Special Treatment

The All India Institute of Medical Sciences (AIIMS) is iconic in the landscape of Indian healthcare. Established in the early years of independence, this enormous public teaching hospital rapidly gained fame for the high-quality treatment it offered at a nominal cost; at present, an average of ten thousand patients pass through the outpatient department each day. With its notorious medical program acceptance rate of less than 0.01%, AIIMS also sits at the apex of Indian medical education. To be trained as a doctor here is to be considered the best.

In what way does this enduring reputation of excellence shape the institution's ethos? How does elite medical education sustain India's social hierarchies and the health inequalities entrenched within? In the first-ever ethnography of AIIMS, Anna Ruddock considers prestige as a byproduct of norms attached to ambition, aspiration, caste, and class in modern India, and illustrates how the institution's reputation affects its students' present experiences and future career choices. Ruddock untangles the threads of intellectual exceptionalism, social and power stratification, and health inequality that are woven into the health care taught and provided at AIIMS, asking what is lost when medicine is used not as a social equalizer but as a means to cultivate and maintain prestige.

"Ruddock's description of the overcrowded out-patient departments at AIIMS; and the common (though not exclusive) attitude of the faculty and students that patients are 'interesting cases', with little understanding of the social context of disease and healing, will be familiar to medical students from any government college in the country... A single institution cannot be expected to change the medical culture in the entire country, as Ruddock says, yet it is sad that AIIMS has not used its privileged position to show the way."—George Thomas, The India Forum

"Special Treatment is a valuable, much-needed addition to the sparse body of ethnographic work on elite institutions of professional education. Anna Ruddock has crafted a sensitive and sympathetic—yet nuanced and critical—account of how the best-regarded doctors in the country are trained at the All India Institute of Medical Sciences. This book overcomes the daunting difficulties of studying a powerful 'institution of excellence' and illuminates its functioning without descending into hagiography."—Satish Deshpande, Delhi University

"Who is medical education really for? What do medical schools actually teach? This quietly devastating study of India's 'best' medical school, and the 'best' students who attend it, reveals how good intentions and entrenched ideas about value and merit combine to produce fragmented, expensive, ill-distributed and disrespectfully delivered medical care. Special Treatment illuminates troubling patterns that extend well beyond contemporary India."—Claire Wendland, University of Wisconsin-Madison