Medical Sociology: Some Problems for Study

C Parvathamma
S Sharadamma
In India till now very little work has been done in the field of medical sociology, The social scientist so far
has held no place in the field of medicine in our country.
In the Western countries, on the contrary, phenomenal growth of knowledge is noticed in every field that has
a bearing on health problems. Many sociologists have done research on health problems independently and also in
collaboration with medical scientists. Further, the tools of social science are being increasingly applied to analyse the
medical social structure in the West.
In this essay an attempt is made to discuss some of the important problems of approach involved in the study
of medical sociology.

SOME Western sociologists, notably accessible to its social stratum. Now he lasting problems in medicine". An as-
Merton and Kendall have suggest- is enrolled as a member of a new cul- piring medical student's mental equip-
ed a useful list of substantive areas of ture-setting, namely, the medical-setting ment, in other words, should be such
sociological research in medicine. They consisting of its complex institutions, that he would become a scientist of
are: Social Etiology and Ecology of schools hospitals and clinics, its per- precision while solving a problem, and
Disease, Social Components in Therapy sonnel, its standards and codes, its re- an artist of immense skill while hand-
and Rehabilitation, Medicine as a So- cruitment policies, its relation with ling a sick person. The other and more
cial Institution, and Sociology of Medi- public and its mechanisms of sociability important aspect of the problem is how
cal Education.1 The area chosen for a and control. Here socialization of re- to select students coming from differ-
sociological study of medical under- cruits consists of induction into the ent social backgrounds who could hold
graduates in Mysore comes under the common core of the profession, over a a promise of versatility as far as medi-
last category (See Section II below). period of five-and-a-half years. cal education is concerned. Till now
It is important to substantiate fur- medical educators have paid but little
Medical education equips a student
ther how a sociological investigation of not only with the existing body of me- attention to this aspect of the problem.
the 'medical universe' will unfold seve- dical knowledge but also with informal
The concept of medicine and health
ral interesting problems. A student's attitudes and patterns of thought. Fur-
care as a social institution enlarges the
choice of medical career, his inclina- ther it makes him conversant with the
scope of the sociological study of me-
tion towards specialization, his process modern technology and scientific out-
dical education. The medical student
of learning and his reliance on teach- look in medicine. Basic medical values,
enjoys a particular status. He is en-
ing, the mode of his interaction with important parts of medical culture are
gaged in a complex array of social re-
the faculty members, his method of ac- acquired by the students during this
lations with his fellow students and the
quiring values of medical culture, and period of professional training. "Stud-
faculty, with other health professionals,
finally, his emergence as a physician ents are expected to develop the abili-
technicians, and with patients. These
offer interesting areas for sociological ty to live up to the norm of 'detached
people too occupy definite positions and
research. concern'; they are taught how to be play well defined roles. Thus the stu-
interested in a patient without becom- dent is involved in an organised net-
Who Chooses a Medical Career? ing emotionally involved". 3 Blumgart work of role-relationships. The social
Further, a sociological study will calls the profession of medicine 'a structure of the medical school helps
throw light as to who chooses a medical house of many mansions', embodying him to learn these patterned social re-
career and why? From which socio- numerous professions within itself, with lationships. Besides, he learns to per-
economic and professional group does different types of persons working in form his many roles as healer, 'chief
he come? What are the mechanisms different capacities. of a 'unit', Head of a Department, medi-
for generating and nurturing medical cal researcher, educator, member of a
ambition? Does a student change over Selecting the Right Students
professional society, and also as a mem-
the five-and-a-half years he spends in Here arise some further problems of ber of his local community.
a medical school? Are there students interest to a medical educator as well
untouched by the medical setting? as a sociologist. Medical educators are Merton observes that "medical
What are the modes of adaptation and confronted with the most important schools act as guardians of values basic
which social strata find it a smooth problem of selecting a student "who to the effective practice of medicine.
process? Does the medical school pre- will contribute to medical science as an Their job is enabling the medical man
pare student-physicians for their insti- art, who will be actively interested in to live up to the expectations of the
tutional role inculcating values basic the progress of medical research, and professional role long after he has left
to its culture? These and many more will be able to tackle successfully ever- their sustaining environment."5
problems are of immense interest to a
social scientist. Table 1 : Sex and Classwise Distribution of Student Population
The mind of an entrant to the me-
dical school is yet to be moulded and
his personality to be developed. He is
partially socialised; his family, as 'a
major transmission belt for the diffu-
sion of cultural standards',2 has trans-
mitted only a portion of the culture
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 December 4, 1965 THE ECONOMIC WEEKLY

In the held of medical education The complex of the medical inslitu- The student population is heterogen-
much of the research done by Western tions is spaciously situated right in the eous in the sense it consists of young
sociologisls has concerned itself with heart of the well-planned city. There men and women drawn from different
the generalised effects of medical edu- is the Medical College occupying an socio-economic, linguistic, religious and
cation on the student. Mary Jean Hunt- area of 82.000 sq ft affiliated in the cultural backgrounds. From the econo-
ingion has shown that medical students University of Mysore, the Government: mic point of view, the students can be
gradually develop a "professional self- College of Indian Medicine (Ayurvedic said to be drawn 55 per cent from low
image" in the course of their medical and Unani) and the various hospitals income group, 11 per cent from mid-
naming. R C Fox says that the medi- attached in the Colleges. dle income group, and 12 per cent
cal student barns and assimilates the Until I 930, the medical courses were from high income group. The details
trails a student will need to play the held in Bangalore where 30 students are given in Table 3.
role of physician once he has left the used to be admitted every year to the The high percentage (55 per cent) of
school. She says that students are the M.B B S class. From 1930 onwards the students from low income group be-
roughly trained to deal with the many medical courses have been in Mysore. lies the popular notion that medical
areas of uncertainly and in develop Nowadays, the number of students has education is the privilege of the rich
'detached concern.' Decker and others increased greally in the Medical Col- or that only the sons and daughters of
are particularly concerned with the le- lege. For the last 3 years the number the rich can afford medical education
vel and direction of academic effort of has ranged between 200 and 220. Du- which is admittedly expensive. The
medical students. Naihanson, compar- ring 1964-65 academic year, there were high percentage of medical students
ing interviews of freshmen with those 978 .students; 752 men and 226 women. from low income group has become
of senior medical students, says that Sex and classwise distribution of the possible because of several factors, the
freshmen are oriented to The interest medical student population is given in Government's liberal policy and incen-
of the patient, while seniors emphasize Table 1. tives in the form of scholarships, fee
the need for preseiving the solidarity concessions and loans have attracted
and protecting the interest of the pro- Ther are 152 teachers of various many students from poor families
fessional group. ranks on the reaching staff of the Col- who would, otherwise, not have
lege. This gives a student-teacher ratio turned to medical education. The
These and several other problems arc of 6 : 1 . The distribution of the teach-
'liberalization' of admissions by the in-
there. Mysore is a semi-iirhan cnmmu- ing staff according to sex, designation
troduction of the 'quota system" for
nity and the student population is and the courses they Leach is given in
different economic and caste-groups
drawn from different religious, Linguis- Table 2.
has enabled many students to enter
lie, caste and socio-economic groups.
A study of such medical undergraduates
tes in Mysore city will certainly high-
light several interesting problems. Sys-
tematic collection of data so as to give
sociological dimensions to the study of
the medical universe is thus the first
step towards building up medical so
ciology in India to-day.

I I
In January I965. a sociological study
of the medical undergraduates in My-
sore was undertaken The study is con-
fined to the undergraduates admitted
to the pre-professional course leading,
to M R B S degree under the 'New
Scheme' which has been in operation
since 1959

Table 2: Distribution of Teaching Staff by Sex, Designation and Courses Taught

THE ECONOMIC WEEKLY
medical institutions. In the absence
of the 'quota system' students belong-
ing to low economic groups or certain
relatively backward caste-groups would
have been elbowed out of the 'compe-
tition' for admission by the other stu-
dents, not necessarily on the strength
of intrinsic merit, but often on the
strength of wealth,, opportunities for
development, and significantly better
family background and upbringing.
Further, the low income group students
dents are enabled to be in the medi-
cal colleges because of their parents'
preparedness and determination to mus-
ter all possible resources and make all
possible sacrifices to see their sons or
daughters through the medical courses.
It is possible to argue that the poor
parents look upon their wards' educa-
tion as an investment which will bring
dividends in future and raise the
standard of the entire families. What-
ever the reasons prompting the parents,
they do encourage and help their wards
through the medical courses. An -.maly-
sis of our recorded data supports the
above observations.
From the point of view of the occu-
pational background of the parents, 11
per cent students come from the fami-
lies of physicians, 6 per cent from the
families of teachers, 6 per cent from .
Table 4: Regionwise Distribution of Students
Table 5: Castewise Distribution of Students
families of clerks, 11 per cent from
business families, and 36 per cent from
agricultural families. The remaining 30
per cent come from the families of
engineers, lawyers, executives,, artisans
and those serving in the defence forces,
the police department, railways and
public works department.
From the point of view of regions
to which they belong, out of the 978
students, 970 are Indians and 8 are
foreigners. Of the foreign students,
2 tome from Nepal, 2 from Malaya, 2
from Africa, 1 from Iran and 1 from
Ceylon; of these some are 'nominees'
of the Government of India and some
have come under the Colombo Plan.
Of the 970 Indian students, 722 are
from Mysore State, 245 from Kerala
and 3 from Goa. Table 4 gives the re-
gionwise distribution of the Medical
College students.
As the students come from different
regions, they also speak different lan-
guages. The group consists of students
speaking English, Kannada, Telugu,
Tamil, Malayalam, Hindi, Urdu and
dialects such as Tulu and Konkani.
From the point of view of religious
and caste backgrounds, setting aside the
8 foreign students, 5 per cent of the
students are Muslim, 3 per cent are
Christian, while the remaining may be
December 4, 1965
broadly said to be Hindu. Among the
Hindus 25 per cent belong to various
subcastes of Brahmins, 7 per cent are
Lingayats who constitute a dominant
non-Brahmin Saivite group in Mysore
Slate, 13 per cent are Okkaligas who
are another dominant nun-Brahmin
group of the State. Twelve per rent of
the students come from Scheduled
Castes and Scheduled Tribes. 7 per cent
are Bants mostly coming from South
Canara. While 3 per cent come from
artisan castes like Carpenter, Black-
smith and Goldsmith, the remaining
23 per cent come from Banajiga, Barber,
Coorgi, Kuruba, Valmiki and Yadava
caste-groups (see Table 5).
Notes
I Kendall, P, and K K Menon, 1938.
PP 321-22.
Merton, R K 1959, P 147.
Fox, R C, 1957, pp 207-43.
Wahi. P N , 1963. p 85.
Corwin. 1961, p 605.
References
(1) Becker and others, 1961: "Boys in
White", University of Chicago
Press.
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