NMC’s expert committee recommends LGBTQIA+ friendly MBBS curriculum. Find the list of changes here

The Expert Committee, after detailed discussion and deliberation, has recommended making modifications to the Competency-Based Medical Education curriculum
Picture for representational purpose only | (Pic: Express)
Picture for representational purpose only | (Pic: Express)
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The National Medical Commission (NMC), after consulting an expert committee, has now recommended making modifications in the curriculum for Competency-Based Medical Education, to address issues related to the LGBTQIA+ community. 

In a letter issued on August 18, the NMC stated, “In pursuance to the order dated August 31, 2021, passed by the Hon'ble High Court of Madras in W.P.(c) No. 7284 of 2021 titled Ms. S. Sushma & Anr. vs The Commissioner of Police & Ors., an Expert Committee was formed by the Undergraduate Medical Education Board to address the issues related to the LGBTQIA+ community.” 

The Expert Committee, after detailed discussion and deliberation, has recommended making modifications to the Competency-Based Medical Education curriculum, the letter stated. The committee recommended changes in the Forensic Medicine Competency and Psychiatry Competency. 

The list of changes can be found below:

Forensic Medicine Competency

Existing competency

Modified Competency

FM3.16 Describe and discuss adultery and unnatural sexual offences - sodomy, incest, lesbianism, buccal coitus, bestiality, indecent assault and preparation of report, framing the opinion and preservation and

despatch of trace evidences in such cases.

FM 3.16: Describe and discuss informed consent in sexual intercourse.

Describe and discuss histories of gender and sexuality-based (sexual orientation) identities and rights in India.

Describe history of decriminalisation of 'adultery' and consensual adult homosexual sexual behaviour.

Describe sexual offences with its medicolegal significance —

- forced/non-consensual penetrative anal sex 

- forced/non-consensual oral sex sexual acts with animals/ bestiality/zoophilia

- forced/non-consensual insertion of fingers or objects

- forced/non-consensual touching or groping or disrobing ('indecent assault').

FM3.13: Describe different types of sexual offences. Describe various sections of IPC regarding rape, including the definition of rape (Section 375 IPC), Punishment for Rape (Section 376 IPC) and recent amendments notified till date

FM3.13: Describe various sections of IPC & CrPC related to the definition of rape and sexual assault, medical examination of the rape victim and accused of rape, police information by the doctors and medical care with recent amendments notified till date (i.e., Section 375 IPC, 166 B IPC, 357 C & 164 A, 53 A of CrPC).

Describe the relevant provisions of POCSO Act related to medical examination, emergency medical care and police information.

FM3.17: Describe and discuss the sexual perversions fetishism, transvestism, voyeurism, sadism, necrophagia, masochism, exhibitionism, frotteurism, Necrophilia.

FM3.17. Describe the difference between Paraphilia and Paraphilic disorder. Describe paraphilic disorder as per the latest guidelines of DSM & ICD and describe medico-legal implications of paraphilic disorder by referring scientific literature and legal justification (if any).

Describe and discuss the various paraphilias in the context of informed consent during any sexual interaction.

FM3.18 Describe anatomy of male and female genitalia, hymen and its types. Discuss the medicolegal importance of hymen.

Define virginity, defloration, legitimacy and its medicolegal importance.

FM3.18 Describe legitimacy and its medicolegal importance.

Describe and discuss how 'signs' of virginity (so-called 'virginity test', including finger tests on female genitalia) are unscientific, inhuman and discriminatory.

Describe and discuss how to appraise the courts about the unscientific basis of these tests, if the court orders it.

FM14.14: To examine & prepare a report of an alleged accused in rape/unnatural sexual offence in a simulated/ supervised environment

FM14.14: To examine and prepare a report on an alleged accused person in cases of various sexual offences in a simulated/ supervised environment.

Demonstrate an understanding of framing the opinion, preservation and despatch of trace evidences in such cases.

Describe and discuss personal opinions and their impact on such examinations and the need for objectivity/neutrality to avoid prejudice influencing the case.

FM14.15 To examine & prepare medico-legal report of a victim of sexual offence /unnatural sexual offence in a simulated/ supervised environment.

FM 14.15 To examine and prepare medico-legal report on an alleged victim of various sexual offences in a simulated/ supervised environment. (Guidelines and Protocols of Medico Legal Care for Survivors Victims of Sexual Violence. Ministry of Health & Family Welfare, GOI- with latest modifications if any).

Demonstrate an understanding of framing the opinion and preservation and despatch of trace evidences in such cases.

Describe and discuss sympathetic/ empathetic examination and interview of victims of sexual assault, including the presence of a trusted adult figure in cases of minor victims.

Psychiatry Competency

Existing competencyModified Competency

Topic Name: Psychosexual and gender identity disorders (Vol Il Page 210)

Topic Name: Human sexuality;

Gender incongruence or Gender dysphoria;

Gender non-conformity;

Differences of sex development (DSD) or Intersex;

Paraphilia and Paraphilic disorders;

Sexual dysfunctions.

PS 13.1: Enumerate and describe the magnitude and etiology of psychosexual and gender identity disorders.

PS13.2 Enumerate, elicit, describe and document clinical features in patients with magnitude and etiology of psychosexual and gender identity disorders.

PSI 3.3 Enumerate and describe the indications and interpret laboratory and other tests used in psychosexual and gender identity disorders

PS 13.4 Describe the treatment of psychosexual and gender identity disorders including behavioural, psychosocial and pharmacologic therapy.

PS13.5 Demonstrate family education in a patient with psychosexual and gender identity disorders in a simulated environment.

PS 13.1: Enumerate and describe the magnitude and etiology of psychosexual and gender identity disorders.

PS13.2 Enumerate, elicit, describe and document clinical features in patients with magnitude and etiology of psychosexual and gender identity disorders.

PSI 3.3 Enumerate and describe the indications and interpret laboratory and other tests used in psychosexual and gender identity disorders

PS 13.4 Describe the treatment of psychosexual and gender identity disorders including behavioural, psychosocial and pharmacologic therapy.

PS13.5 Demonstrate family education in a patient with psychosexual and gender identity disorders in a simulated environment.

PS13.1: Demonstrate an understanding of the difference between sex and gender/ biological and social construction of personhood;

Demonstrate an understanding of gender identity;

Demonstrate an understanding of transgender, gender non-conformity, and other gender diverse identities.

Demonstrate an understanding of sexual/sexuality identity, sexual orientation, sexual desire;

Demonstrate an understanding of the wide variety of sexual orientations and desires;

Describe and demonstrate an understanding of the differences in sex development in individuals who don't fit into the biological binary of male or female;

Demonstrate an understanding of common myths and misconceptions about LGBTQIA + identities like Hijra, Intersex;

Demonstrate an attitude of openness and respect for all genders and sexualities;

Demonstrate an understanding of common psychosocial stressors faced by members of LGBTQIA+ communities in India;

Demonstrate Knowledge about basic tenets of LGBTQIA+ affirmative counselling.

Demonstrate knowledge and ability to educate family members that unnecessary medical interventions on individuals with intersex variations are unethical.

PS13.9: Describe the difference between Paraphilia and Paraphilic disorder.

Describe different paraphilias.

Describe and discuss the importance of informed consent during any sexual interaction.

Describe and discuss the impact of personal opinions on working with people who express paraphilias.

PS13.10: Describe the prevalence & etiology of paraphilic disorders.

PS13.11: Enumerate criteria for the diagnosis (diagnostic criteria) of paraphilic disorders according to the latest psychiatric classification.

PS13.12: Demonstrate in the simulated environment the ability to educate the individual/family members that paraphilia in itself is not a disease and may not require clinical intervention.

PS13.13: Enumerate the reasons for specialist referrals for any of the cases.

PS13.14: Describe the stages and differences in the human sexual cycle.

PS13.15: Enumerate the diagnostic criteria of various sexual dysfunctions corresponding to the stages of the human sexual cycle.

PS13.16: Describe the management (till the level of MBBS graduate domain) and reasons for specialist referral in cases of sexual dysfunction.

This move comes after the NMC’s decision in May that dropped the term “unnatural” from the classification of sexual activities, like buccal coitus, lesbianism from ‘Forensic Medicine & Toxicology’ subject of the MBBS course, as stated in a report by PTI. 

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