“NMC withdraws controversial guidelines listing sodomy and lesbianism as ‘unnatural sexual offences’ after public outcry. Explore the impact on medical education, the response from activists, and the need for inclusive curriculum reforms.”

The National Medical Commission had recently come under heavy criticism for bringing back some controversial guidelines in the Competency Based Medical Education Curriculum, CBME 2024, which included sodomy and lesbianism as “unnatural sexual offences.” Amid the furore by the medical fraternity, LGBTQIA+ activists, and disability rights, the NMC hastily withdrew the guidelines on Thursday, September 5, 2024.

Controversial Guidelines and Public Backlash

The now-withdrawn CBME guidelines were issued on August 31, 2024, as part of the NMC’s revised curriculum for MBBS students. These guidelines not only listed sodomy and lesbianism as offenses under the subject of forensic medicine and toxicology but also termed transgenderism as “sexual perversion.” The guidelines have also brought back concepts of virginity defined by the hymen in medico-legal practices.

These are regressive elements, many of which had been deleted earlier following the court’s directives. These have come in for public criticism from all quarters. This discriminatory content of the NMC has particularly outraged activists and medical professionals in a modern medical curriculum. In this regard, Dr. Satendra Singh, Co-Chair of International Council for Disability Inclusion in Medical Education, has taken to social media to express his anger. He expressed how this approach towards inclusion in medical education requires constant legal intervention to see that such discriminatory content is not included.

Immediate Withdrawal by the NMC

As the criticism raged, on September 5, 2024, NMC issued a circular which stated that the ‘controversial’ CBME guidelines are withdrawn and cancelled immediately. It said, “The circular of even number dated August 31, 2024, thereby issuing guidelines under Competency Based Medical Education Curriculum (CBME) 2024, stands ‘withdrawn and cancelled’ with immediate effect.” On the other hand, it said, NMC would revise and update those guidelines in due course.

Medical Education and Future Guidelines

The reaction to the NMC guidelines forms a part of the larger concern over what exactly students are taught in India’s medical schools. The presence of unscientific and discriminatory material in the MBBS curriculum would go on to poorly educate doctors and perpetuate stereotypes and harmful biases. For long, the requirement has been felt of an inclusive curriculum that is evidence-based and stands in consonance with contemporary human rights standards.

The fact that the NMC moved to immediately withdraw the guidelines is a positive step, and yet there is an apprehension as to what the future revisions might have in store. Activists and professionals alike are cautious over the history of multiple U-turns by the NMC over such issues. Dr. Singh and many more strongly pointed out that vigilance is required so as not to allow the revised curriculum to revert to the same content as now.

Forensic Medicine and Toxicology in Education

Forensic medicine and toxicology form an important part of medical education, as they help equip students with the necessary knowledge to deal with medico-legal cases in a highly professional and ethically considerate manner. On the other hand, entrenching obsolete and prejudicial concepts within the ambit of these subjects degrades the quality of education and the ethical ethos that every medical professional should strive to work within. It therefore becomes obligatory on the content of the curriculum to not only be updated according to current scientific understanding but also promulgate equality, respect, and inclusivity within the practice of medicine.

The Way Forward for Inclusive Education

The roiling controversy over the NMC CBME guidelines reminds us of the imperative need to constantly revise and review the medical curriculum with a view to bring it up to date with the changing ethical dimensions. In so far as the NMC has begun the task of revising the curriculum, there is an imperative need that the new guidelines are drafted with the involvement of wide-ranging stakeholders from the medical profession, academia, as well as representatives from marginalized groups.

The attempt should be to formulate a curriculum that would ensure medical competencies for future doctors but also a development of a sense of responsibility to accord all patients respect and dignity, regardless of their sexual orientation, gender identity, or physical abilities. It is only then that the NMC would be assured that the medical education system in India is progressive, inclusive, and fit for the 21st century.