Public Health Ethics in the Medical College Curriculum: Challenges and Opportunities

This chapter offers a historical background of medical education in India and the place of ethics within it. It traces the journey of training of the “medical graduate” in healthcare: from uniformity of competence to the social role of the physician and the evolution of aims of the current undergraduate medical education programme. There are several current challenges in medical education that run counter to the social role of the physician: commercialization of medical education, privatization of medical education, the hidden curriculum, basic degree vs. the basic doctor, basic doctor vs. the specialist, skill based vs. education based, technical vs. humanistic skills, cure vs. cause, and consequences vs. social determinants. The case of St. John’s Medical College in Bangalore, with its historical institutional inspiration, and efforts to reach underserved areas, the evolution of the 2-year compulsory rural placement scheme on graduation, the pioneering effort at the introduction of medical ethics, and the community health outreach efforts have been highlighted. The outreach activities serve as a good stimulus for public health ethics as also public health research at the undergraduate and post-graduate levels. Challenges and opportunities exist in the conventional medical college setup and within the present medical curriculum in integrating public health ethics.