Faculty of Arts and Sciences, Department of the History of Science, Harvard University, Cambridge, Massachusetts, USA.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Sociol Health Illn. 2024 Jun;46(5):831-848. doi: 10.1111/1467-9566.13696. Epub 2023 Aug 1.
In 1950, the leaders of independent India celebrated the contributions that surgeons could make to modernising India. Surgeons, however, faced a difficult choice. Some wanted to invest in generalist surgeons to make basic surgical care available to all Indians. Others wanted to invest in specialists to ensure that India participated in cutting-edge surgical research and care. These debates shaped the emergence of cardiac surgery at two centres: the Christian Medical College in Vellore and the King Edward Memorial Hospital in Bombay. CMC invested in thoracic surgery in the 1940s to offer new treatments for tuberculosis. This gave surgeons the opportunity to explore new techniques of cardiac surgery. Debate quickly emerged about whether investments in cardiology and cardiac surgery made sense. In the end, the specialities were supported in order to attract paying patients. A parallel controversy took place at KEM, where the dean debated the Bombay Municipal Corporation about the role of surgical research at a public hospital. The Rockefeller Foundation influenced both sites, offering financial support if they adopted an American model of full-time faculty clinician-researchers. The two case studies reveal how unusual dynamics could contribute to the establishment of new medical specialities in India.
1950 年，独立后的印度领导人庆祝外科医生为印度现代化所做的贡献。然而，外科医生面临着一个艰难的选择。一些人希望投资培养通科医生，为所有印度人提供基本的外科护理。另一些人则希望投资培养专家，以确保印度参与尖端的外科研究和护理。这些争论塑造了两家医院的心脏外科的出现：位于维洛尔的基督教医学院和位于孟买的爱德华国王纪念医院。CMC 在 20 世纪 40 年代投资于胸外科，为治疗结核病提供新的治疗方法。这为外科医生提供了探索心脏外科新技术的机会。很快就出现了关于心脏病学和心脏外科技能投资是否合理的争论。最终，为了吸引付费病人，这些专业得到了支持。在 KEM，也发生了一场平行的争论，院长与孟买市政公司就公立医院的外科研究角色展开了争论。洛克菲勒基金会影响了这两个地点，如果他们采用全职教师临床医生-研究人员的美国模式，基金会将提供财政支持。这两个案例研究揭示了不寻常的动态如何有助于在印度建立新的医学专业。
