The recent revisions to the Competency-Based Medical Education (CBME) curriculum by the National Medical Commission (NMC) have sparked significant concern among disability rights activists and transgender advocates. The lack of inclusion of critical disability and transgender rights laws in the new curriculum raises serious questions about the commitment to inclusivity and equity in medical education. As India strives to provide comprehensive healthcare for all citizens, it is imperative that medical training reflects the needs of marginalised communities.
Ministry Intervention: A Call for Action
On October 14, 2024, the Ministry of Social Justice and Empowerment sought a response from the NMC regarding the non-inclusion of key provisions from the Rights of Persons with Disabilities Act, 2016, and the Transgender Persons (Protection of Rights) Act, 2019. In an official memorandum, the ministry directed the NMC to review a representation submitted by Siddhartha Singh, Doctors with Disabilities, and Air Commodore (Dr) Sanjay Sharma (Retd.), CEO of the MD Association for Transgender Health . The ministry has requested that the NMC prioritise this matter and respond within 15 days.
International Backlash: Threats to NMC's Recognition
Two international organisations advocating for disability inclusion in medical education and transgender health have threatened to complain against NMC to the World Federation for Medical Education (WFME) over the violation of existing laws in the newly released curriculum. The organisations–The International Council for Disability Inclusion in Medical Education and the World Professional Association for Transgender Health–expressed dismay at the NMC's “ableist” and “transphobic” guidelines. They highlighted that the NMC's omission of disability and transgender rights provisions not only contravenes the 2016 and 2019 Acts but also risks its recognition by the WFME, which is critical for maintaining educational standards.
CBME Controversy: From Release to Withdrawal
The new CBME curriculum was released on August 31, 2024, but was deemed outdated and contradictory to Supreme Court judgments and previous guidelines. Following widespread media coverage and public backlash, the curriculum was withdrawn on Teachers' Day, September 5, 2024. However, the revised curriculum released on September 12, 2024 also failed to reintegrate essential disability competencies and adequately address transgender health issues, leaving activists disheartened.
Explained: The Controversy Around NMC’s Revised Curriculum
As already mentioned, the NMC’s revised curriculum has sparked controversy, with critics highlighting several key areas of concern. The omission of essential terms like "dignity" and "transgender" raises questions about the curriculum's commitment to inclusivity. Additionally, the removal of disability competencies and the use of outdated, stigmatising language reflect a broader issue of outdated attitudes that fail to address the diverse healthcare needs of modern society.
1. Lack of Key Terms: "Dignity" and "Transgender": The revised curriculum notably omits crucial terms like "dignity" and "transgender," which are essential for fostering an inclusive understanding of healthcare. This absence not only undermines the rights of these communities but also sends a troubling message to future healthcare professionals about the importance of dignity and respect in patient care. The lack of such terminology hinders the curriculum's ability to promote an inclusive mindset among medical students.
2. Removal of Disability Competencies: While dedicating eight hours to sports during the foundation course, the NMC has entirely removed the previously mandated seven hours of disability competencies. This is a significant setback, as it fails to equip future doctors with the necessary knowledge to address the specific health needs of persons with disabilities. Such an omission jeopardises the quality of care that these individuals will receive, perpetuating systemic inequities in the healthcare system.
3. Inclusion of Outdated Terminology: The use of terms like "gender identity disorders" in psychiatry is concerning, as it reflects outdated attitudes towards gender diversity. Such terminology not only misrepresents the experiences of transgender individuals but also contributes to stigma and discrimination. Future healthcare providers must be educated with language that respects and affirms diverse identities rather than perpetuating harmful stereotypes.
4. Mischaracterisation of Intersex Variations: The continued description of intersex variations as "abnormalities" in physiology is both misleading and damaging. This perspective reinforces negative stereotypes and fails to acknowledge the natural diversity of human biology. A more accurate understanding of the topic is essential for promoting compassionate and informed medical care for individuals with intersex variations, fostering an inclusive healthcare environment.
5. Binary Understanding of Gender: The revised curriculum's focus on a binary understanding of gender neglects the complex realities faced by transgender individuals. By failing to address the unique health needs of these individuals, the curriculum risks perpetuating systemic biases within healthcare. An inclusive approach is vital for ensuring that all patients, regardless of their gender identity, receive appropriate and respectful medical care.
Moving Towards an Inclusive Medical Education Framework
In conclusion, the dissatisfaction expressed by the Central Advisory Board on Disability and the Association for Transgender Health in India highlights the urgent need for the NMC to amend the revised CBME curriculum. By reintroducing mandatory disability competencies and ensuring that transgender health issues are adequately addressed, the NMC can take meaningful steps towards creating a more equitable and inclusive healthcare system in India. The voices of marginalised communities must be heard and respected in the nation's medical education framework to ensure that all individuals receive the care they deserve.
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Ministry Intervention: A Call for Action
On October 14, 2024, the Ministry of Social Justice and Empowerment sought a response from the NMC regarding the non-inclusion of key provisions from the Rights of Persons with Disabilities Act, 2016, and the Transgender Persons (Protection of Rights) Act, 2019. In an official memorandum, the ministry directed the NMC to review a representation submitted by Siddhartha Singh, Doctors with Disabilities, and Air Commodore (Dr) Sanjay Sharma (Retd.), CEO of the MD Association for Transgender Health . The ministry has requested that the NMC prioritise this matter and respond within 15 days.
International Backlash: Threats to NMC's Recognition
Two international organisations advocating for disability inclusion in medical education and transgender health have threatened to complain against NMC to the World Federation for Medical Education (WFME) over the violation of existing laws in the newly released curriculum. The organisations–The International Council for Disability Inclusion in Medical Education and the World Professional Association for Transgender Health–expressed dismay at the NMC's “ableist” and “transphobic” guidelines. They highlighted that the NMC's omission of disability and transgender rights provisions not only contravenes the 2016 and 2019 Acts but also risks its recognition by the WFME, which is critical for maintaining educational standards.
CBME Controversy: From Release to Withdrawal
The new CBME curriculum was released on August 31, 2024, but was deemed outdated and contradictory to Supreme Court judgments and previous guidelines. Following widespread media coverage and public backlash, the curriculum was withdrawn on Teachers' Day, September 5, 2024. However, the revised curriculum released on September 12, 2024 also failed to reintegrate essential disability competencies and adequately address transgender health issues, leaving activists disheartened.
Explained: The Controversy Around NMC’s Revised Curriculum
As already mentioned, the NMC’s revised curriculum has sparked controversy, with critics highlighting several key areas of concern. The omission of essential terms like "dignity" and "transgender" raises questions about the curriculum's commitment to inclusivity. Additionally, the removal of disability competencies and the use of outdated, stigmatising language reflect a broader issue of outdated attitudes that fail to address the diverse healthcare needs of modern society.
1. Lack of Key Terms: "Dignity" and "Transgender": The revised curriculum notably omits crucial terms like "dignity" and "transgender," which are essential for fostering an inclusive understanding of healthcare. This absence not only undermines the rights of these communities but also sends a troubling message to future healthcare professionals about the importance of dignity and respect in patient care. The lack of such terminology hinders the curriculum's ability to promote an inclusive mindset among medical students.
2. Removal of Disability Competencies: While dedicating eight hours to sports during the foundation course, the NMC has entirely removed the previously mandated seven hours of disability competencies. This is a significant setback, as it fails to equip future doctors with the necessary knowledge to address the specific health needs of persons with disabilities. Such an omission jeopardises the quality of care that these individuals will receive, perpetuating systemic inequities in the healthcare system.
3. Inclusion of Outdated Terminology: The use of terms like "gender identity disorders" in psychiatry is concerning, as it reflects outdated attitudes towards gender diversity. Such terminology not only misrepresents the experiences of transgender individuals but also contributes to stigma and discrimination. Future healthcare providers must be educated with language that respects and affirms diverse identities rather than perpetuating harmful stereotypes.
4. Mischaracterisation of Intersex Variations: The continued description of intersex variations as "abnormalities" in physiology is both misleading and damaging. This perspective reinforces negative stereotypes and fails to acknowledge the natural diversity of human biology. A more accurate understanding of the topic is essential for promoting compassionate and informed medical care for individuals with intersex variations, fostering an inclusive healthcare environment.
5. Binary Understanding of Gender: The revised curriculum's focus on a binary understanding of gender neglects the complex realities faced by transgender individuals. By failing to address the unique health needs of these individuals, the curriculum risks perpetuating systemic biases within healthcare. An inclusive approach is vital for ensuring that all patients, regardless of their gender identity, receive appropriate and respectful medical care.
Moving Towards an Inclusive Medical Education Framework
In conclusion, the dissatisfaction expressed by the Central Advisory Board on Disability and the Association for Transgender Health in India highlights the urgent need for the NMC to amend the revised CBME curriculum. By reintroducing mandatory disability competencies and ensuring that transgender health issues are adequately addressed, the NMC can take meaningful steps towards creating a more equitable and inclusive healthcare system in India. The voices of marginalised communities must be heard and respected in the nation's medical education framework to ensure that all individuals receive the care they deserve.
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