Vellore: At the Christian Medical College (CMC) in Vellore, Tamil Nadu, a rural stint after graduation isn’t an option that can be brush-ed aside. Two-year service in the villages is mandatory, and students have to sign up for it before they can join the institution. They also have to serve at hospitals in remote areas during their first three years in the college.
Anand Zachariah, vice-principal for undergraduate medical education at CMC, says this kind of exposure “sensitizes students to the local problems”. The hospitals serve as a huge “training resource” for students.
This kind of training is possible because of CMC’s unique structure. The college has a relationship with 225 Christian mission hospitals, all in remote and rural areas.
This network, the students say, gives them the kind of training no other medical school can offer.
“I think the level of exposure here…is not something that other colleges can compete with,” says Srujan Sharma, 22, an undergraduate student at CMC from Hyderabad. “We are sent to hospitals around the country...mission hospitals where we actually see grass-roots medicine being practised. This is not something that I have heard of in other colleges.”
CMC’s admission system reflects the school’s relationship with the church. The college admits only 60 students a year for its undergraduate programme; it boasts a student-teacher ratio of 12:1. Of the 60 seats, 50 are reserved for Christian minorities; and of the remaining seats, two are reserved for the Scheduled Caste and Scheduled Tribe categories, and one is reserved for a government nominee.
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The Christian Medical College Vellore Association, a registered society formed by 60 churches across the country, manages the medical school and the hospital associated with it.
The churches nominate eligible students for training. The students, in turn, sign a legal document promising two years of rural work after graduation.
Students in the open category were earlier excluded from the mandatory two-year rural service, but they too have to agree to the stint now.
“If you work in a rural area, you have to be multi-competent; you can’t just be a specialist... you have to be able to handle a range of problems, you have to be clinically confident and you have to work within the investigations and facilities available there,” says Zachariah.
Fair treatment: Around 70% of the alumni of Christian Medical College, Vellore, are working in India, 80% of them in remote areas, according to the school’s statistics. Babu Ponnapan / Mint
Around 70% of CMC’s alumni are working in India, 80% of them in remote areas, according to statistics provided by the school.
One of the most striking features of this medical school, 7km from the heart of Vellore, is the low tuition fee. Each student pays around Rs3,000 a year. A part of the hospital’s income is also diverted to the school.
The hospital also subsidizes treatment, charging the poor 50% of actual expenses
Of its total income of Rs252.71 crore in 2007-08, Rs49.88 crore went towards treatment subsidies for the poor and Rs26.85 crore towards education subsidies—an average of Rs4.68 lakh per student.
George Mathew, CMC’s principal, says the school’s values come from Ida Sophia Scudder, an American missionary and doctor who, moved by a lack of medical facilities for women in Vellore a century ago, decided to set up a hospital-cum-medical training institute.
Scudder was in India to take care of her ailing mother—her parents were Christian missionaries. During her stay, she was witness to women dying during childbirth owing to a lack of medical attention. The local culture barred male doctors—including Scudder’s father—from attending to pregnant women. This inspired her to study medicine in the US and return to Vellore, where she set up a single-bed clinic.
Until the 1950s, CMC was closely associated with foreign churches and voluntary agencies that contributed funds. Then, the institution was transferred into the hands of Indian churches and voluntary bodies.
“From then on, the attempt has been to be self-sustaining because we knew that external fund source(s) would become less and less. Now, we are fully self-sustaining,” says Mathew.
In an era when medical costs can sometimes be exorbitant, CMC manages to provide subsidized healthcare to a significant percentage of its patients. Mathew attributes this to four factors: a large number of patients, cost-cutting, no unnecessary medical investigations and modest salaries for staff.
The students say the faculty is always accessible. “We get a lot of attention (from the faculty members),” says Nalini Newbigging, a 19-year-old student.
“The teachers live on campus, so we can interact with them any time we want to,” says another student, Anna Paul, also 19.
It’s the “foster family” concept at work. Each faculty member takes care of two-three undergraduate students and the student becomes a “foster child” of that faculty member.
“Each one of us in every batch...we are actually taken care of by the staff like we are their own children,” says Aleena Jana, who will graduate next year.
Many of the faculty are former CMC students themselves. John Jude, associate professor in the department of microbiology, decided to stay back at CMC after his postgraduation because of the “work ethos”.
“There were no vacancies when I passed out in 1999, but (I) came back in 2004. There is job satisfaction here. What we take for granted here are considered great outside; what we consider routine and normal here is very difficult to get down elsewhere. I can say this because I have worked in other places as well,” he says.