Dear Shri Nadda ji,
This is to register our strong remonstration against the continuation of certain blatantly discriminatory attitudes in the matter of admissions to MBBS, as reflected in the latest “Amendment Notification” of February 4, 2019 modifying the Regulation on Graduate Medical Education, 1997. These amended regulations debarring certain categories of disabled persons from pursuing medicine is a clear violation of the provisions of the Rights of Persons with Disabilities Act, 2016 and the rules framed thereunder.
The revised regulations prohibit those with locomotor disabilities above 80 per cent from getting admitted to MBBS, as it pronounces them “ineligible”. Same is true with those with blood disorders. The notification also debars students with chronic neurological conditions with a disability of over 80 per cent. This is in contempt of the Supreme Court directions in the Sachin v/s State of Haryana and Others (SLP(C)25936/2018).
You may recall that in our letter to you dated August 14, 2018, we had, while strongly objecting to the guidelines published by the MCI last year, stated that in the framing of the guidelines certain preconceived notions and prejudices were patently visible. We had also underlined that it was drafted without proper application of mind, oblivious of the best practices worldwide and divorced from the reality that advances in science and technology have become great enablers.
Permit me to quote, once again, Stanley F.Wainapel, MD, MPH:
“Much of the focus in medicine is on incapacity rather than preserved capacity, even if some functions can be augmented. How many physicians who are not specialists in the medical care of people with disabilities would be aware that a paraplegic doctor can stand up in the operating room using a special device, that a physician whose vision precludes reading chart notes can easily access electronic medical records using screen-reading software, or that a medical student with a hearing impairment can do cardiac auscultation using an electronic stethoscope? These examples of existing technological accommodations emphasize the central role of technology in enhancing the functional potential of those with motor or sensory limitations”.
The current regulation also perpetuates the same discriminatory provision by barring persons who have a locomotor disability in the range of 80 per cent and above. Hemato-oncologist, Dr. Suresh Advani who was awarded the Padma Vibhushan is a living example of a wheel chair user with disability of above 80 per cent.
Making such persons “ineligible” in fact militates against the suggestion made by your ministry that persons having a disability of above 80 per cent may be allowed subject to their functional competency being determined with the aid of assistive devices post their selection.
We also find that for those with visual impairment and hearing impairment would be eligible only if their disability is brought down to less than 40 per cent with the aid of assistive devices. We had annexed with our letter mentioned above a research article jointly authored by Dr. Stanley F Wainapel and Dr. Marla Bernbaum citing several instances of physicians with visual impairment practicing. We had also attached another article by Ramona Walhof wherein the story of David Hartman, a person with visual impairment who successfully fought to gain admission to Medical school is recalled.
All these instances cited above more than underline the fact that creation of enabling environments and provision of reasonable accommodation is all that is needed. These are, it needs no reiteration, mandated by the Rights of Persons with Disabilities Act, 2016.
We also find in the new notification dysgraphia has been excluded from Specific Learning Disabilities. This is intriguing. The notification does admit that “currently there is no Quantification scale available to assess the severity of SpLD”. We however, apprehend that this will be utilized to deny admission to students with Specific Learning Disorders.
In the light of the above we would urge upon you to direct the MCI to reframe guidelines that would act as an enabler for persons with disabilities to pursue a career in medicine rather than act as a deterrent. It is needless to add that in this exercise that has to be urgently undertaken, the involvement of doctors with disabilities as well as organisations working among persons with disabilities should be ensured.
We also opine that department/institutions like Department for Empowerment of Persons with Disabilities, ICMR, DGHS, Directors of all National Institutes on Disabilities under Ministry of Social Justice & Empowerment as well as experts from other institutions who jointly framed disability assessment guidelines, also be involved in this process, as they are better equipped to deal with disability related issues.
Last but not least, you will also appreciate the fact that not all those join MBBS do surgery or practice. Some of them pass on the knowledge they have gained, as teachers.
We request that these issues be considered with the seriousness that they warrant and in the interests of students with disabilities desirous of pursuing MBBS.
Copy to: MCI Board of Governors
Copy: Shri Thawar Chand Gehlot, Minister of Social Justice & Empowerment
Copy: Secretary, Dept of Disability Affairs, MSJE, GOI