After the syllabus underwent amendments following a HC directive, the National Medical Commission now appears to have reverted to the ‘unscientific’ guidelines of 2019
NMC in 2022 had decided to teach medical students how virginity tests are unscientific, inappropriate and discriminatory. Representation Pic
The recent MBBS second and third year syllabus announced by National Medical Commission (NMC) for academic year 2024-2025, has skipped a major modification in the syllabus recommended by an expert committee in relation to LGBTQIA+ and virginity, as per the directives of the Madras High Court.
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The skip has irked a few committee members, who had recommended the changes, and learnt about the skip on Saturday August 31. One of them, who spoke to mid-day, apprehended that, if the expert panel recommendations are not included in the syllabus, the matter would once again come under the judicial lens of Madras High Court, as petitioners may object to failure to comply with the court orders.
The National Medical Commission (NMC) in 2022 had taken the decision to teach medical students how signs of virginity (so called virginity test including two finger test of female genitalia) are unscientific, inappropriate and discriminatory. NMC had further taken the decision to teach medical students how to appraise the courts about the unscientific nature of virginity test if court orders it in matrimonial disputes like nullity of marriage and impotence, etc.
mid-day’s report dated July 6, 2022 on this subject
The decision was taken based on the recommendations of the expert panel constituted by Dr Aruna Vanikar, president of Under Graduate Medical Education Board (UGMEB) of NMC, on the orders of Madras High Court to address the issues about LGBTQIA+ community in the MBBS curriculum. However, on the request of Dr Indrajit Khandekar, professor of forensic medicine, Mahatma Gandhi Institute Medical Sciences (MGIMS), Sevagram, (also part of the expert panel) the virginity issue was added in the domain of the expert panel.
The expert panel consisted of following members: Dr Vijendra Kumar, member-UGMEB; Dr Prabha Chandra, senior professor, psychiatry, NIMHANS; Dr Surekha Kishore, executive director, AIIMS, Gorakhpur and Dr Khandekar.
Mid-day in its article titled ‘Virginity test unscientific, discriminatory, says National Medical Commission’ dated July 6, 2022, had highlighted the NMC expert panel concern.
The present concern
Recently, the National Medical Commission issued Competency-Based Medical Education (CBME) Guidelines, 2024, along with CBME Competencies Volumes I, II, and III, and has asked all the institutions concerned to strictly adhere to the same from the MBBS batch of 2024-25 onwards.
Dr Indrajeet Khandekar, professor of forensic medicine, MGIMS, Sevagram
“I am really upset to see this directive. It is very unfortunate that the new CBME guidelines for 2024 have not included the modified competencies in relation to the virginity and LGBTQIA+ community that have been modified by the NMC in view of the Madras High Court Order, way back in 2022. In pursuance of the Madras High Court order in Writ Petition titled Ms S Sushma and Another vs. The Commissioner of Police & Others, the NMC had modified the competencies related to the LGBTQIA+ community and virginity and had issued the notification on August 18, 2022 for the same," said Dr Khandekar.
Revert to old syllabus
“The first CBME documents were released in 2019. Then it was modified for the first time in 2022 in view of the Madras High Court order. And now NMC has issued the CBME 2024. It was the responsibility of the NMC to include the competencies related to virginity and the LGBTQIA+ community that were modified in 2022 in view of the High Court order in these new 2024 directives. However, unfortunately, the new directives have kept the old competencies of 2019 in relation to the LGBTQIA+ community and Virginity as they are. It thus appears to be a copy and paste of the old one,” said Dr Khandekar.
“The competencies in relation to virginity and LGBTQIA+ community were challenged on the ground that they were unscientific, inappropriate, discriminatory, derogatory, and objectionable. The outdated or obsolete words like sexual perversions are still used in the new 2024 directives. It also includes sodomy itself as an offence, which interestingly, so far is not considered as an offence under the new criminal laws (Bhartiya Nyaya Sanhita, 2023)” he added.
Issues with the new CBME 2024 issued by NMC as observed by Dr Khandekar-
1. In the modified competencies of 2022, it was specifically asked to teach the students about the unscientific basis of signs of virginity. Even doctors were taught to appraise the courts about the unscientific basis of the virginity test when the courts asked the doctor to perform the virginity test. But this aspect is removed in the 2024 directives.
2. The outdated or obsolete words like sexual perversions are still used in this new 2024 document.
3. It also includes sodomy itself as an offence (which so far is not an offence under BNS 2023).
4. But now in the new document, the old competencies of 2019 are copied, as it is ignoring the modifications done in 2022 in view of the high court order.
Miscarriage of Justice
“Virginity test has been ordered by the courts across the country in various matrimonial disputes. On court orders, the doctor conducts it even if the test has no scientific basis as doctors are not taught to explain to the courts about the issue. Such practices keep on leading to miscarriage of justice. This was to be the first time in the history of medical education that medical graduates were to be taught to appraise courts about unscientific basis of any test/signs if court orders so. Previously medical students were taught about the medico-legal significance of virginity but this was removed in 2022, and it will now be once again introduced in the medical courses. Medical students across the country were also to be taught about the unscientific basis of virginity tests, which cannot happen, under the recent directives issued by NMC,” explained Dr Khandekar.
Unscientific and not proven
“Medical students until now till 2022 were following the two methods of testing -two finger test and checking hymen injuries and opening of hymen - which experts from NMC had claimed that such methods of testing are unscientific and not proven. Therefore it was recommended in the year 2022 to teach topic 'signs / features of virginity' in chapter virginity for second and third year forensic medicine with a disclaimer. But this won’t happen, if the latest NMC directives are not lifted immediately,” said Dr Khandekar.
Necessary to train our medical students and doctors
“Actually, our Indian courts including family courts are also unaware about the unscientific basis to ascertain virginity and its test. That's why in matrimonial disputes like nullity of marriage and impotence the courts most of the time orders doctors to conduct virginity tests on the wife. Therefore, it is necessary to train our medical students/doctors to appraise the courts about the unscientific basis of signs of virginity and test if the court orders it. This will help to clear the issue and slowly our Indian courts will stop ordering virginity tests. I think this was a historical change in 2022. We all need to understand that there is no scientific way by which one can know whether the girl is virgin or not. Similarly for a male signs of virginity are never ever mentioned in any medical book till date, and this may not happen under the ambit of the new directives” said Dr Khandekar.
Moreover, it was recommended by the expert panel that the students will be trained to inform courts that such tests cannot be done and there is no way to ascertain if the woman in question is virgin or not, which also is to safeguard the woman's dignity. However this tranining may not happen, with the current directives. The expert also opined, “No person has a right to know if the other person is virgin or not,” and hence the courts should be sensitised about the same.
Why has it not been dropped from the syllabus?
When asked, the reason for not dropping the said topic from the syllabus itself, to avoid any confusion, Dr Khandekar clarified, stating, “From the academic perspective, the said topic is very crucial, and the text books from 2022 academic year, had to have an additional disclaimer paragraph, reasoning to do away with such unscientific practice, which may not happen if the NMC new directives are implemented. Also, if not retained in the forensic textbooks, the probability of future generations incorporating the unscientific tests methodology in the forensic textbooks, once again, cannot be ruled out, due to sheer ignorance. And hence they (students) have to be informed today about the reasoning behind elimination of such a practice, which unfortunately, has not happened in the present curriculum issued by NMC,” said Dr Khandekar.
Attempts made to contact Dr Aruna Vanikar, President under Graduate Medical Board, NMC, did not yield any result.
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