Fifty-six-year-old Dr Rajagopalan grew up in Tamil Nadu, southern India but has spent the last 28 years abroad, mainly in the US.

He is a specialist in critical care medicine and interventional pulmonary.

His return to India was prompted by his daughter, who wanted to pursue her own medical career there.

So, returning to India, Rajagopalan answered the call of Dr Devi Shetty, the founder of the Narayana Hrudayalaya health city, who has always had a vision to upgrade the clinical and practical skills of nurses. His aspiration was to bring them close to the level of a junior doctor but with just one year of training as opposed to six.

Forty-five nurses have taken on the challenge of participating in the new 'nurse intensivist' course led by Rajagopalan.

The course requires a lot of studying, which is difficult for many of the nurses - particularly those with children and family obligations that also place demands on their time.

And for someone like Rajagopalan, who is used to working in well-resourced teaching hospitals in the US with nurses who are highly educated and motivated, there are plenty of challenges. Many of the nurses are poorly educated and English is not their first language.

Returning to India after so many years abroad has not been easy for Rajagopalan. It is a culture shock and even simple things like the Indian attitude to timekeeping - a fairly loose one - often means frustrating waits for nurses to attend sessions.

Despite the challenges, after six months some of the nurses are progressing well and Rajagopalan is confident that at the end of the year he will end up with 10 to 14 good nurse intensivists capable of meeting his rigorous standards.