‘Reeks of Ableism!’- Supreme Court slams NMC ‘both hands intact’ rule for PwD MBBS aspirants

New Delhi: Observing that the requirement under the National Medical Commission‘s (NMC) guidelines specifying that an MBBS candidate must have “both hands intact”, “reeks of ableism”, the Supreme Court opined that the said criteria required to be revised.

Slamming the NMC norm, the Apex Court bench comprising Justices BR Gavai and KV Viswanathan held,

“In our view, this prescription of “both hands intact…” is completely antithetical to Article 41 of the Constitution; the principles enshrined in the United Nations Convention on the Rights of Persons with Disabilities and the salutary provisions of the RPwD Act. It also indicates a classification which is overbroad and glorifies ‘ableism’. It propagates that persons with typical abilities and with faculties similar to what the majority may have or somehow superior. This is precisely what the Directive Principles of State Policy, the United Nations Convention and the RPwD Act abhor.”

Referring to the Supreme Court order in the case of Omkar Ramchandra Gond (supra), where the top court had asked NMC to revise its guidelines, the Apex Court bench noted that in the said Judgment also the “both hands intact” requirement had been expressly rejected. 

“A prescription such as “both hands intact…” reeks of ableism and has no place in a statutory regulation. In fact, it has the effect of denuding the rights guaranteed under the Constitution and the RPwD Act and makes a mockery of the principle of reasonable accommodation,” it further observed.

These observations were made by the court while considering the plea filed by a student, who was denied admission despite clearing the National Eligibility- Entrance Test (NEET) 2024 exam as he did not fulfil the eligibility criteria under the NMC guidelines.

The student has la ocomotor disability of 50% as well as a speech and language disability of 20%. His final disability was computed at 58%. However, when he approached the Government Medical College, Chandigarh to get his disability assessed, the Disability Assessment Board declared him ineligible to pursue the medical course without assigning any reason and without examining the functional disability of the appellant.

Challenging the decision of the Disability Assessment Board, the candidate approached the Punjab and Haryana High Court, which held that it could not substitute the opinion given by experts. Thereafter, the candidate filed a plea before the top court bench.

Also Read: Supreme Court Summons Director General Of Health Services over Disabled MBBS Candidate’s plea

Medical Dialogues had earlier reported that while considering the plea by the candidate, the Supreme Court had recently summoned the Director General of the Centre’s Directorate General of Health Services. The apex court then flagged the ”casual approach” over the grant of admission to an MBBS aspirant from the disability category.

This observation came after the apex Court found that the approach of the Respondents, in this case, was “casual” in a case related to the medical admission of a 20-year old student from Other Backward Class with a locomotor benchmark disability coupled with speech disability since birth.

Earlier, the Court had ordered the Director of All India Institute of Medical Sciences (AIIMS) 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. In the order dated 25.11.2024, the Court had also directed the AIIMS New Delhi Director to co-opt Professor Dr. Satendra Singh as a member of the Committee.

Except for Dr. Singh, the other five members of the Board opined that it was bound by the rule under the Graduate Medical Education Regulations (Amendment), 2019 that required that the candidates must have “both hands intact”.

However, Dr. Singh gave a separate opinion concluding that the appellant could successfully navigate the MBBS course with clinical accommodations and assistive technologies.

Based on the overall reading of the reports, particularly due to Dr. Singh’s opinion and taking into account the point raised by the five members of the Board about the need to revise the NMC Guidelines and considering the legal position, the Court on 12.12.2024, found the appellant fit to pursue the MBBS course and directed his admission.

Later, granting relief to the medical aspirant, the Apex Court allowed him to be admitted to Government Medical College, Sirohi, Rajasthan by creating a supernumerary seat.

The top court bench, while considering the matter, held, “In our considered view, the correct approach is the one that Dr. Satendra Singh has adopted viz.- to not bar a candidate at the threshold but grant the candidate the choice after completing the MBBS Course, to decide whether he whishes to specialize in a nonsurgical or medical branch or continue as a General Duty Medical Officer. As rightly set out by Dr. Satendra 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.”

Stressing the “flexibility in answering individual needs and requirements” as an “essential component of reasonable accommodation”, the top court bench highlighted that “There cannot be a “one size fits all” approach.”

The bench also referred to the order in the case of Omkar Ramchandra Gond v. Union of India, and noted, “The “both hands intact…” prescription has no sanctity in law as it does not admit of a functional assessment of the individual candidate, a matter which is so fundamental in protecting the rights of persons with disabilities. In fact, it was the Union of India through the Ministry of Social Justice and Empowerment which took the lead in issuing the communication of 24.01.2024 pursuant to the directions of this Court in Bambhaniya Sagar Vasharambhai (supra).”

Further, the Court observed that after the order in the case of Omkar Ramchandra Gond (supra), the National Medical Commission (NMC) had assured the Court during the course of hearing in Om Rathod (supra), that it would constitute a new committee of domain of experts to comply with the judgment in Omkar Ramchandra Gond (supra).

Referring to this, the Court noted in this case that “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 the disability rights. A further direction was given that fresh guidelines will be put in place applying the principles set out in the judgments.”

Accordingly, the bench listed the matter for further hearing on 03.03.2025 to consider whether the National Medical Commission (NMC) has formulated the revised guidelines in accordance with the judgments of the Court, as directed in Omkar Ramchandra Gond (supra) and Om Rathod (supra) and further directed that the NMC shall file an affidavit explaining the current status before the said hearing date.

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