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.
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.
“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.