Medical educators call for LGBTQIA+ and Disability Competencies in India’s curriculum

A group of medical educators, public health researchers and LGBTQIA+  community members associated with iHEAR initiative of Sangath Bhopal, have called for the National Medical Commission (NMC) to revise its recently updated Competency Based Medical Education (CBME) Curriculum 2024 to include competencies addressing the healthcare needs of LGBTQIA+ individuals and persons with disabilities. 

A letter submitted to the Secretary of the NMC outlines critical gaps in the curriculum that undermine inclusive healthcare for marginalised communities and has a detailed list of competencies that they have asked to include. The recommendations submitted to the NMC are based on extensive consultations with over 150 community members, healthcare professionals, and educators. This process included consultative workshops, national conferences, and virtual meetings held between 2021 and 2023. 

These efforts resulted in the development of 36 LGBTQIA+  competencies and 27 core competencies on disability for healthcare education. The group is urging the NMC to include these competencies in the new curriculum. Part of the disability competencies were included in the earlier curriculum but were removed as part of the recent changes. 

The letter highlights the following concerns: 

1. Absence of disability competencies: Despite the Rights of Persons with  Disabilities Act (2016), the new CBME guidelines omit dedicated hours for Disability  Competencies that were included in the previous curriculum. 
2. Lack of protections for intersex individuals: The curriculum fails to address the prevention of harmful corrective surgeries on intersex children, which have been banned in states like Tamil Nadu and Kerala. 
3. Gaps in the AETCOM module: The module on Attitude, Ethics, and Communication does not include LGBTQIA+ or disability-related competencies. 
4. Stigmatising terminology in psychiatry and physiology: Outdated terms like  “gender identity disorders” continue to reinforce stigma in the medical field. 
5. No focus on gender-inclusive pediatric care: Training on gender-affirming care for children is absent from the Pediatrics curriculum.

The letter urges the NMC to align the CBME curriculum with global best practices and ensure compliance with national laws, such as the Transgender Persons (Protection of  Rights) Act (2019) and the Rights of Persons with Disabilities Act (2016). They also stress the importance of legal and social responsibility in training future healthcare professionals. 

“Much of the conversation is about removing negative queer-phobic content. We have, through extensive consultations, identified the positive content that needs to be included.  We now urge the NMC to include it in the new curriculum”, said Dr Harikeerthan  Raghuram, Associate Director at iHEAR, Sangath Bhopal.