Following a petition in the Delhi
High Court, the Medical Council of India has said that those with over 80
percent disability won’t be barred from postgraduate courses
The Medical Council of India
(MCI) recently submitted to the Delhi High Court that discriminatory
regulations for postgraduate (PG) medical education have been amended and
people with over 80 percent disability will no longer be barred outright. They
will now be considered on a case-by-case basis and evaluated for functional
competency while using assistive devices.
This followed a petition by
Anjani Bala, an MBBS doctor from Ranchi with polio, who was denied admission to
a PG medical course after she was evaluated at Safdarjung Hospital in Delhi.
She graduated from the Indira Gandhi Institute of Medical Sciences in Patna and
secured rank 80,506 in the NEET PG, making her eligible for specialisation. She
interned in all departments. She petitioned the Court, saying that when she had
completed her MBBS and done internships and worked in every department, both
clinical and non-clinical, why couldn’t she be allowed to do an MD? The exam
for MD is on May 5 and the guidelines are yet to be finalised.
In response, the MCI submitted
that the regulations had been amended. However, the amended regulations only
solve the problems of those with locomotor disability of over 80 percent. For
several other categories of disabilities, the problems still persist. For
example, those who have had one hand amputated still can’t get admission.
Last year, the Supreme Court in
the Muskan Sheikh case asked why the petitioner couldn’t become a doctor as
only one hand was amputated. Thereafter, she was granted admission in the MBBS
course. But the new regulations require an applicant to have both hands and
defy the SC’s observations. Similarly, those with blood disorders such as
haemophilia, thalassemia and sickle cell disease were also barred. Those with
more than 80 percent of these diseases are not eligible for admission. But when
persons with 80 percent locomotor disability— including those using
wheelchairs—are not barred, why should persons with other disabilities be?
Disability is calculated by a
board specified by the State (in this case, Safdarjung Hospital in Delhi) based
on visual, locomotor, speech and mental impairment and multiple disabilities.
Minimum impairment should be 40 percent and the disability certificate is valid
for five years for temporary disability and lifelong for permanent disability.
With respect to specific learning
disabilities, the MCI guidelines were discriminatory for both UG and PG
admissions through NEET. This includes dyslexia, dysgraphia and dyscalculia.
But now dysgraphia has been removed from the allowed categories. So why have
the other two categories been allowed and not this?
As for international laws, the
Americans with Disabilities Act, 1990, prohibits discrimination against
qualified job applicants with disabilities. However, only a few disabled
students enter the medical profession as they must be able to perform the
essential functions of a doctor and each school determines for itself what
these criteria are. The US has many practising disabled doctors. A study in the
American Journal of Physical Medicine and Rehabilitation based on data from
1996 estimated that just 0.2 percent of medical school graduates have some type
of disability. The number of disabled doctors has, of course, grown since the
mid-1990s.
In a case in the US, a federal
jury ruled in favour of a hearing-impaired former student of Creighton
University School of Medicine on September 5, 2013, in Omaha, Nebraska. The
verdict from the controversial lawsuit sets a precedent for the rights of
disabled medical students and doctors to study and practise medicine in the US.
Michael Argenyi was accepted to Creighton University School of Medicine in
Omaha in 2008. He informed the school that his hearing was impaired and that he
would need interpreters and special equipment to attend lectures and
communicate with patients. Argenyi was diagnosed as legally deaf at eight
months old, and had similar accommodation of his disability from grade school
to his undergraduate years at Seattle University.
In 2009, after Creighton refused
to provide Argenyi with “a real-time captioning system for lectures” and a
“cued speech” interpreter during clinical training (he offered to pay for
them), he left the school and sued it for discriminating against him because he
was deaf. One of the reasons the medical school denied Argenyi’s request was
because it felt patients “could be more hesitant to share information when
someone else was present” and that doctors “needed to focus on the patient (not
a third party) to rely on visual clues to make a proper diagnosis”. Argenyi’s
attorney reportedly said that a judge will now decide whether Creighton will
pay the student more than $1,10,000 as reimbursement for medical equipment he
bought.
In India, the Rights of Persons
with Disabilities Act, 2016, along with the Rights of Persons with Disabilities
Rules, 2017 (together, the “Disability Law”) has been enacted by the
government. The Disability Law gives effect to the principles of the United
Nations Convention on the Rights of Persons with Disabilities. It inter alia
seeks to protect disabled persons from various forms of discrimination,
increases measures for effective participation and inclusion in society and
ensures equality of opportunity and adequate accessibility.
Prior to its enactment, the law
governing the rights of the disabled was scattered across the Constitution and
various other Acts. Although these laws aimed at safeguarding the rights of
persons with disabilities, they did not specifically provide for equality of
opportunity especially in matters relating to employment. The Disabilities Act,
2016, replaced the Disabilities Act, 1995. Under the 2016 Act, all
establishments (including the private sector) should have an equal opportunity
policy and employers should register the equal opportunity policy with the
State Commissioner or Central Commissioner (as applicable).
Most MBBS and PG doctors with
disabilities may still be able to contribute significantly in desk and
diagnostic jobs and as writers, speakers, medical artists, creators, administrators,
etc. So why restrict them?
MCI Ethics Regulations 2.1.2
says: “A medical practitioner having any incapacity detrimental to the patient
or which can affect his performance vis-à-vis the patient is not permitted to
practice his profession.” This should be interpreted with regulation 8.5 which
says: “During the pendency of the complaint, the appropriate Council may
restrain the physician from performing the procedure or practice which is under
scrutiny.” So such a person should choose a field in which his disability will
not harm the patient.
All said and done, a
professionally competent doctor with some disabilities should be handled with
concern as he can still be of use to society.
Reproduced
from: India Legal, Published April 22, 2019: p.36-37.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
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