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Foreign doctors question MCI guidelines regarding disabled medical aspirants ahead of crucial hearing

Ahead of a crucial hearing into the petition challenging the Medical Council of India's discriminatory guidelines barring people with certain disabilities from studying medicine comes a major show of support from leading doctors' and doctors' groups from around the world. Read on to find out.

A major show of support for doctors with disabilities in India who are legally fighting to get the Medical Council of India (MCI) to withdraw guidelines that bar students with certain disabilities from studying medicine. Many doctors and organisations that are working to make medicine inclusive across the United States, United Kingdom and Australia have written letters questioning the 80% cut off various disabilities.

Urging the MCI to assess students' capacities in relation to the career choices they are considering, Adam Stein of the Association of Academic Physiatrists has said in the letter to disability rights advocate Dr Satendra Singh:

One of the fundamental concepts in disability studies is that there is no one-to-one correspondence between a medical diagnosis and a disability. The extent of disability an individual caused by a particular condition depends not only on the severity of that condition, but on the individual's residual strengths and the supports available in the physical and social environment. Therefore, we would encourage you to avoid eligibility criteria that relate simply to medical diagnosis and rely, instead, on assessments of the student's capacities when given reasonable accommodations. -Adam Stein, President, Association of Academic Physiatrists

In February this year, Dr Singh, who heads the Doctors with Disabilities in India challenged the government's decision in court. He has submitted these letters of support in court to bolster his petition. His case will come up for hearing next tomorrow, 14 August.

The MCI guidelines have been set aside by many High Courts as well as the Supreme Court of India in different petitions yet the blanket ban persists and is in violation of the Rights of Persons with Disabilities Act 2016, which the Ministry of Social Justice and Empowerment (MSJE) is expected to administer.

One of the main arguments put forth by the government in upholding these guidelines is the need to keep patient safety paramount, but as Lisa Meeks from the Medical School University of Michigan points out, "no case to date has identified patient safety violations involving a physician with a disability. Many concerns regarding safety are unfounded and often times physicians with disabilities overlay additional checks and balances systems to avoid any safety issues".

She also refers to federal regulations in the US which guide evaluation of patient safety, which require the school or programme to make an "individualised assessment based on reasonable judgment to ascertain the nature, duration, and severity of the risk; the probability that the potential injury will actually occur; and whether reasonable modifications of policies, practices, or procedures or the provision of auxiliary aids or services will mitigate the risk. In the absence of this individualized assessment, any concerns regarding patient safety are grounded in assumption, fear, bias and stigma".

The reasoning behind the 80% cut off has also been questioned by the doctors. Dr Kelly Lockwood of the Disabled Doctors Network, UK. Calling the MCI guidelines "shocking", Dr Lockwood says providing definitive evidence that a person's mobility is 80% impaired as opposed to 78% would be very difficult. She further adds, "Here in the UK.. in order to state a threshold of 80% impairment as a cut off for being allowed to undertake medical education, we would have to provide high quality robust evidence".

Among the experts who has supported Dr Singh's petition is Dr Dinesh Palipana from Australia. He is the first quadriplegic medical intern in Queensland. In her letter, Dr Meeks has cited real life instances of doctors with disabilities who are successful in their respective fields of medicine to question the logic of 80% disability as the cut off.



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