revised mbbs curriculum

MCI Finally Updates MBBS Curriculum to Include Disability Rights and Dignity

This curriculum was recently updated for the first time in 22 years.

New Delhi: India has decided to include a substantial component on disability rights and the dignity of disabled people in the under graduate medical curriculum. This curriculum was recently updated for the first time in 22 years.

In April, The Wire had reported how the updated curriculum had skated over the issue. In the days that followed, primarily thanks to the efforts of disability rights activist, Satendra Singh – a disabled doctor himself – two government bodies had directed the Medical Council of India (MCI) to look into this omission. The MCI has now complied.

“This is great news as future Indian medical graduates will now look at disability from a human rights perspective and not just a disease perspective,” says Dr Singh.

He now plans to push for the curriculum to have a separate elective that students can take on disability medicine. Singh contracted polio at nine months of age and has since had locomotor disability.

Also read: MBBS Curriculum Updated After 22 Years, but Barely Mentions Disability

The medical curriculum for the last 22 years approached disability only as a disease, and its management in terms of managing it as an illness, says Singh. “There was nothing on dignity or rights,” he adds.

To this effect, the new curriculum says that doctors should be able describe disability as per the United Nations Convention on the Rights of Persons with Disabilities, and respect diversity among the community of people with disabilities. They should also be familiar with India’s Rights of Persons with Disabilities Act, 2016.

The question arises as to how students will imbibe this knowledge. The curriculum says they could either be given a lecture or take part in a panel discussion, involving a person with disability. One hour has been set aside for this.

Another thing students will learn in this module is “disability etiquette” and how to have verbal and non-verbal empathetic communication while addressing people with disabilities. They will also learn how to have a non-discriminatory attitude towards patients or caregivers with disabilities.

They will also learn about making healthcare accessible for patients with disabilities, including how hospitals are designed.

Some other topics will be covered by introducing students to patient narratives in small groups. Time will be set apart for group exchanges.

Another exercise for students will involve study of case histories and clinical patient encounters. The MCI has suggested using ‘Theatre of the Oppressed’ as an activity, along with visits to NGOs working in the sector. Students will also have to write a “self reflection paper” or blog.

Also read: Health Ministry Delay on NEET Criteria Leaves Disabled Students in a Lurch

“As newly joined medical students, they need to recognise the importance of various deviations from majority that are happening in human life. Disability is part of human diversity. Differently abled individuals need to be understood and recognised by any stream that deals with human life,” says the new curriculum.

This “competency” included in the under graduate MBBS curriculum means that by the end of their course, students must have “the skills and attributes essential to provide quality health care to patients with disabilities.”

This is part of the module on “professional development and ethics.” Other competencies that under-graduate doctors will need to pick up as part of this module include the concept of professionalism and ethics, altruistic behaviour, cultural competence, stress and time management, and interpersonal relationships.

Singh had been working on developing this module with the University of Chicago’s Bucksbaum Institute. He had approached a number of government bodies about the issue. Earlier this year, the Delhi Commissioner for Persons with Disability asked the Union health ministry to look into this. The National Chief Commissioner for Persons with Disabilities also wrote to the MCI about this.

Another related issue in the field is obstructive criteria placed for medical aspirants who are also disabled. They have been facing problems in taking the all-India medical entrance exam and Singh has been petitioning the government to take action on this too. The MCI bars those with 80% locomotor disability from even attempting the MBBS exam.

The updated MBBS curriculum goes into effect from next month.

MBBS Curriculum Updated After 22 Years, but Barely Mentions Disability

The Medical Council of India and the Union health ministry have both been asked to re-examine the curriculum and include a component on disability rights.

New Delhi: After 22 years, medical students in India have an updated curriculum that is due to roll out in August 2019.

India produces around 90,000 doctors every year, with 63,250 undergraduate medical seats, and 34,950 post graduate medical seats.

But the new curriculum skates over the issue of disability and disability rights.

This comes in spite of the 2016 legislation on the Rights of Persons with Disability Act, which says that curriculum in universities, colleges and schools should include information on the rights of people with disabilities.

MCI told to redraft the curriculum

According to two documents with The Wire, the Medical Council of India (MCI) and the Union health ministry have both been asked to re-examine the curriculum and include a component on disability rights.

In March, the Delhi commissioner for persons with disability has written to the health ministry about the issue.

In the letter, the commissioner says that there needs to be a “shift from the medical approach to the rights based approach to disability.” He points out other deficiencies – the new curriculum does not make MBBS students aware of key provisions of this 2016 law for disabled people’s rights, neither does it give students the “human rights perspective” to disability.

A second letter on the same issue was sent to the MCI from the national chief commissioner for persons with disabilities. Here too, the commissioner asked the MCI to look into the points raised by Satendra Singh, a doctor with locomotor disability, and take all stakeholders into consultation on it.

Also Read: Ministry to Safeguard Rights of Disabled Defends Order Discriminating Against Them

The multi-volume new curriculum has been written by doctors at leading institutions such as KEM Hospital (Mumbai), Government Medical College (Kottayam), Christian Medical College (Ludhiana) and AIIMS (Delhi).

How is the new curriculum silent on disability?

These letters about changing the curriculum have come about due to the work of Dr Satendra Singh, a doctor with locomotor disability at GTB Hospital, Delhi. He wrote to the state and national commissioners for disability, alerting them to the issue.

“We often complain that doctors don’t understand patients with disabilities. I have seen people with disabilities often go to a doctor with an ailment but doctors focus only on their disability instead,” said Dr Singh.

This is not a holistic approach, he says. “Disability is so vast and people with disabilities have very different needs. Treatment options are already there, but we now need a human rights approach.”

In his letter, he alerted authorities that “disability competencies are not adequately represented” in this new curriculum.

Also Read: Health Ministry Delay on NEET Criteria Leaves Disabled Students in a Lurch

In fact, in the 94 page booklet on ethics, disability is mentioned only once.

The word ‘dignity’ is not used at all, in this new curriculum, even though that is one of the core tenets of the Rights of People with Disability Act.

The curriculum itself still refers to the repealed legislation for mental health from 1987, whereas India has a new Act as of 2017. It also uses outdated language such as ‘differently abled.’

What does Indian law say on education about disability?

The Rights of People with Disabilities Act, 2016 has two sections relevant to this issue.

Section 39 says that the government should ensure that “the rights of persons with disabilities are included in the curriculum in Universities, colleges and schools” and that there should be “orientation and sensitisation at the school, college, University and professional training level on the human condition of disability and the rights of persons with disabilities.”

Section 47 says that there should be a component about disability for doctors and nurses, and in fact for all schools, colleges and University teachers as well as for para-medical personnel, social welfare officers, rural development officers, asha workers, anganwadi workers, engineers, architects, other professionals and community workers.