Abstract
The importance of social determinants on health has been consistently highlighted in public health debates. However, this has not been the case in the sphere of medical or public health education. This review paper aims to discuss the status and problems associated with teaching social and behavioural sciences in medicine and public health programs in India. A country like India requires a medical / public health manpower that is responsive to social reality and sensitive to the role of social determinants in shaping health and health-inequity. Although social and behavioural sciences form a part of the curriculum in undergraduate and postgraduate medical, public health and health management programs, the space made available for such are limited. The problem rests on the institutional structures through which these programs are offered and on issues such as the way medicine is practiced vis-a-vis the patient and overriding emphasis on doctors in professional hierarchy in public health practice and research. In most medical institutions social and behavioural sciences (SBSs) are taught by people with no formal training in these disciplines. Correspondingly, the priority given to students is too low. Absence of efforts to make a tangible connection between social science learning and medical / public health practice, lack of well-defined career opportunities and professional dominance of mainstream medical disciplines over others are some of the reasons for this low priority. Problems also reside in the degree of heterogeneity in content, vastness of scope, diversity in perspectives within each discipline, and a lack of standardized curriculum and reading materials.
Highlights
The long drawn debate on the questionable contribution of medicine in improving human health may stand unsettled but it underwrote the crucial role of non-medical factors in shaping health or lack of it of a population (Colgrove, 2002; Link & Phelan, 2002)
In the foregoing pages we have attempted to draw the attention of public health and medical educationists to social and behavioural sciences (SBSs) in public health and medical education
In medical and public health education SBSs teaching is yet to come of age
Summary
The long drawn debate on the questionable contribution of medicine in improving human health may stand unsettled but it underwrote the crucial role of non-medical factors in shaping health or lack of it of a population (Colgrove, 2002; Link & Phelan, 2002). Michael Marmot, one of the principal architects behind the Commission has noted that “treating existing disease is urgent and will always receive high priority but should not be to the exclusion of taking action on the underlying social determinants of health” (2005). This importance accorded in the policy sphere has not been reflected meaningfully in medical education globally. In mainstream social and behavioural sciences schools different disciplines maintain independent existence and identity. This is a necessity given the sharp differences in terms of content, theory, methodology and pedagogy. In this perspective the course remains at the critique level of the system from a political economic perspective (Jawaharlal Nehru University, n.d)
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