When I joined Government Dental College, Thiruvananthapuram, in 2000, as an 18-year-old, I arrived with more confidence than clarity. I came from Government Women’s College, where politics was everywhere, in classrooms, corridors, and canteens. Like many of my peers, I leaned towards left politics, without having even a rudimentary understanding of the ideology. But I had grown up believing one thing quite firmly: in a democracy, being apolitical was not an option.

So one of the first things I did on the new campus was to ask about the college union. To my utter disbelief, there wasn’t one. Instead, there was a non-union organization called Students Against Politics in Campus (SAPIC). The name itself felt like a puzzle. Against politics… in a public institution? I was told there had been conflicts and ideological clashes in the past, but the details were unclear. The conclusion of the past turmoil, however, was that politics was best kept out.

I did not quite know what to make of it, and without much thought, I inadvertently drifted towards the Government Medical College student community within the campus, where politics, messy and argumentative, was at least visible. Looking back, what strikes me now is that those who described themselves as “apolitical” were not without political views. They had strong opinions about ideology and about what student politics does to institutions. But instead of engaging with disagreement, they chose withdrawal.

Over time, through my experiences as a student and later as a teacher, I have recognized a pattern in professional training spaces, particularly dental colleges. Politics, especially anything resembling socialist, anti-caste, or gender justice, was treated as excessive, even inappropriate. Doctors, we were told, did not have caste or gender, and we had to be objective and not political. Compassion was acceptable, but only within certain limits. For instance, illness and poverty can be acknowledged; however, they should be regarded with a certain degree of detachment, and without examining their roots or distribution. Fundamental questions of caste, gender, and structural inequality were dismissed as mere rhetoric, while affirmative action was relentlessly mocked in closed circles and cruelly reduced to a question of “merit.”

Merit, in turn, was spoken of as something inherent that is pure, self-evident, and untouched by history. Something one simply had or did not have. Those who succeeded, measured by metrics already stacked in favor of dominant groups, were seen as deserving, while those who did not were expected to accept their place quietly. What remained unacknowledged was how uneven the starting points were, including the access to English education, confidence, and social networks, all of which shaped merit as measured by the dominant metric.

Some of us from backward social sections would occasionally meet, hesitantly, to speak about feeling out of place, about being judged, or about not quite belonging. There was anger too, especially when reservations were mocked, or caste was dismissed as irrelevant. But we did not yet have the language to name what we were experiencing, and so we learned to stay quiet, to adjust, and not draw attention to ourselves. I remember a female student who challenged an evaluation error and paid for it with delay, lost time, and vicious institutional pushback. Internal marks and attendance became tools of control, and contestation came at a cost. None of us stood by her. We did not even contemplate an organized resistance for her, or on any issue of significance, for that matter. We were appallingly well-conditioned to quiet, collective submission and occasional lamenting. Exclusion, I realize now, is rarely loud. It operates quietly through what is normalized, what is ridiculed, and what remains unsaid. Caste and gender, mediated through professional power, danced all around us, but we were driven into believing that speaking about them or resisting them was unprofessional.

In that environment, being “political” was not just unusual; it was something to be contained. Professional education, in effect, was teaching us how to look away. A few of us naively and confidently wore the Kerala brand of caste and gender agnostic politics like a badge of honour, without quite understanding what it meant to be politically aware professionals in a democracy.

Learning to name the discomfort

It would take me another fifteen years to find the language for what I had only dimly sensed as a first-year student. During my doctoral training at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, I encountered a very different kind of classroom under Professor T. K. Sundari Ravindran.

There was an energy in that space that was not just intellectual, but moral, the kind that unsettles you and makes you more alert to the ways of the human world. Discussions moved beyond diseases and health systems into caste, gender, labour, rights, and everyday life. Conversations flowed from films to news to policy without losing their thread. Policies were no longer abstract and technical; they were lived and political.

What became clear was that these questions did not sit outside health. They were central to it. Who falls sick, who receives care, who is heard, and who is dismissed are not accidents; they are shaped by power. Once you begin to see that, it becomes difficult to think of health as anything but political.

We were asked to read, argue, and sit with discomfort. At times, we were reminded quietly that we were politically illiterate. It felt less like a reprimand than an invitation to take our education seriously. We knew how to treat disease, but not how to understand the worlds our patients came from. We had technical knowledge, but little ability to read power. That gap mattered. Slowly, almost without noticing, something shifted not just in what I knew, but in how I saw. It made me political, perhaps for the first time in any meaningful sense.

How does this “apoliticism” reflect in the dental profession?

If it took a doctoral classroom to make me even partially literate in the politics of health, what does that say about how we train our professionals? The gap is not incidental; it is foundational. Professional education in India, particularly in medicine and dentistry, has been constructed as apolitical. Students are trained to master bodies, not societies; to diagnose disease, but not to read the conditions that produce it. The ideal professional is imagined as objective, detached, and technically competent, with politics treated as something external to science.

My doctoral work on dental education in Kerala traced how the sector expanded rapidly through private investment after years of resistance to privatization. This was not a sudden shift, but a gradual reconfiguration shaped by policy choices that enabled markets to grow while regulation struggled to keep pace. The justification was straightforward: if students were already leaving the state to pursue professional education, why not retain that demand locally?

At the same time, a newly upwardly mobile middle class began to invest heavily in professional education as a pathway to legitimacy and mobility. The title of “doctor” carried social value. Aptitude became secondary. For those who could not afford private medical education, dentistry became the next available option. What followed was rapid expansion. Dental colleges proliferated, often as part of larger business ventures, while regulatory oversight remained weak.

The consequences of this unregulated growth are now visible. Concerns about infrastructure, faculty shortages, and inadequate clinical exposure have been widely documented. Many newly graduated dentists report feeling unprepared for independent practice, particularly those trained in private institutions. At the same time, an oversupply of graduates and limited public sector opportunities have produced widespread underemployment and financial precarity.

Training itself has changed. Skills once acquired through mentorship are now accessed through expensive, commercialized courses. Informal systems of learning and support have weakened, reshaping not just education but professional culture. This shift also reflects a longer transformation within dentistry itself. From its origins as a craft practice associated with barber-surgeons, dentistry has evolved into a highly specialized, technology-driven profession, largely centered in urban private practice. In the process, its orientation has become increasingly curative, commercial, and individualized, often distancing it from broader questions of public health and social context. Within the profession and education, social hierarchies persist in reconfigured forms. Despite women constituting a significant proportion of dental graduates, training spaces often operate through informal “boys’ club” networks, where access to mentorship, clinical opportunities, and recognition is unjustly distributed. Women practitioners report wage disparities, lack of respect, and constrained career mobility, revealing how gendered norms continue to shape professional life.

One consequence of these shifts is the erosion of solidarity within the profession. Dentistry, like many self-regulated professions, once functioned through a guild model, where informal mentorship and mutual support were central. Today, in an overcrowded and competitive market, colleagues become competitors and seniors become gatekeepers. This shift is not only economic but unethical. The harshness increasingly visible in training spaces must be understood in this context. When a profession loses its sense of collective identity, it also risks losing its capacity for care.

There is also a deeper contradiction. While many in the profession express frustration at the lack of societal support when doctors face violence, we rarely extend the same solidarity to others, farmers, students, or frontline health workers. Such selective engagement reflects a broader disengagement from public life. This is where political illiteracy becomes consequential. The crisis in dental education and practice did not emerge in isolation. It reflects a broader inability within the profession to engage with policy, regulation, and institutional design. Professional bodies, which could serve as sites of collective reflection, often serve as networking sites, and even their response to socio-political issues is episodic and nominal rather than organized and structural.

Health is the most political of all

More than a century ago, Rudolf Virchow described medicine as a social science and politics as medicine on a larger scale. Health is inherently political, and so are health professions. Training apolitical professionals is therefore not neutral; it shapes how problems are understood and addressed. When political literacy is absent, structural issues are reduced to individual failures, inequality is normalized, and discrimination is overlooked.

Political education, in this context, is simply the ability to recognize power and ask questions about it, why disease is distributed unevenly, why institutions work differently for different people, and why some forms of knowledge are valued over others. Health and care are shaped by social structures as much as by biology, and professionals are part of these structures, not outside them.

Training spaces themselves reflect this. What we often describe as “neutral” training spaces are anything but neutral, and are shaped by histories of professional education, social hierarchies, and the enduring structures of caste and gender. These spaces have long functioned as savarna-dominated institutional worlds, where norms of behavior, language, and belonging are implicitly defined. Those who do not share these backgrounds are often required to adjust, adapt, or remain silent to fit in. These histories are reproduced through everyday practices, through what is taught, what is ignored, and who is made to feel like they belong. Exclusion may not have been explicit, but it is far more vicious and entirely by design.

Integrating political education into professional training is therefore less about adding content and more about transforming how professionals are trained to think, by engaging with policy alongside practice, creating space to examine inequality, and enabling participation in the systems that shape professional life.  What we include or exclude from professional education ultimately shapes the kind of society we build. If professionals are trained to look away from politics, institutions will continue to miss structural injustice and treat recurring crises as isolated events. Health and health care are already political. The question is whether we are willing to recognize that and act on it.

This also calls for a more conscious effort to make training spaces inclusive. Inclusion here is not a matter of accommodation or goodwill, but of recognizing rights and representation. It requires students, faculty, and institutions to be attentive to how caste, gender, and class shape everyday experiences, who belongs, who is marginalized, and who is expected to adjust. Moving beyond the exclusionary lens of meritocracy is central to this shift. What is also missing in many of these spaces is organization and collective response. Silence is often easier than dissent, especially within hierarchical institutions. The recent death of a dental student in Kerala has brought into focus not only grief, but also a troubling sense of helplessness within such spaces where even acts of solidarity can feel difficult. Without organized engagement and cultivated resistance within classrooms, campuses, and professional bodies, these structures will remain unchallenged, hollowing out the ethics of care these professions rest on.

(Dr Malu Mohan is an independent health researcher based in Chennai)