St. John’s Medical College, Bangalore has the proud status of being the ONLY catholic medical college in the country. Having studied there for a 8 years and having worked there for two years, I feel that the college has failed to live up to standards in some vital areas.
The medical college selects students based on merit and religion. The college is governed by the Catholic Bishops Council of India (CBCI), who demand reservation and other benefits for the dalit converts to Christianity. The CBCI itself does not practice this in its medical college, and most of its students are élite, city bred, Mangaloreans, Goans or Keralites. Even the little representation at the student level completely breaks down at the level of heads of departments, senior faculty or management. The non Catholics in St. Johns are almost 100% brahmin – this, from a college that demands reservation in other non-Catholic bodies, is hypocritical.
Secondly, the medical college is directly linked to a tertiary hospital. Other than tokenisms, the medical students are not exposed to the reality of the Indian situation. Mugalur, the rural exposure centre could hardly qualify as representative of rural India. Students who come from elitist backgrounds are trained in the tertiary hospital and have no concept of primary or secondary care. If Johnite graduates were placed in a primary care setting, they would not be able to cope and definitely would not be able to manage cases like diarrhea, TB, malaria, HIV, vaccine preventable diseases, antenatal, intranatal or post natal care. This is one of the major reasons for Johnites hesitating to take up the two year rural bond – an inability to manage at the peripheries without the technology that they have been trained with. St. John’s claim that many of its students work in rural areas, is mainly met by the religious nuns who constitute about 25% of the intake every year. The rest of the students have profiles very similar to a private commercial medical colleges.
The majority of alumni of St. John’s are based in the US or UK and feel that Johnites need not know about primary care and that is the role of ‘government hospitals’. The Johnites have a clear segregation about what products of their medical college should know compared to what products of a government medical college should know. This segregation is artificial, and the alumni would do well to read Indian medical college guidelines before they apply differential standards and expectations.
Neither the management nor faculty nor governing board of St. Johns is oriented to the social determinants of health. Again this is seen as a ‘government’ prerogative. Medical doctors who are anyway from a city based, ‘upper class/caste’, elitist background, directly move out of the country for a degree abroad and therefore have absolutely no exposure to issues like poverty, poor sanitation, low education and caste discrimination. They do not understand the issues related to accessibility, availability, affordability and quality of primary health care. Neither do they know, nor do they care. As one alumni lucidly put it “I care a rat’s arse about the poor in India”
The most shocking aspect of the training at St. Johns is that many of the graduating doctors do not know how to conduct a delivery. Again the alumni feel this is the responsibility of the Obstetrician. The alumni have no concept of the shortage of doctors in India and the importance of every doctor at least being trained in conducting deliveries. This apathy in a country with one of the highest maternal deaths shows how disconnected medical training is from the health needs of the people.
There is a collusion of silence about the problems of medical training at St. Johns. Neither the alumni nor existing faculty nor governing board questions these basic issues. The college does not have a grievance redressal mechanism for employees, students or patients. There is no sexual harassment policy in the college. Fund flow within the college is not accounted for and is non transparent. Some Johnites in favour with the management receive promotions and benefits that other more hard-working faculty are denied.
There is a need for an external review of St. Johns that goes beyond the token accreditation that places St. Johns in the top 10 medical colleges of the country. Either that, or it should stop being given more credit than is due to it and St. Johns should call itself a ‘for profit medical college’ rather than one which ‘provides care to the medically unreached, with a commitment to social justice’.