Protocols and Set-Ups

Within the larger context of commodified medical practice and compromised standards in under-resourced government services, premier government medical colleges are reputed to be the enclaves where ‘scientific medicine’ is practised. In the past decade, these have begun to admit a significant proportion of less socially privileged students. This chapter examines the contribution to the production of knowledge of obstetricians graduating from two such institutions who have returned to the ‘periphery’. These students approach medical education without the cultural resources to engage with medicine as a knowledge system. The focus is on instilling discipline and imparting skill in technique, which students imbibe as protocols, without acquiring a broader understanding of the field, an affinity for research, or an exposure to evidence-based practice. Unable to visualize their practice as a conscious engagement with their context, they define their adaptations as violations of the ‘protocolic practice’, undermining their self-assessment as practitioners of science.