NMC’s revised CBME guidelines failed to honour rights of disabled, transgender persons: Doctors

NEW DELHI: Expressing disappointment over the revised NMC CBME guidelines, the disability and transgender groups are demanding the restoration of the provisions under the Rights of Persons with Disabilities Act, 2016 and the Transgender Persons (Protection of Rights) Act, 2019 in the new MBBS curriculum. The National Medical Commission (NMC) re-released the Competency Based Medical Education (CBME) guidelines, dropping references to sodomy and lesbianism as “unnatural” after receiving backlash on the previous document.

In a letter to the Union minister of social justice and empowerment, the doctors belonging to the disabled and transgender communities sought his intervention and demanded re-introduction of mandatory hours on disability competencies before the commencement of new MBBS session; and integration of RPDA and TPA into the AETCOM (Attitude, Ethics, and Communication) curriculum with case studies in the context of disability, transgender, intersex, and queer persons. They also sought involvement of health professionals and students from the disability and queer community for such revisions, and sensitization of members of NMC and its medical boards on the two Acts.

Issues with NMC guidelines on MBBS curriculum

The health professionals believe that the revised CBME guidelines failed to honour the Acts despite NMC’s acknowledgement of its mistake in the media. They argued that there is no mention of the major terms such as “dignity” and “transgender” in the 466-page document. In the curriculum, during the two-week foundation course, eight hours of protected time is dedicated to “sports”, however, there is no explicit mention of disability competencies which were mandatory in the 2019 curriculum being seven hours, they pointed out.

“Psychiatry continues to refer to “gender identity disorders” and Physiology describe sexual differentiation/intersex variations as “abnormalities.” Furthermore, Pediatrics fails to address gender incongruence, dysphoria, or non-heterosexual orientations not mentioning SOGIESC,” the letter read as the groups pointed out the deficiencies in the latest CBME curriculum.

Provisions of RPDA, TPA

The medical groups recalled that not only did the United Nations (UN) India praise the inclusion of the disability competencies, the National Council on Disability in the United States (US) took inspiration from the practice. Even the World Health Organization (WHO)’s guidelines also mandated the training for all healthcare professionals.

The doctors reminded the public how the Acts mandate inclusion of the rights of these communities in the educational institutions which the medical commission has disregarded. “Section 39 (2)(f) of the RPDA mandates the inclusion of the rights of persons with disabilities in the curriculum of universities, colleges, and schools. Section 47 (1)(b) further requires the integration of disability as a component in all educational courses for university teachers, doctors, nurses, and paramedical personnel. This is a mandatory requirement, which the NMC has blatantly disregarded,” they said.

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They further complained that the new guidelines are only focussed on the typical male and female binary and disregard transgender people. “As per section 15 of the TPA 2019: 15. The appropriate Government shall take the following measures in relation to transgender persons, namely: (e) review of medical curriculum and research for doctors to address their specific health issues; (d) bring out a Health Manual related to sex reassignment surgery in accordance with the World Profession Association for Transgender Health guidelines,” the letter quoted.

Further, the healthcare professionals alleged that they didn’t receive any response from the health minister despite writing to him twice.