A Career Chapter · Karachi, Pakistan
Where I sat beside one of Pakistan's finest psychiatrists every evening and watched, session by session, how mastery is actually practised.
From October 2021 to the end of 2023, I served as Medical Officer at the G.A. Asghar Institute of Psychiatry & Behavioural Sciences — caring for admitted patients and working alongside Professor Nadeem Iqbal in his OPD. It was an education that no formal course could replicate: watching a master clinician at work, every single evening.
The Institution
One of Karachi's established centres for psychiatric care and behavioural health — serving a patient population that travels from across Pakistan, including significant numbers from Balochistan, seeking specialist consultation.
Psychiatry Behavioural Sciences Inpatient & OPDBy October 2021, I was already well into my tenure at SSWAB Trust Kidney Care, managing a demanding morning schedule in nephrology and chronic disease OPD. But the instinct to keep learning — to never let one speciality become the boundary of one's clinical world — led me to G.A. Asghar Institute of Psychiatry & Behavioural Sciences in the evenings.
My role there was twofold: as Medical Officer, I was responsible for all admitted inpatients on the ward — their day-to-day clinical management, monitoring, and care. And in the evenings, I worked directly in the OPD of Professor Nadeem Iqbal, one of Pakistan's most respected and sought-after psychiatrists.
What followed across the next two years was one of the most quietly transformative learning experiences of my career — not through lectures or textbooks, but through the daily, living practice of psychiatry at the highest level.
For two years I held both positions simultaneously — the mornings belonged to nephrology and metabolic medicine at SSWAB Trust; the evenings belonged to psychiatry at G.A. Asghar. It was a demanding rhythm, but one that built a breadth of clinical perspective few physicians carry.
Nephrology · Chronic Disease OPD
Managing the OPD for Diabetes, Hypertension, and Chronic Kidney Disease — a high-volume, high-complexity environment where metabolic medicine was the daily language.
Psychiatry · Inpatient Ward & OPD
Caring for admitted psychiatric patients and assisting Professor Nadeem Iqbal in his OPD — where the clinical language shifted entirely, and a different kind of attentiveness was required.
The structure of Professor Nadeem Iqbal's OPD was itself an education. Patients came from across Pakistan — many travelling from Balochistan specifically to be seen by him. My role within that process gave me an exceptional vantage point.
From across Pakistan — many from Balochistan — carrying complex, often long-standing psychiatric presentations.
I would take a full history, assess the presentation, form an initial clinical impression, and document comprehensively before the consultant review.
The patient would then see Professor Nadeem Iqbal — where diagnosis was refined, treatment was decided, and prescriptions were made.
Comparing my own assessment to the master's decision — session after session — was the real classroom. I watched how illness evolves, and how it is treated at the highest level.
The Mentor
Senior Consultant Psychiatrist · G.A. Asghar Institute of Psychiatry & Behavioural Sciences
Professor Nadeem Iqbal is among Pakistan's most distinguished senior psychiatrists — a clinician whose OPD draws patients from every corner of the country, including long journeys from Balochistan, because his reputation for precision, depth, and clinical wisdom is simply unmatched. Working alongside him every evening for two years was a privilege I do not take lightly. I watched how he listened, how he diagnosed, how he prescribed — and the gap between my initial assessments and his final decisions became, session by session, my greatest teacher. By the time I left G.A. Asghar, that gap had narrowed considerably.
Psychiatry, more than perhaps any other discipline, lives in the space between what a patient says and what is actually happening. Sitting in Professor Nadeem Iqbal's OPD — seeing how he moved through a consultation, how he listened for what was not being said, how he tracked the evolution of an illness across months — refined something in me that no examination syllabus could.
I learned how psychiatric illnesses evolve — not just their acute presentations but their trajectories, their relapses, their recoveries. I watched how complex presentations are carefully unpacked and how prescribing decisions are made with nuance, adjusting not just for diagnosis but for the individual in front of you. And because patients came from as far as Balochistan, I encountered a breadth of clinical diversity — different cultural contexts, different illness narratives, different degrees of chronicity — that broadened my clinical thinking considerably.
Two years of evening OPD sessions with Professor Nadeem Iqbal were worth more than any textbook. I was not just assisting — I was being shaped as a clinician, one consultation at a time.
The inpatient ward work added a different dimension — the close, sustained clinical relationship with admitted patients, tracking their progress day by day, adjusting care, and understanding the full arc of psychiatric treatment rather than only the outpatient snapshot.
What I Gained
Psychiatric illness trajectory mapping
Complex psychopharmacology — observing master-level prescribing decisions
Inpatient psychiatric ward management
Cultural breadth — patients from across Pakistan including Balochistan
Clinical assessment under a senior consultant's review — the discipline of being accountable for your impression
When I joined the Karwan-e-Hayat Community Outreach Program in 2025 — taking mobile medical camps into Karachi's most underserved communities — I encountered complex mental health presentations regularly, often without specialist backup, often in difficult field conditions. It was the clinical depth I had built at G.A. Asghar that allowed me to handle those cases with confidence.
The ability to recognise a complex psychiatric presentation early, to understand how it might evolve, to make a sound prescribing decision independently — these were not skills I developed in the field. They were skills I had been quietly building across two years of evenings at G.A. Asghar, beside one of Pakistan's finest psychiatrists. That learning came forward with me, and it continues to serve every patient I see in community outreach today.
By the end of 2023, the expansion of services at SSWAB Trust required more of my mornings — and gradually more of my time altogether. I left G.A. Asghar on good terms, carrying with me two years of learning that continues to shape how I practise psychiatry in the field today.