April 2, 2019
The absence of disability competencies in medical curriculum and training and
the consequent impact on people with disabilities has been raised time and
again. The failure to include a rights based perspective towards disabled
people means that time and again they are met with apathy and indifference,
not care and attention.
In a welcome step, T D Dhariyal, State Commissioner
for Persons with Disabilities, National Capital Territory of Delhi
has written to the Ministry of Health and Family Welfare
(MoHFW) asking for this gap in the MBBS curriculum to be addressed.
An earlier letter to this effect was written by Kamlesh Kumar
Pandey, Chief Commissioner, Persons with
Disabilities to the Medical Council of India (MCI).
In his letter, Mr Dhariyal has said that the MBBS curriculum should be
designed so as to reflect and include the basic principles and essences of
essential legislations like the Rights of Persons with Disabilities
Act 2016 (RPWD Act 2016).
Mr Dhariyal has referred specifically to the competencies framed by
Dr Satendra Singh, Founder, Doctors with
Disabilities in collaboration with the Bucksbaum Institute
for Clinical Excellence, University of Chicago.
The letter to the Ministry says – “Though the curriculum of medical
education courses contain disability components, yet these need to reflect
the provisions in the disability specific legislations like RPWD Act 2016 and
the principles and approach underlying their enactment….Students pursuing
medical courses should be made aware of the key provisions of these
legislations, the human rights perspective and the latest approach to
disability”.
The competencies proposed by Dr Singh and the UCMS as given in the
Disability-Inclusive Compassionate Care: Core Competencies on
Disability for Health Professions Education were arrived at after a
series of focused group discussions with doctors with disabilities,
disability rights activists and medical educators.
Section 47(1)(b) of the Act mandates that disability be a
component of all education courses at schools and colleges with Section
39(2)(d) specifying that orientation and sensitization towards
disability and people with disabilities be a part at university and
professional training.
None of this finds reflection in the MCI’s revised undergraduate
curriculum.
The impact, says Mr Dhariyal, is that people with disabilities are deprived
of basic medical care and attention.
The need to include issues affecting persons with disabilities, especially
early detection and intervention is something I had written about even when
I was chief commissioner. It is important that every medical professional
have this information to address the specific needs of people with
disabilities. Otherwise doctors will work mechanically. With the right
intervention for instance, over 30% of hearing impairments can be avoided.
Introducing this early in the medical training can make a big difference
and the Ministry must intervene and make sure this happens – T D
Dhariyal, State Commissioner (Disabilities), National Capital Territory,
Delhi
Dr B Srinivas, Additional Director General,
Directorate General of Health Services agrees that building sensitivity from
an early stage is important.
“Even now there are well trained doctors who are not aware of the
difficulties that people with disabilities face. The MBBS curriculum should
have that aspect so they are more sensitive about how to deal with such
patients”
One of the key aspects of the disability competencies framed was that
disability must be assessed and documented on a functional basis, an
amendment the MCI made after two public interest litigations were filed
against them in the Delhi High Court.
Dhariyal also says the curriculum change must reflect the new laws and
guidelines that have come into being regarding people with high support
needs.
“There should be scope in the curriculum to include further change and it
should be the responsibility of the institute imparting the course to include
these changes. There must be a mechanism for that”.
Hopefully with two statutory bodies coming forward to take the lead, the
MoHFW will look into the matter to ensure the medical curriculum is updated
to reduce the barriers that people with disabilities face in accessing
clinical and preventive services.
Source: https://newzhook.com/story/21845
