Sketch by Duncan Smith

This interview originally appeared in the BMJ:  2018;360:k1173 on March 21, 2018


Madhukar Pai, 47, has a Canada research chair in epidemiology and global health at McGill University in Montreal, where he is also director of global health programmes. He is a member of the Royal Society of Canada and a fellow of the Canadian Academy of Health Sciences. He trained as a doctor in Vellore, India, and got his PhD at the University of California, Berkeley, where he was recently named among the 75 most influential alumni of the School of Public Health . He is passionate about eliminating tuberculosis, especially in India, where a quarter of the world’s 1.7 million TB deaths occur each year. His work on using “mystery” (simulated) patients is exposing major gaps in how TB patients are managed in many countries. TB cannot be eliminated globally without serious investments and quality improvement, he argues.

World TB day 2018 is Saturday 24 March.

What was your earliest ambition?

To be a doctor. For a brief while I flirted with the idea of becoming an astrophysicist, but maths freaked me out.

What was your best career move?

To train in the US, live in Canada, and do global health work in India. I have the best of three worlds.

What was the worst mistake in your career?

Oh, I’ve made a ton of mistakes in my research career. But I don’t regret them—they made me a better researcher and teacher (see my 2004 letter in The BMJ).1

How is your work-life balance?

I get asked all the time whether I ever sleep. Need I say more?

How do you keep fit and healthy?

Shovelling snow in Canada. I also use my Apple watch to hit daily targets.

To whom would you most like to apologise?

My wife, Nitika; my daughter, Annika; and my dog, Dora, for my globe trotting. But they understand my global health mission and haven’t thrown me out of the house (yet).

What do you usually wear to work?

“Tacky” stuff, says my daughter. Shorts and T shirts in summer; blue jeans and mock turtlenecks in winter.

What living doctor do you most admire, and why?

Gita and Arjun Rajagopalan, a couple in Chennai, India. Leading by example, this physician couple showed that it’s possible to offer quality healthcare without resorting to irrational or unethical practices. They inspired generations of medical students and trainees.

Who is the person you would most like to thank, and why?

Six amazing teachers, for encouraging and inspiring me: Ramanathan Sivanantham (who taught me chemistry in school and helped me get into medical school); Arjun Rajagopalan (who taught me evidence based medicine, even before the term was coined); Jayaprakash Muliyil (who inspired me to do epidemiology and made me a better teacher); Jack Colford (who mentored me during my PhD and inspired me to aim high with my career choices); Art Reingold (who gave me my biggest break and funded my training at Berkeley); and Phil Hopewell (who inspired me to do global TB policy work). I’d also thank my wife and daughter for putting up with my lack of work-life balance.

What single unheralded change has made the most difference in your field in your lifetime?

The explosion of interest in, and funding for, global health.

What new technology or development are you most looking forward to?

In my field of TB I desperately want to see a simple, point-of-care diagnostic test. Right now we’re missing too many people with TB.

What book should every doctor read?

All health professionals will be patients someday, so they should all read In Shock by Rana Awdish.

What is your guiltiest pleasure?

Binge watching the Harry Potter films (for the 100th time). My daughter thinks that I’m 11 years old.

Where are or when were you happiest?

The San Francisco Bay Area in California, where my wife and I did our training.

What television programmes do you like?

Game of Thrones. Can’t wait for the epic finale in 2019.

What personal ambition do you still have?

To witness a substantial decline in the TB epidemic in my lifetime—especially in India, which has the world’s highest burden.

If you were given £1m what would you spend it on?

On giving back to India, my homeland. I do this already,2 but I’d like to do much more.

Summarise your personality in three words

Ambitious, persistent (my wife prefers “stubborn”), hardworking.

What is your pet hate?

That most low and middle income countries don’t invest enough in health.

What would be on the menu for your last supper?

Chicken and beer.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

I’m still in my 40s and haven’t planned my funeral yet.

Is the thought of retirement a dream or a nightmare?

At this stage in my career I have a lot to accomplish. So, a nightmare.

If you weren’t in your present position what would you be doing instead?

I think that I’d be teaching science to school kids. Teaching and students make me happy.


March 22, 2018