HC denies relief to PwD MBBS candidate, says Courts Can Only Examine Expert Medical Disability Reports if Lacking Sufficient Reasons
Delhi High Court
New Delhi: The Delhi High Court bench recently clarified that courts can interfere with the medical opinion of the Medical Disability Board/Disability Assessment Board only when such reports lack clarity regarding detailed reasons.
"It is apparent that in case there are sufficient reasons contained in the medical opinion of the Medical Disability Board/Disability Assessment Board, the Courts may not interfere. Only when the said Medical Report lacks clarity in terms of detailed reasons, would the Court examine such Medical Reports," noted the HC bench comprising Chief Justice Manmohan and Justice Tushar Rao Gedela.
These observations were made by the Court while considering a plea by a PwD category candidate, who was denied MBBS admission due to the opinion of the Medical Board certifying his disability percentage.
The petitioner appeared for the National Eligibility-Entrance Test (Undergraduate), 2024 examination as an SC-PwD category candidate and his disability percentage was recorded at 42% as per his Disability Certificate dated 9th December, 2023, which is a benchmark disability as defined under Section 2(r) of the Rights of Persons with Disabilities Act, 2016.
He secured a PwD category rank 176, well above the cut-off score for the SC/EWS-PwD category and became eligible for the next stage in the admission process, which required issuance of a Certificate of Disability for NEET Admissions from a designated Disability Certification Centre.
Accordingly, he approached Vardhman Mahavir Medical College- Safdarjung Hospital, a recognized Disability Certification Centre in New Delhi on 16th August 2024.
However, allegedly, despite the VMMC-SJ Hospital quantifying his disability at 68% in the NEET Disability Certificate dated 19.08.2024 i.e. within the permissible disability range of 40% to 80%, the said Hospital concluded that the appellant was not eligible to pursue medical courses.
Challenging this, the appellant approached the Single Judge bench of the High Court, which directed the formation of a Medical Board at All India Institute of Medical Sciences, New Delhi to independently assess the nature and extent of appellant’s functional disability, as well as to determine whether his condition meets the requirements necessary for being eligible to pursue MBBS course.
In compliance with this order, the Medical Board, after conducting a thorough evaluation of the appellant's condition, submitted its report dated 6th September 2024 concluding that the appellant's disability makes him ineligible to pursue the MBBS course. Based on this, the Single Judge dismissed the plea on 10th September 2024, and challenging the Single Judge bench's order, the student approached the Division Bench.
The student's counsel referred to the Disability Certificate dated 9th December, 2023 issued by the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, Government of India to submit that the appellant is an admitted case of Congenital amputation of Multiple fingers in both hands and second and third toe of the left foot.
He further submitted that the appellant is assessed at 42% permanent disability, and he belongs to the SC category and has done exceptionally well by scoring 542 marks out of 700 marks. But for the rejection by the Medical Board, the appellant is otherwise fully qualified and entitled to be admitted to MBBS course, submitted the counsel further adding that the appellant is very keen and enthusiastic to become a medical doctor.
The counsel for the appellant further argued that on the one hand, VMMC-SJ Hospital assessed that the appellant had 68% permanent disability, yet on the other, has rejected his candidature and found him ineligible on the ground of "Bilateral upper limb involvement."
Arguing that the assessment was invalid, the appellant's counsel invited attention to the Guidelines regarding the admission of students with "Specified Disabilities" under the RPwD Act, 2016 with respect to the admission in the MBBS Course- particularly to clause (f) under "Specified Disabilities", to contend that the Medical Board did not assess the competency of the appellant with the aid of assistive devices to ascertain whether affected part possesses sufficient motor ability as required to pursue and complete the course satisfactorily. Therefore, the counsel urged the Court to set aside the Disability Certificate, challenged in the plea, and requested for a proper re-evaluation with assistive devices.
Further, it was argued that both the Disability Certificates issued by VMMC-SJ and AIIMS, New Delhi were vitiated for not following the mandate of directions in letter dated 24th March, 2024 issued by the Ministry of Health and Family Welfare, Government of India.
On the other hand, the counsel for the National Medical Commission (NMC) submitted that the Single-Judge had granted the appellant's demand for a re-evaluation of his disability and a fresh Medical Board was constituted by the order dated 3rd September 2024.
He pointed out that the report of the Medical Board, set up based on the Single Judge's orders, clearly gave a detailed opinion as to the parameters on which the appellant was examined and sound reasons were mentioned in the report to hold the appellant ineligible to be admitted to the MBBS course.
It was also submitted that the AIIMS Medical Board had examined the appellant with all stipulated parameters including assistive devices and "reasonable accommodation". He further stated that all the concerned were taken note of by the reconstituted Medical Board, which submitted the opinion on 30th September 2024.
While considering the matter, the Court noted that the appellant came from a deprived strata of society. However, he is a brilliant student and despite this, he was unable to give wings to his dreams.
"There are limitations which circumscribe the jurisdiction of Constitutional Courts lest the Court starts substituting its own opinion, contrary or otherwise, to the one rendered by a body constituting highly experienced professionals who are experts in their line," noted the Court while opining that it would examine the contours of the appeal, by firstly examining the Medical Board's opinion.
The Court noted that through the Disability Certificate dated 19th August, 2024, the VMCC-SJ Hospital ascertained the appellant as a person suffering from locomotor disability to the extent of 68% with a remark "bilateral upper limb involvement", opining that the appellant is not eligible to pursue the medical course as per the NMC norms.
Further, the court noted that when this Certificate was challenged by the appellant, the Single-Judge bench set up a Medical Board, which gave its opinion on 6th September, 2024 and opined that "The Medical Board is of the opinion that the petitioner Sh. ***is NOT ELIGIBLE to pursue the MBBS graduation course. This Medical Board is of the opinion that this candidate will face certain difficulties in the course of time pursuing MBBS, because of the significant involvement of both hands with missing multiple fingers leading to limitations in acquiring and executing certain essential skills."
Taking note of the report, the Single Judge dismissed the plea on 10th September, 2024, which was challenged before the Division Bench of the High Court. The AIIMS Medical Board included a doctor with disability and after detailed assessment of the candidate, the Board stated that the candidate belonged to the category of persons with benchmark disability (forty percent or more disability) due to congenital absence of multiple fingers in both hands as well as involvement of left foot (second and third toe). This disability is of the locomotor system and permanent in nature.
Apart from this, the Medical Board also considered the possibility of reasonable accommodation with assistive devices or prostheses and observed that the main objective of the undergraduate medical curriculum is to prepare a skilled and responsible physician to serve at the primary care level and this includes several medical and surgical competencies including General Surgery and Allied disciplines like Orthopedics, Obstetrics and Gynecology etc (Guidelines for Competency Based Medical Education (CBME) Curriculum).
"The Medical Board confirms with the finding of the previous Medical Board and is of the opinion that the petitioner Sh. Kabir Paharia is NOT ELIGIBLE to pursue the MBBS graduation course as per the current NMC norms," the Medical Board mentioned in the report.
Taking note of the Medical Board's report, the court said,
"So far as the Medical Report dated 30th September, 2024 rendered by the reconstituted Medical Board of AIIMS, New Delhi having a doctor/health professional who is a person with disabilities is concerned, this Court finds that the said Medical Board had revisited the examination of the appellant keeping in view the possibility of “reasonable accommodation” with assistive devices or prosthesis. This Court finds that the Medical Board had rendered a clear and cogent medical opinion concluding that the appellant is ineligible to pursue MBBS Course, having the said parameter as a primary aspect. Contrary to the submissions of the learned senior counsel for the appellant that the Medical Boards so constituted did not consider the alternate plea of the appellant pursuing MBBS Course only for the purposes of teaching, this Court finds that the second Medical Board had clearly taken the said aspect into consideration prior to ruling out the alternate plea. This is clear from the observation, in that, “Though the candidate may seek to pursue non surgical branches at a later date, acquiring and demonstrating competencies in these surgical disciplines is a prerequisite for completing the Medical Under Graduate Programme”. Thus, the argument on the aforesaid premise is untenable."
"It is trite that Courts ordinarily do not interdict or substitute their own opinion over that of expert bodies. In the present case, highly qualified and experienced medical doctors were to render an opinion as to whether the appellant could or could not be eligible to complete the MBBS Course, even if the appellant were to only become a teacher. That opinion has been rendered in detail. Moreover, Courts are not experts in the field of medical science "to sit over decisions taken by the experts in the field and substitute it with its own wisdom"." noted the Court.
Therefore, the Division Bench noted that in case there are sufficient reasons contained in the medical opinion of the Medical Disability Board/Disability Assessment Board, the Courts may not interfere.
"Only when the said Medical Report lacks clarity in terms of detailed reasons, would the Court examine such Medical Reports. So far as the present appeal is concerned, this Court finds that the Medical opinion rendered by both the Court constituted Medical Boards of AIIMS, New Delhi have sufficiently explained the reasons for concluding that the appellant is ineligible to be admitted to the MBBS course," the HC bench observed.
While the court did not agree with the appellant's contentions, it reiterated the directions passed by the Division bench of the Court in the case of Neha Pudil vs. Union of India & Ors., where, under similar circumstances, the Coordinate Bench had directed the authorities to explore the possibility of such PwD candidates to pursue some of the disciplines, if not all, of medical education, considering the advancement of science and technology.
Further, the Division bench noted that NMC informed the Single Juge bench that a fresh policy has been framed in this regard and it would be applicable from the next academic year.
"In that view of the matter, it is directed that the aforesaid directions be complied with by the respondent strictly within six (6) months. Consequent thereto, the appellant would be at liberty to re-apply for the admission in NEET (UG) Programme and his condition would be re-assessed based upon the newly formulated guidelines of the respondent," the Division bench ordered while dismissing the appeal.
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/delhi-hc-disability-263594.pdf
