CHENNAI: It feels rare when news that is upsetting and in favour of the regressive or the bigoted is quickly rolled back. This is why the National Medical Council withdrawing its 2024 Guidelines under Competency Based Medical Education Curriculum (CBME) for MBBS students, a few days after the curriculum was announced at the end of August is a relief and a win — and not just old news, a soon-forgotten glitch.
The guidelines which were retracted included a number of egregious facets, such as calling homosexuality an unnatural offence and eliminating a mandatory training on disabilities. Some of these were reversals to amendments made to the 2022 guidelines after a Madras High Court ruling. The ruling had decreed that lesbianism, sodomy and the two-finger test for rape cases were unscientific, and also made a distinction between sexual proclivities like cross-dressing and criminal behaviours like necrophilia. (This was four years after the Supreme Court’s ruled that Penal Code Section 377, which was used to criminalise homosexuality, was unconstitutional — which means the NMC took its time catching up even then).
The NMC responded to pressure from activists from women- and queer-led groups, who rightfully threatened to report the governing body to the World Federation of Medical Education, which could have resulted in its suspension from the same. It’s interesting how the threat of global delegitimisation could stop an attempt to return to archaic practices, which even in the medical and scientific worlds are rooted in the notion of “culture”. Had the cancelled curriculum not been challenged, elements that activists and forward-thinking members of the medical fraternity worked for decades to have excised or changed would have slid back into the norm.
At this point, it’s unclear what happened within the NMC that allowed for the regressive parts of the cancelled curriculum to be reinstated at all. That is a subject that deserves further, possibly even formal, investigation. An organisation such as the NMC surely has numerous internal processes and checks and balances, and that these did not prevent the approval and publication of the curriculum is cause for concern. That outdated and discriminatory approaches were reinstated is surprising, even after the rollback.
At the same time, progressive activists enjoying a win, stopping something dangerous in its tracks — increasingly unusual in a world that veers deeper and deeper into shackles and punishments — is worth celebrating. Even if just for a moment. These congratulations are not just for the organisations that stood up to the NMC, but for all people who may receive medical care without the shadow of prejudice.
It will take more years for a new, more open-minded generation of medical practitioners to emerge — those who will be willing to do away with what their seniors practice or taught them (such as bodyshaming and slutshaming, which are very common parts of the patient experience in India). But a curriculum that does not condone discrimination, even if it is modelled by seniors, helps. A revised curriculum for the 2024-2025 academic year is awaited. Let’s see if it does better by the patient population, and fulfils the National Medical Commission’s own stated aims to produce medical graduates who are “globally relevant