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.

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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.

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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.