Medical courses must focus on rights of disabled persons

Disabilities education has been given scant attention in the medical curriculum. Most students enter and leave medical school with little or no exposure to people with disabilities. The World Report of Disability states that people with disabilities were twice as likely to find the healthcare provider's skills and equipment not up to the mark. The Medical Council of India's outdated curriculum treats disability as a purely medical issue instead of a human rights issue. 

According to WRD, 15% of the world's population lives with some form of disability and 80% of them are in developing countries. While the report suggests people with disability are likely to be treated poorly by health workers and healthcare providers, RTI replies revealed that our medical curriculum does not have much matter on disability. All that they have is an internship on physical medicine and rehabilitation (PMR) post-MBBS which, too, often takes place in hospitals without a PMR unit. 

"Being a doctor, teacher and person with disability, I can tell that healthcare professionals need much more education about human behaviour and the highly variable relationships among disease, distress and disability. Our outdated curriculum treats disability as a purely medical issue whereas it's a human right issue," said Dr Satendra Singh, coordinator of the enabling unit at University College of Medical Sciences, Delhi University. 

Objectionable behaviours on the part of the physician include addressing the companion of a blind patient or one who is in a wheelchair instead of talking to the patient directly, or leaving a disabled patient in a disheveled and uncomfortable state after completing a physical examination, Singh said. 

"Polio has been eradicated but awareness about post polio syndrome is abysmal. Many people disregard a disabled person's sexuality, so disabled are excluded from the national HIV programme. Even medical students generally had limited knowledge about cerebral palsy and displayed negative attitudes towards people suffering from it," said Singh who is also a fellow at the Foundation of Advancement of International Medical Education and Research. 

In response to an RTI query on policies changed in line with UN Convention on the Rights of Persons with Disabilities 2006 protocol, MCI stated that that is the job of the union government. Asked about steps to introduce disability education in medical curriculum, the Council responded saying there is a chapter under physical medicine and rehabilitation as part of internship training.

"Ironically, internship starts after completion of MBBS. A majority of medical institutions in India do not have a PMR department. My earlier letter to the chairman, MCI, is supposedly lost in MCI office as they could not locate it," Singh said. 

According to Dr Ved Prakash Mishra, who is heading the medical education curriculum review and is also a member of the academic council of MCI, disabilities education will be accorded priority and it has been proposed that departments like radiotherapy and PMR be made mandatory for all hospitals. "We are working on a curriculum that will enforce complete compliance of rules which includes education to broaden the professional's understanding of disability," Mishra said. 

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