NMC reintroduces MBBS CBME curriculum, talks about informed consent
National Medical Commission
New Delhi: After withdrawing the Competency-Based Medical Education (CBME) Curriculum 2024, issued on 31.08.2024, the National Medical Commission (NMC) has now published the revised guidelines for the MBBS CBME Curriculum 2024.
Issuing a notice in this regard, the NMC Secretary Dr. B Srinivas mentioned, "The revised guidelines for Competency Based Medical Education (CBME) Curriculum 2024 by the Under Graduate Medical Education Board (UGMEB) is enclosed herewith. All concerned stakeholders are requested to kindly take note of the same."
In the new guidelines, the apex medical commission has talked about informed consent in sexual intercourse and removed the term 'unnatural' while listing the sexual offences including sexual acts with animals/ bestiality/ zoophilia along with forced/ non-consensual penetrative anal/ oral sex, forced/ non-consensual insertion of fingers or objects and forced/ non-consensual touching or groping or disrobing (‘indecent assault’).
In its earlier curriculum which stands withdrawn, the NMC listed sodomy, incest, lesbianism, buccal coitus, bestiality, and indecent assault as unnatural sexual offences which drew major flak. Moreover, the NMC also didn't mention any hours dedicated to Disability Competencies in the MBBS foundation course. Moving against this, activists wrote to the Health Minister and sought intervention.
Following this, NMC withdrew the CBME Curriculum 2024 and now revised guidelines have been published by the Commission.
Disability Guidelines:
In the revised CBME 2024 guidelines, NMC informed that "Modified guidelines for the academic year 2025-’26 onwards regarding admission of students with ‘specified disabilities’ under the ‘Rights Of Persons With Disabilities Act 2016’ with respect to admission in MBBS will be notified separately."
The Commission further mentioned that the "disability guidelines (page numbers 96 to 98) stipulated under CBME Guidelines 2023 dated 1st August, 2023 shall be applicable for the academic year 2024-’25."
"Lesbianism", "Sodomy" Removed from list of "Sexual Offences" and Informed Consent introduced:
In the modified CBME 2024 guidelines, NMC has also removed "lesbianism", "sodomy" words from the list of "sexual offences" and removed the word "unnatural" from the syllabus of Forensic Medicine & Toxicology of MBBS course.
The new syllabus asks students to describe and discuss informed consent in sexual intercourse. As per the syllabus, students are required to describe and discuss histories of gender and sexuality-based (sexual orientation) identities and rights in India.
They are also required to describe the history of decriminalization of 'adultery' and consensual adult homosexual sexual behaviour. Further, the students are also required to describe sexual offences with its medicolegal significance-
" Forced/ non-consensual penetrative anal sex
Forced/ non-consensual oral sex
Sexual acts with animals/ bestiality/ zoophilia
Forced/ non-consensual insertion of fingers or objects
Forced/ non-consensual touching or groping or disrobing (‘indecent assault’)."
Earlier NMC CBME guidelines:
Medical Dialogues had earlier reported that even though the Undergraduate Medical Education Board (UGMEB) of the Commission had earlier notified the CBME Curriculum 2024 via a circular dated 31.08.2024, it was later "Withdrawn and Cancelled" after it was alleged that the new MBBS curriculum was 'queerphobic' and 'non-inclusive'.
These guidelines were criticised by activists alleging that they violated the Rights of Persons with Disabilities Act (RPDA) 2016 and the Transgender Persons (Protection of Rights) Act (TPA) 2019.
Two activists, who represent the disabled and transgender people, recently wrote to the Union Health Minister and NMC Chairperson pointing out how the newly released MBBS curriculum listed sodomy and lesbianism as "unnatural sexual offences" and also removed the Disability Competencies, which should have been longitudinally throughout the curriculum in AETCOM, from the guidelines. An RTI has also been filed in respect to the latter.
Under the Curriculum for Forensic Medicine, the CBME 2024 has listed "lesbianism" and "sodomy" as "unnatural sexual offences", which according to the activists is a violation of the TPA 2019. Further, it identified "transvestism" (cross-dressing) as a "sexual perversion".
Another issue that the activists have pointed out is that even though disability rights as mandatory disability competencies were introduced in the CBME 2019 guidelines, there is no mention of the same in the Foundation Course of the MBBS Curriculum, which has now been reduced to just two weeks.
Highlighting these irregularities, Dr. Satendra Singh from Doctors with Disabilities: Agents of change (India), co-chair of the International Council for Disability Inclusion in Medical Education, and Disability Core Group, National Human Rights Commission (NHRC), and Air Cmde (Dr) Sanjay Sharma (Retd) CEO & Managing Director of Association for Transgender Health in India (ATHI) had mentioned in a joint statement that if NMC did not respond to their objections, they would write to the World Federation of Medical Education seeking a temporary suspension of the NMC's recognition "for the violations of WFME standards and the laws of India (RPDA 2016 and TPA 2019) until the necessary requirements are fulfilled."
In 2021, the Madras High Court highlighted the need to revamp the existing medical courses' curriculum and make them up to date. The bench had observed that medical courses in India reaffirm queerphobia and discrimination against the LGBTQIA + communities.
Back then, the Court had sought NMC to file a report as to how it would handle the issue in the future by carrying out necessary changes in the curriculum. Thereafter, in a similar order, the Kerala High Court directed the NMC to review the queerphobia text in MBBS course textbooks.
Later, NMC issued an advisory asking to make the textbooks LGBTQIA+ friendly and the Commission also removed the word "unnatural" from the classification of sexual activities including sodomy, buccal coitus, and lesbianism from the subject of Forensic Medicine & Toxicology of MBBS course.
Following this, an expert committee of NMC made suggestions to modify the CBME MBBS curriculum to make it LGBTQIA+ ( Lesbian, gay, bisexual, and transgender) Community-friendly.
To view the revised CBME 2024 guidelines, click on the link below:
https://medicaldialogues.in/pdf_upload/cbme-2024-guidelines-252294.pdf
Also Read: NMC Withdraws new MBBS curriculum CBME 2024 Guidelines, revised framework soon
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