Medical curriculum revision sparks outrage by activists over omission of disability and transgender rights

NEW DELHI: Disability rights activists and transgender advocates have raised alarms over the non-inclusion of provisions outlined in the Rights of Persons with Disabilities Act (RPDA), 2016 and the Transgender Persons (Protection of Rights) Act (TPA), 2019 in the National Medical Commission's revised Competency-Based Medical Education (CBME) Curriculum.

In a letter addressed to Union Minister for Social Justice and Empowerment Dr Virendra Kumar, the leaders of disability and transgender communities expressed their dismay. The letter penned by Central Advisory Board on Disability Chairperson Dr Satendra Singh and Association for Transgender Health in India CEO Air Commodore (Retd.) Dr Sanjay Sharma highlighted how the new curriculum, released on August 31, 2024, fails to address critical issues impacting these marginalized groups.

"The curriculum has been deemed outdated and archaic, contradicting the Supreme Court judgements and previous guidelines," stated the letter. The controversy led to widespread media coverage and public backlash, culminating in the withdrawal of the curriculum on Teachers' Day, September 5, 2024. While the revised curriculum was re-released on Thursday, the activists are disheartened by its failure to reintegrate disability competencies and adequately address transgender health issues.

Key terms omitted

Despite an acknowledgment of the oversight by a senior NMC member, the curriculum remains unchanged on these fronts, the letter said. One of the most striking omissions is the failure to include key terms such as "dignity" and "transgender" within the 466-page document. The curriculum dedicates eight hours to sports during the foundation course but has completely removed the previously mandated seven hours of disability competencies.

Moreover, terms like "gender identity disorders" continue to appear in psychiatry, while physiology continues to describe intersex variations as "abnormalities". This lack of inclusion has broader implications. The letter pointed out that the RPDA mandates integrating disability rights into educational curriculums for the university teachers, doctors, nurses, and paramedical personnel. The omission of these competencies, which were previously part of the 2019 curriculum, is not only a setback for disability rights but also undermines India's commitment to the UN's Sustainable Development Goals (SDG 10), which aim to reduce inequality.

Binary gender focus

The letter also underscored the importance of transgender-inclusive healthcare as mandated by the TPA, 2019. Section 15 of the Act requires medical curricula to address transgender-specific health issues, including creating a health manual for sex reassignment surgeries. Yet, the new curriculum remains focused on a binary understanding of gender, ignoring the health needs of transgender individuals entirely.

The activists urged Dr Kumar to intervene and ensure the reintroduction of mandatory disability competencies before the start of the new MBBS session on October 14. They further requested that case studies focusing on disability, transgender, and queer persons be included in the longitudinal ethics curriculum, ensuring that the voices of marginalized communities are not ignored in the country's medical education framework.