Dr Malvika Gupta would be forgiven for throwing her hands up and declaring it’s all too hard throughout her career. But her perseverance has paid off in the form of two clinics she set up in Melbourne and a life she loves in Australia.
If there’s an anecdote summing up the ‘all-in’ approach Dr Malvika Gupta applies to her work, it’s the one about convincing RANZCO she was worthy of staying in Australia to work as an ophthalmologist.
It was 2015 and her final year of a vitreoretinal fellowship in Sydney. She was working, ticking off bucket list items and preparing to head back to her native India with a young family in tow. Given the plight of others in her position – whose training wasn’t considered comparable to the Australian system – it seemed a foregone conclusion.
But she found a mentor, a senior paediatric ophthalmologist, who urged her to investigate how she could prove she matched the criteria for an Australian-trained ophthalmologist.
Whether she measured up or not, the cost was $6,000 – a significant bet given her relatively meagre fellowship salary. But the gamble paid off, sparking a fulfilling career that’s led her to Melbourne’s eastern suburbs where, against the odds, she operates two greenfield Eastern Eye Specialists clinics today.
“I thought OK, it’s only a $6,000 gamble. I took three to four months to prepare the application for RANZCO, with folders sorted into every curriculum standard showcasing how my training was equivalent,” she says.
“It included patient letters, referrals from mentors, thank you cards, logbooks – everything one could dream of. It was in a suitcase that I had to deliver personally, as it was too big to post. I was given feedback the college has never received an application like that.
“But that was pure me – I didn’t want to leave the college the option to say ‘you aren’t good enough’. When I take up something, I have to put my heart and soul into it and leave no stone unturned.”
‘It was a no-win situation’
For every ounce of grit, Dr Gupta has a pound of ambition. This is despite being brought up and educated in a patriarchal system never designed for someone like her to flourish.
As the daughter of a paediatric surgeon (father) and obstetrician-
gynaecologist (mother), a medical career seemed destined as she grew up in New Delhi, acing her exams and topping her classes.
“I know how to study and I know how to score, and in India that allows you to choose your career path,” she says.
“My parents put everything they had into work. But I felt a little differently. I wanted time for myself, my family, to do something else. I wanted a life where my career was an important part, but was not my whole life.”
But she also didn’t want to pursue core specialities like medicine, surgery, obstetrics or paediatrics.
“Which pretty much rules out most important specialties in medicine,” she says. “And then, by default, I looked into eyes. I was so naive thinking it was going to be a simple subject, with the slimmest books, and you could be surgical or non-surgical, so there were options – and my exam score allowed me to pick this.”
The more she delved into it, the complexity of eyes became apparent, but so did her passion.
“I’ve been almost 20 years in ophthalmology now and the passion only increases every year. I’m still learning, and it’s a beautiful kind of learning, not the kind where you sit exams and cram. It’s those ‘wow’ moments that really capture you with ophthalmology.”
What also became clear was a gender bias in the Indian health system.
The expectation for specialists in India is to work 9am-1pm, break for the afternoon, and return 5pm-9pm. It would have prevented her from a life she desired – a career, family, time in nature and a few moments for herself.
“It meant I would never measure up, I would always have to make compromises.”
The caste system also meant jobs weren’t being offered on merit. It began to increasingly feel like a no-win situation for Dr Gupta.
“I like to work well, but also respect myself and feel respected in the workplace, which seems like such a such a natural thing to expect, but isn’t always the case for a women working in that environment.”
She started looking beyond India’s borders, and Australia seemed like the kind of place that would satisfy her personally and professionally.
She needed a foothold, which led to a one-year vitreoretinal fellowship at Westmead Hospital, NSW. That was extended another year, and she began cramming in trips to places like the Great Barrier Reef, New Zealand and Uluru before an expected return to India.
But then she threw the expensive roll of the dice to practise in Australia. Surprisingly, it paid off initially, but it wasn’t the answer to all her problems.
Indeed, RANZCO considered her application worthy – meaning further training wasn’t required – and she only had to sit the final RACE exam. he high wire act continued.
“At that time, there were only one or two international medical graduates who had passed the exam. Most others didn’t make it because the examination system was quite different to the Indian pattern and also there was no leverage with respect to second attempts,” she says.
“It’s challenging because the Indian exam system is very knowledge-based, while in Australia they give you scenarios and ask you how you’d approach it. Plus, the nomenclature and protocols vary.”
Finally, she passed, but the uncertainty didn’t.
“The moment you pass an exam and finish [the fellowship], you have no job. If you don’t have a job, then you don’t have a visa, even though I had the license to practise. It was like being back to square one.”
Thankfully Eastern Health and Northen Health in Melbourne took her on as a consultant in the public system before a colleague invited her to join their private practice.
“Being shy and the way I was back then, that surprised me, and I was very grateful. But that’s the culture here,” she recalls.
“Soon my priorities became clearer, and that’s when I realised that if I’ve got to do this, I have to do it my way.
“I’ve always known how to work hard; when there’s a course, I can follow it. But when there isn’t a strict process to follow, that’s when I get lost, which was the case setting up a practice.”
From little things, big things grow
By this time, Dr Gupta had been in Australia five years. A glaring hole in Victoria’s eye health system appeared while she was performing public work for Eastern Health.
In the Yarra Valley, east of Melbourne, patients were driving long distances for intravitreal injections (IVIs) for their macular disease.
“I was thrown by that. How could that ever happen in a first world country like Australia?”
Sensing the opportunity, she took the leap, leasing a room in Lilydale. She acquired an OCT, and became the only clinic in a 100km radius between Alexandra and Ringwood to offer IVIs (another has since opened in Croydon).
“I was given a six-month rent-free period, and thought, that’s great,
all I have to do is do some injections.”
This was 2020, and she began introducing herself to every GP and optometrist in town. She was making it up on her own, and quickly realised she had a loving community around her, even as COVID lockdowns came into effect a few months later.
“Despite that, I have never had a day where I felt off and wondered, ‘will this work?’”
Today, Eastern Eye Specialists is located in Lilydale Medical Centre. She has since branched out with a second location in Bayswater within the Knox Health Hub.
The second site came through a chance meeting with the Australian College of Optometry (ACO) who had just moved in and had half the building free.
As demand ramped up, the service was broadened to encompass cataract, glaucoma, pterygium, blepharoplasty and now refractive laser eye surgery. Three other ophthalmologists now consult with her.
Dr Gupta charges a private fee, but her referrers know that she will not “let down her community” if finances become an issue.
“When you are new to a community where nobody else bulk bills, people always take you as less, like it’s the only way she can get business. I wanted to put value on myself and time,” she says.
“But I want to respect the people who cannot access care and, for instance, won’t follow up with their appointments at The Eye and Ear because they’re old and cannot drive and see. There has been no patient lost to me because they couldn’t pay.
“There’s so many needy patients who cannot afford a private service, and they then end up waiting a year for something like a retinal laser procedure in the public system. But in that time, it could bleed and they could go blind,” she says.
“I operate by the mantra that there’s no point being a Christmas tree with false, empty gifts wrapped underneath it. You want to earn enough to support the business, support your family and mortgage, but at the same time, you don’t want to be a health provider that nobody can reach and benefit from.”
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