Healthcare Design is all about creating functional spaces that go beyond visual appeal and aesthetics in order to provide rich human centric experiences !

Monika Kejriwal, our next pathbreaker, Director for Healthcare at RSP, one of the largest architectural design firms in India, works on projects for established healthcare groups, with a focus on single-specialty as well as multi-specialty hospitals.

Monika talks to Shyam Krishnamurthy from The Interview Portal about the power and potential of healthcare design in supporting the delivery of superior care by clinicians and improving the quality of life of patients.

For students, this is a highly specialized and operations driven field that requires a comprehensive understanding of hospitals and the specific requirements of each department or service in a hospital.

Monika,  Your background?

I grew up in multiple cities across North India as my father was an IAS officer and had a transferable job. My mother was a housewife, and it was the expected thing for the entire family to move every couple of years when he got transferred to a different city.

Oftentimes, my father would get transferred in the middle of the school year and my brother and I would change schools, and invariably, even switch school boards with just a few months to go for the final yearly exams. Luckily, I was a very good student and did well academically. However, it did mean that I was forever catching up and adjusting to a new environment and a new curriculum. I had to spend extra time on academics in order to do well, and it didn’t leave me with much time for extra-curricular or social activities. Consequently or even otherwise, I was more of an introvert growing up. I was a voracious reader and enjoyed drawing and painting, but I don’t remember having too many other interests or a lot of friends.

On the other hand, I feel the frequent moves made me resilient and also very industrious. This has definitely stood me in good stead later in my life, as architecture is a very labor and time intensive profession.

I must also mention here that my father belonged to a relatively conservative and highly patriarchal business community. Being a girl, it became even more important to do well to have any kind of identity or life of my own. 

In retrospect I feel, it got ingrained in my mind very early on that the only way to survive is to work hard and do well. 

What did you do for graduation/post graduation?

I studied mainstream architecture at both graduation and post graduation levels. I did my Undergraduate program in Architecture in a college in Gujarat and Masters in Architecture at Ohio State University in the US. Both times, my choice of school/college was a combination of the quality of the program and merit /scholarship based admission.

Particularly for post graduation studies, since I was looking to go abroad (the travel bug had set in early in life), financial considerations were extremely important. For most middle or upper-middle class families in those times, US college tuition fees was not affordable. 

Therefore, I carefully selected a mix of 5-6 colleges to apply to, that included good state universities that had good scholarship programs and also a couple of private universities including Ivy leagues.

I finally accepted the offer from Ohio State University as not only was its architecture program ranked well, but I was also awarded a fellowship that included a full tuition waiver and a monthly stipend that helped me meet my living expenses. 

What were some of the influences that led you to such an offbeat, unconventional and unusual career?

There was no great advance planning about my career or any strategy about how I should shape my career. Neither would I attribute my choice of career to any person or mentor who influenced my decision. 

Around 30 years ago when I was finishing school, and even more so given my family background, it would have been an equally natural thing to do if I had chosen to not pursue a career, and had just got married.

I was the first girl of my generation in my family to pursue a professional degree and work. None of my older girl cousins had gone to professional college and there was no precedent or role model for me. Now, ofcourse, almost all the younger girls in the family are highly educated and doing well in their own right.

Therefore, sometime soon after the 12th grade results came out, discussion about what I wanted to do next came up. I was good at science & maths and was also creative – which was understood to be a good combination and were prerequisites for a career in architecture…and that was that. I started applying for architecture entrance exams and got into a good program in Gujarat.

How did you get your first break?

I would say it was serendipitous that I got my first job after completing my Masters with Ashen + Allen (A+A), which was one of the best healthcare design firms in the USA. We were allowed to work for a year after completing the Masters program under what was called ‘Optional Practical Training’ as part of our student visa/status. We had only a year to get a job and a work visa through the employer. So basically, I started applying right after my Masters and took the first job that I was offered. It is with this very first firm abroad that my grounding and love for healthcare design started and; the rest as they say is history.

What were some of the challenges you faced? How did you address them?

Challenge 1: This was my first corporate job in a large firm, in a new country and new culture. From a technology standpoint as well, the tools and programs used in the office to do design work were more advanced and different from what I was used to. The learning curve was very steep for me. I tried to focus on observing and learning from everything that was happening around me, and take it each day as it comes. 

Challenge 2: Healthcare planning is highly specialized, and operations driven. While I was beginning to understand and love medical planning, I didn’t know enough about all that is required in a hospital. I signed up for an evening class on healthcare design, after work, which helped me get a better and more comprehensive understanding of hospitals and the specific requirements and operations of each department or service in a hospital.

How did you plan the steps to get into the career you wanted? Or how did you make a transition to a new career? Tell us about your career path

At A+A, each person was assigned to a project or two at the most and worked full time on those projects till the project’s completion. I started out as an architectural designer on a large project in Utah. For the first year or so, I helped out with whatever ongoing project priorities or deadlines were, but as more of a generalist. Healthcare or medical planning as it is known, is a specialized area of work that involves operational knowledge of healthcare that comes with experience and requires a keen spatial design sense. It was again serendipitous that a small planning assignment came my way as it was urgent, but no medical planner was available at that point. Not only did I manage to plan it in an unexpectedly short time, but it was exceptionally well done.

I still remember the thrill of recognition by the team, but also knew that I had found my calling. I had enjoyed that single assignment at A+A more than any other in my time there and I had clearly and quietly absorbed a lot of hospital planning. Gradually, I started to establish myself as a medical planner, and infact was put on a fast track young talent program in the company.

My husband and I are both aligned in our desire to travel the world and experience different cultures. Therefore, after a few years in the US, we decided to move to the UK. After moving to London, I joined the healthcare practice of HOK. The London offices of HOK handled projects in the UK, Europe and the Middle East. With HOK I got a chance to work on the design of an Orthopedic Hospital in Dubai and a few projects in the UK. In UK, healthcare is primarily provided through the NHS which is a public sector organization. This gave me an insight into the design drivers and imperatives of public sector as opposed to those of private hospitals. In addition, the procurement process for projects in UK was very different from USA. In UK, projects are awarded as part of contractor led consortiums. This was again a very different way of bidding for and working on projects. 

About 15 years ago, I moved back to India due to personal reasons. At that point, there were hardly any architectural firms specializing in healthcare design. I joined Technopak, which was a management consulting firm that worked on strategy consulting. However, the company wanted to start offering concept to commissioning services, including design for healthcare clients. I joined them to drive this initiative. At Technopak, I got exposure to the strategy side of hospital conceptualization. 

My next job with Chaithanya was a client side role. The group was in the process of setting up a hospital and I was hired as the in-house architect. Once again, being on the client side helped me understand the business side of things. 

As one can see, the first few years of working were spent in just learning the ropes and understanding what was involved in building a building in real life, as opposed to on paper. I was not focused nor had a preference in terms of the type of buildings I wanted to work on. It was also probably too early for me to develop a design style or design sensibility.

For the first few years, I did not get to even work on the design of a building independently, and felt very reined in. This was a far cry from college days where we got to design fantastical projects of our own where creativity was the primary consideration. However, as I progressed in my career, I learnt to balance creativity and practicality.  

Also, and very importantly, the multi-pronged opportunities that I got of working on private and public sector projects in different geographies, and both as an external consultant as well as part of an client organization has helped me in getting insights and thorough understanding of all aspects of a project. As I set up Latitude Design, my own firm focused on healthcare projects, this definitely helped me in understanding my clients’ requirements better and approach my projects with a greater understanding.

Where do you work now? What problems do you solve?

I currently work as Director for Healthcare in one of the largest architectural design firms in India.

Lack of space, budget constraints and tight project timelines are the three most common problems I face on every project I have been involved with. Therefore, invariably problems that I need to solve are how to create the best possible hospital design in the space available, and how to implement the chosen design in the most cost-effective and fast track manner.

I am currently working on projects for most of the established healthcare groups, as well as some relatively newer healthcare groups. My current portfolio comprises of both single-specialty as well as multi-specialty hospitals, with most of them being set up for the highest level of care. From a scope perspective, it includes both interiors renovation work as well as full service comprehensive design services including planning, interiors, building services design etc. 

What skills are needed for your role? How did you acquire the skills?

Creativity, technical know-how, and people management are some of the skills needed for the job. Some of these skills are inherent, while some are acquired with professional education and good work experience. Travel and exposure to good design also help in broadening one’s horizons.

What’s a typical day like?

A typical day involves multi-tasking and is very unpredictable. There is a bit of everything everyday – some design work, some business development, client servicing, project management, sometimes site visits. On some days it’s all of these for one project, and on other days I do one thing, but the same thing for multiple projects.

What is it you love about this job? 

I find healthcare design very gratifying. In addition to the visual appeal of good design, the outcome can go beyond aesthetics and help in improving performance and promote a feeling of well being in patients.

How does your work benefit society? 

Good design is known to help improve the occupants/users quality of life. It is even more true of healthcare where design has the potential and the power to support the delivery of care by the clinicians and can help patients feel well.

Tell us an example of a specific memorable work you did that is very close to you!

One of my most memorable projects and a hospital design that is close to my heart also happens to be one of the smaller projects I have worked on in terms of size. This was for a boutique specialty hospital and I got the chance to get involved in all aspects of design, even scope of work that is traditionally not part of architectural design such as branding and uniform designs. This helped me carry the vision, identity and the design thought across multiple touch points in the hospital and resulted in a very cohesive end product. 

Your advice to students based on your experience?

I would advise students to spend the initial years exploring different aspects or sub specialties within your chosen professions. However, once you have built a solid foundation, work to strengthen and focus on the aspects you love most for the rest of your life. It will make work effortless.

Future Plans?

I have never strategized or planned my career consciously. I have so far mostly gone with the flow as long as I was continuously learning and enjoying my work.

I will probably continue in the same manner in future, though it’ll most definitely be in the field of healthcare design. Having said that, I am trying to be more personalized and have an operations outcome based approach to my work.