New Delhi: The Supreme Court Friday expressed strong disagreement with guidelines of the National Medical Commission (NMC) that make it incumbent for differently-abled candidates to have “both hands intact, with intact sensation and sufficient strength” to pursue an MBBS course.
Such a mandate, the top court observed, reeks of “ableism” that “has no place in a statutory regulation”.
Framed in 2019, the Graduate Medical Education (Amendment) Regulations underline conditions for medical admissions and lay out specific criteria for candidates with “Specified Disabilities.”
The bench of Justices B.R. Gavai and K.V. Viswanathan held the ‘both hands intact’ requirement under the rules as “arbitrary” and “antithetical” to the Constitution.
This kind of regulatory prescription “denudes” the rights guaranteed under the Constitution, and to make it part of the Rights of Persons With Disability (RPWD) Act makes a “mockery of the principle of reasonable accommodation”, the court said.
The Act provides for reservation for the differently-abled in government jobs and higher educational institutions, thereby requiring a more inclusive approach towards physically handicapped aspirants.
The bench’s criticism of the rules came Friday as it reaffirmed its December 2024 order that directed admission of a differently-abled candidate in Government Medical College, Sirohi, Rajasthan, to enable him to pursue MBBS studies.
The candidate, named Anmol, had appeared for the NEET-UG 2024 examination conducted in May 2024 and secured 2,462 rank in the Persons with Disability (PwD) category. Anmol suffers from locomotor disability of 50 percent with a club foot and right lower limb phocomelia. Further, he has speech and language disability of 20 percent. The final disability computed was 58 percent.
This is not the first time that the two judges have shown their disapproval towards the NMC rules. Last October, a bench comprising the same judges had advised the NMC to revise its guidelines for assessing PwD candidates.
Anmol’s case arose from a Punjab and Haryana High Court order that, in September 2024, had dismissed his plea to direct Chandigarh-based Government Medical College to grant him a disability certificate. The high court had rejected his prayer “on the ground that the court cannot substitute the opinion of the experts in the field of disability”.
Anmol had requested the government college for the certificate after the NEET results were announced. He wanted the document to facilitate his admission in the PwD category.
However, the college, opining against the grant of certificate, rendered him ineligible to pursue medical course. This was done without assigning any reason and examining Anmol’s functional disability.
On Anmol’s appeal, the SC while issuing notice in the matter to various parties asked AIIMS, New Delhi, to constitute a committee to examine as to whether the disability suffered by the petitioner would come in the way of his pursuing medical studies. Following the direction, a six-member panel was set-up to examine Anmol.
Five of the six members had opined that he was “not suitable to pursue undergraduate medical education programme (MBBS), which is a competency-based programme of five-and-a-half years, including one year of compulsory rotatory internship”.
The sixth member, Dr Satinder Singh, however, had given a separate opinion and held that Anmol need not be barred at the threshold. In a detailed assessment, he had said that Anmol “can successfully navigate the MBBS course with clinical accommodations and assistive technologies”.
Based on Singh’s assessment, the top court in September 2024 issued its interim order, allowing admission to Anmol in the MBBS course.
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SC’s observations
On Friday, in its final judgment in Anmol’s case, the court hailed Dr Singh’s “correct approach” that called for giving Anmol an opportunity to complete the MBBS course, instead of halting him at the threshold.
Later, he can be asked to exercise the choice of whether he wants to specialise in non-surgical or medical branch or continue as a general duty medical officer, Dr Singh had suggested.
“As rightly set out by Dr Satinder Singh, it will be unfair to presume incompetence at the threshold without first providing an opportunity to the candidate and ensuring the availability of accommodations and assistive products,” the Supreme Court bench said.
With regard to the report of five other experts, the court added: “Even otherwise, we find that the report of the five members has not set out any reasons and does not indicate as to how the functional assessment of the appellant was carried out. No doubt, it mentions that a functional assessment was carried out, but the five members are completely silent on how the appellant failed in the functional assessment test… accepting the report of five members and denying the admission of the appellant would be upholding the theory of ableism which we are not prepared to do.”
The court observed that the ‘both hands intact’ prescription is an overbroad classification and, therefore, has no sanctity in law, “as it does not admit a functional assessment of the individual candidate, a matter which is so fundamental in protecting the rights of persons with disabilities”.
“It propagates that persons with typical abilities and with faculties similar to what the majority have are somehow superior. This is precisely what the Directive Principles of State Policy, the United Nations Convention and the RPWD Act abhor,” the court said, frowning at the “one-size-fits-all approach”.
“…Flexibility in answering individual needs and requirements is an essential component of reasonable accommodation,” the bench said. Such a condition defies Article 41, it observed.
Article 41 requires the state to “make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want”.
The court further said, “While we are conscious that courts are not expert bodies in the matters of medicine… courts have the jurisdiction to ensure that the manner in which the Board proceeds and functions are in compliance with the established principles of law. We will only add that it is not just a question of jurisdiction of the court but a duty cast upon the court; since it is the courts which enforce the fundamental rights.”
Court hauls up NMC
Before parting with the case, the bench reminded the NMC about its direction in the Omkar Ramchandra Gond case last October and decided to call upon the commission to know the status of its compliance.
In the Gond case, the bench had asked NMC to issue revised regulations and guidelines in supersession of the guidelines with regard to admission of students with specified disabilities under the RPWD Act with respect to the MBBS course.
Pursuant to the verdict, the NMC had assured the bench that it would constitute a new committee of domain experts to comply with the judgment.
“Noting the assurance of the NMC, this court directed that the committee to be so constituted will include persons with disability or one or more experts conversant with disability rights. A further direction was given that fresh guidelines will be put in place applying the principles set out in the judgments,” it said.
The bench will now take up the matter on 3 March to consider whether NMC has formulated the revised guidelines in accordance with the judgments of the court.
(Edited by Nida Fatima Siddiqui)
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