How Institutions Can Comply With Duties To Afford Reasonable Accommodation To Disabled Medical Students: SC Give Suggestions To Govt.

The Supreme Court has given suggestions to the Central Government on how the institutions can comply with their duties to afford reasonable accommodation to disabled medical students.

The Court was dealing with a civil appeal preferred by a specially abled medical student against the Director General of Health Services.

The three-Judge Bench of CJI D.Y. Chandrachud, Justice J.B. Pardiwala, and Justice Manoj Misra observed, “In the UK, the General Medical Council, which regulates medical education, has issued an advisory guidance titled Welcome and valued. The guidance outlines how institutions can comply with their duties to afford reasonable accommodation to disabled medical students. The guidance inter alia lists the steps for supporting medical students. After addressing student requirements and agreeing on a support action plan, the guidance outlines the following steps, which are indicative and may not be appropriate for all –

a. Forming a support group or a lead to deal with support arrangements of incoming students with disabilities;

b. Identifying key persons of contact with students with disabilities and for each of the services involved in exploring the support arrangements;

c. Informing students on how their information will be used in compliance with confidentiality. Colleges are further recommended to:

i. Keep a clear audit trail of decision making for supporting disabled learners as this is likely to help schools make sure they have taken appropriate steps to provide reasonable adjustments;

ii. Keep a record of all conversations between the support group and student. Agree on the method of recording such conversations and allow the student to see a draft record of any discussions;

iii. Create a separate file with different access arrangements for confidential information related to health outside of the general student record.

d. The lead must thereafter organise a meeting between the student and the support group. The group may also arrange meetings to evaluate cases and discuss progress; and

e. Lastly, a decision may be made on whether the student with disability can be provided adequate support to enable them in meeting the outcomes desirable in a medical graduate.”

Senior Advocate Shadan Farasat represented the appellant while Senior Advocates Archana Pathak Dave and Gaurav Sharma represented the respondents.

In this case, the appellant had lower limb myopathy – a locomotor disability. He secured an A1 grade in his matriculate (Class X) and intermediary (Class XII) examination held by the Central Board of Secondary Education (CBSE). He then aspired to enter the medical profession and with this resolve, he appeared for the NEET UG Examination 2024 under the unreserved/EWS-PwD category and secured 601 marks out 720. This placed him at an all-India PwD rank of 84 and a State PwD rank of 4. Despite having a Disability Certificate which was to be valid until 2025 – he submitted himself to the mandatory assessment to get his eligibility certified by a designated medical board at AIIMS, Nagpur.

The medical board at AIIMS, Nagpur comprised of an Associate Professor in Physical Medicine and Rehabilitation; an Assistant Professor of Orthopaedics; and a Professor who was the Chairman of the Disability Board at AIIMS, Nagpur and the Board, by a NEET Disability Certificate, opined that the appellant was 88% disabled and was therefore ineligible to pursue an MBBS/Dental course. Being aggrieved, he filed a writ petition before the Bombay High Court and the same was dismissed. The appellant underwent a crash course in navigating the Indian legal system from statutory prescriptions, regulatory stipulations, High Court adjudication, regulatory and court ordered disability assessments to the race to justice before the Apex Court.

The Supreme Court in view of the above facts, remarked, “No nation can truly progress until all her people realize a stake in their collective outcome. In one sense discrimination excludes the aggrieved from the collective imagination of the nation. In another sense the nation is deprived of the expertise and brilliance of those who are discriminated. We aspire to have institutions and systems which reflect the rich diversity of our country. The aspiration is one rooted in our commitment to the nation. Diverse institutions are vital to ensure the governance of a diverse nation.”

The Court added that, when persons with disabilities are discriminated against, it not only affects their individual aspirations and dignity - it strikes a blow to the entire nation and the collective goal of integration and fraternity.

“Dr Martin Luther King Jr has famously remarked that "injustice anywhere is a threat to justice everywhere." When we allow injustice to occur, we normalize the idea that fundamental rights and freedoms are violable. The inviolability of our collective commitment is weakened. Discrimination cracks open a wedge in the fabric of the society - it violates the Constitution and erodes the humanity of the person discriminated against. The discrimination can manifest directly or indirectly. Its manifestation eats into our commitment to each other and of the State to the people”, it further noted.

The Court said that the provision of an audit trail to assess whether a given accommodation required by a student with disability places an undue burden on the institution is a vital safeguard for transparency and fairness.

“Dr Satendra Singh in his report dated 20 October 2024 has made suggestions to (i) rename the Disability Assessment Boards as Ability Assessment Boards to align them better with their intended purpose; (ii) include a doctor with disability or who is well conversant with disability rights in such Boards; (iii) use a human rights model of disability for assessment; (iv) issue guidance on clinical accommodations; (v) train the Boards in carrying out the disability competency assessment; and (vi) use the Enabling Units to serve as a contact point for clinical accommodations. As far as the inclusion of doctors with disabilities in the Disability Assessment Boards is concerned - the first respondent has issued a circular on 24 March 2022 mandating such inclusion. This direction shall be complied with by all Boards”, it also directed.

The Court ordered that the committee shall recommend fresh guidelines to replace the existing guidelines and that the suggestions shall be duly considered by the government on its own merits. It said that the recommendations so formulated shall comply with its judgment.

The Court issued the following directions –

• A supernumerary seat shall be created at the AIIMS, Nagpur and the seat shall be allocated to the appellant, provided that he has not already secured a seat at a college of his choosing.

• The college shall be given the report which makes suggestions as to the accommodations which may be extended to the appellant to successfully pursue the MBBS course.

• The appellant shall be protected from victimisation.

• The judgement shall apply in rem.

The Court further concluded the following points –

a. The second respondent shall issue fresh guidelines for admitting persons with disabilities into medical courses. The committee formulating the guidelines must include experts with disability or persons who have worked on disability justice.

b. The Disability Assessment Boards shall eschew from a benchmark model to test the functional competence of medical aspirants with disability.

c. The Disability Assessment Boards shall include a doctor or health professional with disability as per the directions of the first respondent dated 24 March 2022;

d. The conduct of the Disability Assessment Boards shall be fair, transparent and in compliance with principles of the rule of law.

e. Reasonable accommodation is a gateway right to avail all other fundamental, human and legal rights for persons with disabilities. Non-availability of reasonable accommodation amounts to discrimination and violates substantive equality of persons with disabilities.

f. The inclusion of persons with disability in the medical profession would enhance the quality of healthcare and meet the preambular virtue of fraternity and the guarantees in Articles 21, 19, 14 and 15 of the Constitution.

g. Applicants to the NEET examination must be informed about the compliance of accessibility norms and provisions of reasonable accommodation available at colleges. The respondents shall issue appropriate directions to create a database with relevant information on accessibility and reasonable accommodation.

h. Enabling Units at medical colleges shall act as points of contact for persons with disability desirous of accessing clinical accommodations.

Accordingly, the Apex Court allowed the appeal and set aside the impugned judgment.

Cause Title- Om Rathod v. The Director General of Health Services & Ors. (Neutral Citation: 2024 INSC 836)

Appearance:

Appellant: Senior Advocate Shadan Farasat, AOR Talha Abdul Rahman, Advocates M Shaz Khan, Taha Bin Tasneem, Sudhanshu Tewari, Rafid Akhter, Faizan Ahmad, and Pranav Dhawan.

Respondents: Senior Advocates Archana Pathak Dave, Gaurav Sharma, AORs Amrish Kumar, Prateek Bhatia, Advocates Shashank Bajpai, Sushma Verma, Karunesh Kumar Shukla, Gopi Chand, Dhawal Mohan, Paranjay Tripathi, Rajesh Raj, and Ankita Dogra.

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