Anil Mandhani1, Pooja Sharma2, and Adarsh Keshari3
1MBBS, MD, MCh, Chairman, Urology and Kidney Transplant, Fortis Memorial Research Institute & Co-Founder, UnivLabs, Gurugram, India
2MBBS, MD, CEO & Co-Founder, APAR Health; Project Lead, SUFI (Surgeons for Innovation), Gurugram, India
3PharmD, Senior Research Fellow, APAR Health, Gurugram, India
ABSTRACT
While the traditional apprenticeship model in surgical training remains valuable, it often underutilizes the surgeon’s potential as a co-creator of solutions to pressing clinical challenges. As surgical device development increasingly emphasizes locally relevant and immediate problem-solving issues, innovation in surgical education is no longer optional but an essential component of modern training.
This commentary introduces the Surgeons for Innovation (SuFI) program, a nonprofit collaborative program spearheaded by surgeons, researchers, and engineering teams. Designed as a structured yet adaptable model, SuFI integrates innovation training directly into surgical education in India.
The program fosters collaboration among surgeons, researchers, and engineers to co-develop effective, and scalable medical devices of relevance to the local and global users. Its framework is built on four pillars:
- design conceptualization
- access to incubators
- regulatory approvals and
- a repository of problem statements.
Through this approach, SuFI will successfully guide surgeon–engineer teams from problem identification to prototype development, patenting, and market launch of effective, patient-centered devices inspired by real surgical needs. By positioning surgeons as co-creators rather than passive end-users, SuFI strengthens the national innovation ecosystem and aligns with calls to institutionalize innovation within medical curricula. This model offers a potential blueprint for advancing surgical education, particularly in resource-constrained settings.
Key Words: Surgical education, Innovation, Frugal innovation, Surgeon-engineer collaboration, India
Date submitted: 23-September-2025
Email: Dr. Pooja Sharma (drpooja.apar@gmail.com)
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Citation: Mandhani A, Sharma P, and Keshari A. Surgeons as co-creators: the SuFI model for embedding innovation in surgical education. Educ Health 2025;38:435-438
Online access: www.educationforhealthjournal.org
DOI: 10.62694/efh.2025.471
Published by The Network: Towards Unity for Health
The apprenticeship model of surgical education, which prioritizes the transfer of technical skills, is increasingly insufficient for addressing the complex, resource-constrained healthcare challenges of the 21st century. A new paradigm is emerging that positions surgeons not merely as end-users of technology, but as co-creators of innovative solutions.1 This approach, often referred to as “surgineering,” formalizes the partnership between surgical and engineering disciplines to solve problems in the operating theatre.2
Evidence suggests that interdisciplinary partnerships between surgeons and engineers accelerate medical device development,3 although barriers such as disciplinary silos and communication gaps persist.4
The Surgeons for Innovation (SuFI) program represents a structured and scalable model for embedding this collaborative ethos directly into surgical training in India. This commentary outlines how SuFI addresses the gaps in traditional surgical education and positions itself as a significant contributor to the global dialogue on surgical education and innovation, with a contextually relevant approach.5,6
SuFI is deeply rooted in India’s unique innovation ecosystem, which is characterized by the concept of “frugal innovation.” This philosophy, also known as jugaad, emphasizes developing high-impact, affordable solutions by embracing constraints as catalysts for creativity.7 While this improvisational ingenuity has long existed, the challenge has been to transition from ad-hoc solutions to a systematic, formalized process that can lead to commercialization and academic publication. Exemplars such as Aravind Eye Care and Narayana Health demonstrate the potential of frugal systems and devices to achieve both affordability and high quality.8,9
SuFI addresses this by institutionalizing frugal innovation within surgical training while leveraging India’s supportive policy environment.
By aligning with these initiatives, SuFI bridges clinical insights with institutional infrastructure, regulatory approvals, and entrepreneurial opportunities, thereby creating a pipeline from surgical idea to societal impact.
The SuFI program is built on four interconnected pillars that distinguish it from informal collaborations:
A guided collaboration between clinicians, engineers, and design experts ensures that multidisciplinary teams overcome communication and cultural barriers while progressing through the innovation cycle.
Training models in design thinking have shown promise in building innovation skills among medical students and surgical trainees.15–17
SuFI emphasizes compliance with regulatory frameworks and aligns with national policies to ensure that trainee innovations are academically recognized and commercially translatable.
Partnerships with national incubation hubs (AIM, BioNEST) offer infrastructure, funding, and technical resources to transform concepts into prototypes and market-ready devices.
A continuous feedback system gathers real-world surgical challenges, ensuring that projects remain patient-centered and clinically relevant. This aligns with biodesign principles of needs finding5,6 and mirrors India’s grassroots innovation platforms, such as the National Innovation Foundation and the Honey Bee Network.18,19
Although SuFI is a relatively young program, its early outcomes highlight its potential. It has successfully guided clinician–engineer teams from problem identification to prototype development, patent filing, and translational planning.20
Comparable examples in India—such as gasless laparoscopy devices developed through frugal, participatory design—demonstrate the feasibility and global relevance of such innovations.21–23
These outcomes illustrate SuFI’s role as a bridge between clinical insights and deployable innovations, demonstrating how structured mentorship and institutional support can accelerate frugal device development.
By embedding innovation development within surgical training, SuFI reframes the surgeon’s role from end-user to co-creator of solutions. This shift cultivates a mindset where problem-solving becomes integral to professional identity.
Future directions include:
Ultimately, SuFI provides a blueprint for resource-constrained health systems, demonstrating how structured, context-sensitive, and policy-aligned models can drive sustainable medical innovation.
The authors gratefully acknowledge Team UnivLabs and APAR Health for their contributions in conceptualizing and advancing the SuFI initiative.
1. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. International Journal of Obstetric Anesthesia. 2016;25:75–78. https://doi.org/10.1016/j.ijoa.2015.09.006
Crossref
2. Feussner H, Wilhelm D, Navab N, Kranzfelder M, Schneider A. Surgineering: a new type of collaboration among surgeons and engineers. International Journal of Computer Assisted Radiology and Surgery. 2019;14(2):187–90. https://doi.org/10.1007/s11548-018-1862-9. PMID:30560556
Crossref
3. Yoda T. The effect of collaborative relationship between medical doctors and engineers on the productivity of developing medical devices. RD Management. 2016;46(S1):234–45. https://doi.org/10.1111/radm.12161
4. Heller CA, Michelassi F. Forging successful interdisciplinary research collaborations: a nationwide survey of departments of surgery. Surgery. 2012;151(4):502–509. https://doi.org/10.1016/j.surg.2011.09.034
Crossref
5. Yock, Paul Zenios, Stefanos Makower, Josh Brinton, Todd Kumar, Uday Watkins, F. Denend, Lyn Krummel, Thomas Kurihara, Christine. (2015). Biodesign: The Process of Innovating Medical Technologies. 10.1017/CBO9781316095843
Crossref
6. Stanford Biodesign. Biodesign Student Guide: Needs Finding and Innovation Process. Stanford University; 2017
7. Radjou N, Prabhu J, Ahuja S. Jugaad Innovation: Think Frugal, Be Flexible, Generate Breakthrough Growth. San Francisco: Jossey-Bass; 2012
8. Honavar S. G. (2019). “Indovation” in ophthalmology - The potential power of frugal innovations. Indian Journal of Ophthalmology, 67(4), 447–448. https://doi.org/10.4103/ijo.IJO_550_19
Crossref PubMed PMC
9. Schuster, Tassilo. (2014). Govindarajan, V., Trimble, C., Reverse Innovation: Create Far from Home, Win Everywhere, Harvard Business Review Press, 2012. Management International Review. 54. 277–282. 10.1007/s11575-013-0189-9
Crossref
10. Atal Innovation Mission. About AIM [Internet]. New Delhi: NITI Aayog; [cited 2025 Aug 27]. Available from: https://aim.gov.in/about-aim.php
11. Biotechnology Industry Research Assistance Council (BIRAC). BioNEST [Internet]. New Delhi: BIRAC; [cited 2025 Aug 27]. Available from: https://www.birac.nic.in/desc_new.php?id=80
12. Indian Council of Medical Research. ICMR/DHR Policy on Biomedical Innovation Entrepreneurship. New Delhi: ICMR; 2022 [cited 2025 Aug 27]. Available from: https://www.icmr.gov.in/
13. Ministry of Health and Family Welfare. Medical Device Rules (MDR) 2017. New Delhi: Government of India Gazette; 2017
14. Startup India. Intellectual Property Rights benefits for startups [Internet]. Government of India; [cited 2025 Aug 27]. Available from: https://www.startupindia.gov.in/
15. van Velzen, M., Boru, A., Sarton, E., de Beaufort, A. J. (2024). Design thinking in medical education to tackle real world healthcare problems: The MasterMinds Challenge. Medical Teacher, 46(5), 611–613. https://doi.org/10.1080/0142159X.2024.2305713
Crossref PubMed
16. Niccum BA, Sarker A, Wolf SJ, Trowbridge MJ. Innovation and entrepreneurship programs in US medical education: a landscape review and thematic analysis. Medical Education Online. 2017;22(1):1360722. https://doi.org/10.1080/10872981.2017.1360722
Crossref PubMed PMC
17. Sharma D, Agarwal P, Yadav SK. Beyond the Scalpel: Is It Time to Make Innovation Learning Part of UG and PG Surgical Education? Indian Journal of Surgery. 2024;86:1093–5
Crossref
18. National Innovation Foundation – India. About NIF [Internet]. Ahmedabad: NIF; [cited 2025 Aug 27]. Available from: https://nif.org.in/
19. Gupta A. Innovations for the poor by the poor. Honey Bee. 2006;17(4):5–10
20. Department of Biotechnology (DBT). Handbook on Biodesign for Med-Tech Innovations. New Delhi: Government of India; 2021
21. Dawkins B, Aruparayil N, Ensor T, et al. Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India. PLoS One. 2022;17(8):e0271559. https://doi.org/10.1371/journal.pone.0271559
Crossref PubMed PMC
22. Webb, M. M., Bridges, P., Aruparayil, N., Chugh, C., Beacon, T., Singh, T., Sawhney, S. S., Bains, L., Hall, R., Jayne, D., Gnanaraj, J., Mishra, A., Culmer, P. R. (2022). The RAIS Device for Global Surgery: Using a Participatory Design Approach to Navigate the Translational Pathway to Clinical Use. IEEE Journal of Translational Engineering in Health and Medicine, 10, 3700212. https://doi.org/10.1109/JTEHM.2022.3177313
Crossref PubMed PMC
23. Doshi, Rajiv Yock, Paul Kumar, Uday Mairal, Anurag Kurihara, Christine Singh, Sandeep Bhargava, Balram. (2016). Stanford-India Biodesign: Outcomes from an eight year collaboration with the government of India to promote medical technology innovation in India. Annals of Global Health. 82. 454. 10.1016/j.aogh.2016.04.250
Crossref
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Education for Health | Volume 38, No. 4, October-December 2025