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Specialists or Generalists: Debates About the Development of Cardiac Surgery in India, 1948-1968


· David Jones Harvard University (Science Center 371, 1 Oxford St., Cambridge, MA, United States of America)


07/26 | 16:10-16:30 UTC+2/CEST


Speaking at the Association of Surgeons of India in 1950, Minister for Health Amrit Kaur described the contributions that surgeons could make to the modernization of independent India. Surgeons, however, faced a difficult choice as they worked to develop their profession. Some wanted to invest resources in generalist surgeons in hopes of making basic surgical care available to all Indians. Others wanted to invest in specialists to ensure that India could participate in cutting-edge surgical research and care. These debates shaped the emergence of cardiac surgery in India at two early centers: the Christian Medical College in Vellore and the King Edward Memorial Hospital in Bombay. CMC had a proud surgical history, having made important contributions to the management of vaginal fistulae and leprosy. Hospital leadership 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 for CMC. 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 appeal of the modern proved irresistible. Both institutions invested the resources needed to make cardiac surgery possible, culminating in the first successful open-heart surgery in India, at CMC in July 1961, and the first heart transplant (unsuccessful) at KEM in February 1968.