaesthetist” (anaesthesiologists in Fiji are commonly referred to as anaesthetists traditionally).
Whether a patient was deteriorating, had difficult IV access, needed urgent surgery, or was in severe pain, the anesthesiologist arrived like a superhero—scrubs on, equipment and medication box in hand—saving both patients and doctors alike. That’s when I knew I wanted to become an anaesthesiologist.
Why did you want to pursue a fellowship with the WFSA?
The WFSA is the largest and most respected global organisation for anesthesiologists, offering access to extensive knowledge, resources, and expertise essential for advancing my pain management skills. The opportunity to learn from leading experts in the field is invaluable, as it allows me to gain insights into the latest techniques and best practices in pain management.
Secondly, I am motivated by the desire to improve healthcare standards in my home country. For the past two years, I’ve led the pain management team at my hospital, but I’ve felt a knowledge and experience gap in providing optimal pain management.
Through the WFSA fellowship, I’m gaining advanced training, hands-on experience, and exposure to the cutting-edge research and innovations, all of which will help me enhance patient care. This aligns with my broader mission to elevate pain management practice and education, not just at my hospital, but across the country and the South Pacific region.
What is the highlight of your working day?
My day starts at 8am with a brief team meeting in the operation theatre suite, followed by surgery cases. I assist the anaesthesia team, performing or observing regional anaesthesia procedures such as spinal, epidural, femoral nerve, and popliteal sciatic blocks, to name a few.
After a short hospital breakfast at 9am, I stay in the theatre until I’m called for inpatient pain management referrals or to follow up on acute/chronic pain cases. The pain clinic runs from 10am, six days a week, where I work with two local pain management fellows, taking detailed histories, examining patients, and discussing cases with Dr. Muralidhar Joshi, senior pain specialist, our supervisor and mentor.
We then perform or assist with pain interventions in the operation theatre, following patients from admission to post-procedure care. Lunch is usually between 1-2pm, and I often help cover surgical duties during this time. After lunch, I continue with the clinic or interventions and participate in bedside demonstrations and discussions when there are no procedures. My day wraps up around 5pm with afternoon tea provided by the hospital canteen.
What are the highlights during your fellowship so far?
Exposure to a wide range of acute and chronic pain patients: I’ve treated a diverse range of acute and chronic pain patients, with conditions such as lower back, knee, shoulder, neck pain, and trigeminal neuralgia. This experience has honed my skills in history-taking, musculoskeletal and neurological exams, and interpreting MRIs. I also manage acute postoperative pain cases daily.
A range of acute and chronic pain management interventions: I’ve had numerous opportunities to observe, assist, and perform pain management interventions, including daily acute pain management via regional anaesthesia in the operating theatre, as well as various chronic pain interventions.
Multiple pain management workshops: to date, I have attended three different pain management workshops here in Hyderabad during my fellowship. This has given me opportunity to visit prominent hospitals in Hyderabad and learn from the different pain gurus from not only India, but the USA and UK as well.
What is a standout case during your fellowship? (case study)
Mrs. P, a 62-year-old woman, presented with severe, worsening abdominal pain for a month, radiating to the back and rated 10/10. She had difficulty with daily activities and oral intake, and her sons shared her history of periampullary pancreatic cancer diagnosed late last year, followed by a Whipple procedure and chemotherapy. She had been prescribed paracetamol, tramadol, and fentanyl patches, which were later switched to buprenorphine.
On examination, she was frail with stable vitals, abdominal tenderness, and mild peripheral edema. A PET CT scan showed metastasis to the lungs and liver, and she was planned for palliative radiotherapy. Blood tests showed mild hyponatremia and hypoalbuminemia.
After counseling the family, she was admitted for intravenous fluids and a coeliac plexus block under CT guidance. The procedure, performed under local anesthesia and sedation with Dr. Muralidhar Joshi, provided significant pain relief. The next day, she could mobilise and tolerate food, and her opioid medications were reduced.
This case taught me how to work up a patient for pain management, perform a coeliac plexus block, and the importance of patient counseling and follow-up planning for chronic pain management.
What transferrable skills have you learned that could be applied back home?
In the past six months, I’ve gained valuable skills that will benefit our team back home, including:
Patient counseling: I’ve learned the importance of clear, honest communication when discussing treatment options, risks, and benefits with patients.
Ultrasound-guided procedures: I’m now confident in performing acute and chronic pain interventions using ultrasound guidance, understanding 3D anatomy, sonoanatomy, and probe techniques.
Fluoroscopy-guided interventions: I’ve learned various fluoroscopic techniques like epidural steroid injections, medial branch blocks, and sacroiliac joint injections.
Chronic pain assessment: My ability to assess chronic pain patients using the biopsychosocial model has improved, including thorough history-taking, exams, and diagnostic interventions.
Chronic pain management: I’ve deepened my understanding of pharmacological and non-pharmacological treatments for chronic pain.
Why were you drawn to India?
India offers a unique blend of cultural diversity and medical expertise, providing an ideal environment for a fellowship in pain management. The country’s varied patient demographics and clinical scenarios offer invaluable exposure to different health conditions.
With advanced training opportunities and high-quality fellowship programmes, India’s institutions emphasise both theoretical knowledge and practical experience. By pursuing a fellowship in India, I would have access to advanced training methodologies, innovative practices, and cutting-edge research in pain management. Additionally, collaborating with esteemed professionals, such as my mentor Dr. Muralidhar Joshi, enhances learning through invaluable mentorship opportunities.
Beyond professional growth, living in India offers personal enrichment by immersing in its culture, strengthening communication skills, broadening my worldview and fostering empathy. Given my ancestral ties to India, this cultural connection adds a personal layer to the opportunity. The people are friendly, and the positive workplace atmosphere makes me feel at home – Hindi is my mother tongue, so communication has been easy.
I love the local food, and have had a chance to visit historical sights like Golconda Fort, Charminar, and Hussain Sagar and festivals like Krishna Janmashtami, Ganesh Utsav, Navratri, and Diwali.
Dr Deo’s fellowship has been sponsored by Neon Laboratories
The WFSA offers its fellowships to anaesthesiologists from low and middle-income countries to increase their skillset and become leaders for anaesthesia once they return to their home countries. Upcoming WFSA fellowships and how to apply
