New Delhi: Disability percentage alone will not determine whether a candidate can pursue a postgraduate medical course, according to new National Medical Commission (NMC) guidelines. The framework makes functional competency, course-specific requirements, reasonable accommodation and patient safety central to assessing candidates with benchmark disabilities for MD, MS and DNB courses.
Candidates seeking admission under the Persons with Benchmark Disabilities category must have at least 40% benchmark disability and a valid Unique Disability Identity (UDID) Card. However, the disability percentage recorded on the card cannot by itself determine eligibility. The Medical Assessment Board will independently assess whether the candidate can demonstrate the competencies required for the specific postgraduate course.
The guidelines lay down course-specific functional requirements, particularly for specialties involving surgery and other hands-on procedures. These include fine motor skills, bimanual dexterity, mobility, depth perception and hand-eye coordination.
However, disability rights advocates have questioned some of these requirements. Dr Satendra Singh of Doctors with Disabilities: Agents of Change said: “The requirement of ‘optimum use of both upper limbs’ and non-recognition of sign language are stark examples of ableist criteria in the guidelines. They appear to treat physical characteristics as proxies for professional competence, rather than assessing whether a candidate can safely perform the essential functions of a speciality, with reasonable accommodation. Such blanket requirements risk excluding otherwise qualified doctors from postgraduate medical education. Eligibility and speciality choice should instead be based on individualised, evidence-based functional assessment, taking into account assistive technology and clinical accommodation.”
For several other clinical specialties, the assessment will include abilities such as history-taking, examination, basic procedures and documentation. Candidates may use assistive devices or receive reasonable accommodation, including modified instruments, accessible workplaces and flexible schedules where appropriate.
The guidelines specifically state that no candidate should be declared eligible or ineligible solely on the basis of the disability category or percentage. Assessment must be individualised, objective and based on functional ability, while reasonable accommodation and assistive technology must be considered before declaring a candidate ineligible.
For candidates with conditions such as autism spectrum disorder, specific learning disorder and intellectual disability, the assessment will consider communication, comprehension, ability to follow and give instructions, structured learning, adaptive functioning and independent functioning, with support where needed.
The Medical Assessment Board can declare a candidate eligible, eligible with reasonable accommodation, or ineligible, after considering demonstrated functional competency, the feasibility of reasonable accommodation and assistive technology, the ability to complete the course and patient safety. Assessments must be fair, transparent and free of physical, environmental, communication or attitudinal barriers.
For specialties requiring fine motor skills, endurance, depth perception or rapid decision-making, the guidelines say disability percentage alone is insufficient and require functional assessment. The framework aims to promote equality and reasonable accommodation while maintaining academic standards and patient safety. It supersedes earlier NMC and Medical Council of India guidelines to the extent that they are inconsistent with the new framework.
