2025 INSC 313 CORRECTED *

REPORTABLE

IN THE SUPREME COURT OF INDIA

CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO. 14333 OF 2024

(@ SPECIAL LEAVE PETITION (CIVIL) NO. 27632 OF 2024)

ANMOL APPELLANT(s)

VERSUS

UNION OF INDIA & ORS. RESPONDENT(s)

J U D G M E N T

K.V. Viswanathan, J.

1.The present appeal calls in question the correctness of the order

dated 23.09.2024 passed by a Division Bench of the High Court of

Punjab and Haryana at Chandigarh in CWP No. 24293 of 2024

(O&M). By a short order, the Division Bench rejected the claim of the

appellant, a ‘person with disabilities’ and upheld the denial of his

admission to the MBBS Course. This Court, by its order dated

12.12.2024, while granting leave, after considering the report of the

Medical Board constituted by the All India Institute of Medical

Sciences (AIIMS), including the separate opinion of Dr. Satendra

1

Singh, a member of the Board, and considering the legal position

directed that the appellant should be admitted in the Government

Medical College, Sirohi, Rajasthan against a seat reserved for Persons

with Disabilities (PwD) (OBC). By the order of 12.12.2024, the Court

had observed that reasons would be separately recorded. The reasons

are being recorded by virtue of the present judgment.

Brief Facts:

2.The facts lie in a narrow compass. The appellant had a

distinguished academic record in school and passed his 10

th

grade and

12

th

grade examination with flying colours. It is clear from the medical

opinion of the AIIMS, including the opinion of Dr. Satendra Singh,

that the appellant has Locomotor disability 50% with Club foot right

lower limb with Phocomalia, Left middle ring finger through middle

phalanx with right middle index finger through middle phalanx.

Further, he has speech and language disability of 20%. The final

disability computed was 58%.

3.The appellant aspired to be a medical professional. The appellant

appeared for the NEET-UG 2024 Examination conducted by the

2

National Testing Agency on 05.05.2024. The results were declared and

the appellant obtained rank 2462 in the Persons with Disability (PwD)

category. The cut-off obtained by him was far above the cut-off for the

OBC-PwD Category. The appellant approached the Government

Medical College, Chandigarh (Respondent No. 6) - the designated

Disability Certification Centre to get his disability assessed.

4.Without assigning any reason whatsoever and without examining

the functional disability and merely being carried away by the

quantified disability, the Disability Assessment Board, by its

Certificate of 02.09.2024, rendered him ineligible to pursue medical

course.

5.Aggrieved, the appellant filed Civil Writ Petition No. 24293 of

2024 before the High Court seeking issuance of a Writ of Certiorari to

quash the disability certificate and sought a fresh assessment. By the

impugned order, the Writ Petition has been dismissed on the ground

that the Court cannot substitute the opinion of the experts in the field

of disability.

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6.When the matter came up before us on 25.11.2024, while issuing

notice to the respondents, we passed the following order. The

operative portion of which is as follows:

“6. In the meantime, we direct Director, All India Institute of

Medical Sciences (AIIMS), New Delhi to constitute a

Committee to examine as to whether the disability suffered by

the petitioner would come in the way of his pursuing medical

studies. We request the Director, AIIMS, New Delhi to co-opt

Professor Dr. Satendra Singh as a member of the Committee.

7. The petitioner is directed to remain personally present

before the Director, AIIMS, New Delhi on 27.11.2024 at 10.00

A.M.”

7.Thereafter, on 28.11.2024, the report as directed by us, has been

furnished. The report is in two parts. Of the total six members, five of

the members, except Dr. Satendra Singh, in their brief report observed

as under:

“This Medical Board after detailed clinical, radiological,

speech and functional assessment of the candidate in the Skills

Lab, SET Facility of AIIMS, and as per the NMC Guidelines

for candidates with disability opines that the candidate has

locomotor and speech related disabilities and belongs to the

category of persons with multiple disability. The candidate

could perform a few basic, essential and simple tasks tested

slowly and with difficulty after having been explained and

demonstrated these.

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The candidate has benchmark disability (Forty percent or

more) as per the current Guidelines for this subject and

notified by the Department of Empowerment of Persons with

Disabilities in a Gazette of India in March 2024. His disability

is permanent in nature, not likely to worsen or improve. He is

not suitable to pursue undergraduate medical education

program (MBBS) which is a competency based program of

5 and a half years, including one year of compulsory rotatory

Internship. The current NMC Guidelines perhaps need

revision, and with respect to the current Guidelines, this

Medical Board is not able to declare the candidate FIT to

join MBBS course.”

(Emphasis supplied)

As noticed above, the five members observed that the current National

Medical Commission (NMC) Guidelines needed revision and that

with respect to the current Guidelines, they are not able to declare the

appellant fit for pursuing MBBS Course.

8.Dr. Satendra Singh gave a separate detailed assessment which

we have discussed in detail hereinbelow. The report of Dr. Satendra

Singh concluded that the appellant can successfully navigate the

MBBS Course with clinical accommodations and assistive

technologies.

9.As mentioned earlier, based on an overall reading of the reports,

particularly due to the clear opinion of Dr. Satendra Singh and taking

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into account the point raised by five members of the Board about the

need to revise the NMC Guidelines and considering the legal position

this Court, by its order of 12.12.2024 found the appellant fit for

pursuing the MBBS Course and directed his admission as stated

above.

10.We have heard Mr. Atif Inam assisted by Mr. Rishit Vimadalal,

Ms. Shrutika Pandey and Ms. Karuvaki Mohanty, learned counsels for

the appellant and Mr. Vikramjit Banerjee, learned Additional Solicitor

General, Mr. Gaurav Sharma, learned senior advocate and Ms.

Pankhuri Shrivastava, learned advocate for the respondents. We have

carefully considered their submissions and perused the record.

Guidelines under the Regulation

11.The Guidelines regarding admission of students with “Specified

Disabilities” under the Rights of Persons with Disabilities Act, 2016

with respect to admission in MBBS Course which constitute Appendix

H-1 to the Graduate Medical Education Regulations (Amendment),

2019, notified on 13.05.2019, in its relevant parts, read as under:

6

S. No.Disability

Type

Type of

Disabilities

Specified DisabilityDisability range

Eligible for

Medical

Course, not

eligible for

PwD Quota

Eligible for

Medical Course,

Eligible for PwD

Quota

Not

eligible for

Medical

Course

1. Physical

disability

A. Locomotor

disability,

including

specified

disabilities (a to f)

a. Leprosy cured

person*

Less than

40%

disability

40-80%

disability

Persons with

more than 80%

disability may

also be allowed

on case to case

basis and their

functional

competency will

be determined

with the aid of

assistive devices,

if it is being

used, to see if it

is brought below

80% and whether

they possess

sufficient motor

ability as

required to

pursue and

complete the

course

satisfactorily.

More than

80%

b. Cerebral Palsy**

c. Dwarfism

d. Muscular

Dystrophy

e. Acid attack

victims

f. Others*** such as

Amputation,

Poliomyelitis, etc.

* Attention should be paid to loss of sensations in fingers and hands,

7

amputation, as well as involvement of eyes and corresponding

recommendations be looked at.

** Attention should be paid to impairment of vision, hearing, cognitive

function etc. and corresponding recommendations be looked at.

***Both hands intact, with intact sensations, sufficient strength

and range of motion are essential to be considered eligible for

medical course.

(Emphasis supplied)

12.These regulations have come up recently for interpretation and

we have discussed the judgments hereinbelow. What is important to

notice is that while the appellant’s disability of 58% renders him

eligible for Medical Course under the PwD quota, what renders him

ineligible is the note against the triple asterix “Both hands intact, with

intact sensations, sufficient strength and range of motion are essential

to be considered eligible for medical course”.

Analysis:

13.It is the mechanical and literal interpretation of the guidelines

that has rendered the appellant ineligible both by the Disability

Assessment Board at Chandigarh and by the five members of the All

India Institute of Medical Sciences. Here, we must add that even the

five members felt that the current NMC Guidelines needed revision

8

and that going by the current Guidelines, they are unable to declare the

candidate fit.

14.There is a very good reason why the five members have lodged

this caveat. The report is dated 28.11.2024. Two judgments of this

Court delivered in the month of October, 2024 had clearly mandated

the revision of the Guidelines. This was on the premise that the

existing guidelines did not provide for the functional assessment.

15.In Omkar Ramchandra Gond v. Union of India & Ors., 2024

SCC OnLine SC 2860 (delivered on 15.10.2024), a three-Judge Bench

of this Court referred to Article 41 of the Directive Principles of State

Policy which provided that the State was within the limits of its

economic capacity and development to make effective provision for

securing the right to work and education for the persons with

disabilities. This Court noted that it was keeping this salutary principle

in mind that originally the Persons with Disabilities (Equal

Opportunities, Protection of Rights and Full Participation) Act,

1995 was enacted and since that Act was not found to be

comprehensive, it was replaced with the Rights of Persons with

9

Disabilities Act, 2016 (hereinafter referred to as the ‘RPwD Act’).

This Court also dealt with the salutary provisions of the RPwD Act

including the mandate for inclusive education and the express

recognition of the concept of reasonable accommodation. This Court

also discussed the United Nations Convention on the Rights of

Persons with Disabilities which was the main reason for the enactment

of the RPwD Act.

16.This Court, in Omkar Ramchandra Gond (supra), highlighted

the principles enshrined in the Convention like respect for inherent

dignity; individual autonomy including the freedom to make one’s

own choices; non-discrimination; full and effective participation and

inclusion in society; respect for difference and acceptance of persons

with disabilities as part of human diversity and humanity; equality of

opportunity and accessibility. Thereafter, this Court in Omkar

Ramchandra Gond (supra) invoking the doctrine of purposive

interpretation held that merely based on the quantification of the

disability, a candidate will not forfeit his right to stake a claim for

admission to the course of his or her choice. This was on the principle

that no classification can be overbroad. Some of the relevant

10

paragraphs on this aspect from Omkar Ramchandra Gond (supra)

have been extracted hereinbelow:-

“21. In any event, adopting a purposive interpretation of

the RPwD Act and, more particularly, of the provisions

extracted hereinabove, we are of the opinion that merely

because of the quantification of the disability for speech

and language at 40% or above, a candidate does not forfeit

his right to stake a claim for admission to course of their

choice. We say so for the reason that any such

interpretation would render the clause in Appendix H-1

under the Graduate Medical Education Regulations of the

Medical Council of India (precursor of the National

Medical Commission) dated 13.05.2019, over broad for

treating unequals equally.

23. We are constrained to hold that the Appendix H-1 in

the notification of 13.05.2019, issued by the Medical

Council of India cannot be interpreted to mean that merely

because on the quantification of the disability percentage

exceeding the prescribed limits, a person automatically

becomes ineligible for the medical course.

25. A Constitutional Court examining the plea of

discrimination is mandated to consider whether real

equality exists. This Court is not to be carried away by a

projection of facial equality. Viewed at first blush, the

regulation providing that all persons with 40% or more

disability are uniformly barred from pursuing the medical

course in the category of speech and language disability,

may appear non-discriminatory. But here too, appearances

can be deceptive. The Court of law is obliged to probe as

to whether beneath the veneer of equality there is any

invidious breach of Article 14.”

(Emphasis supplied)

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17.Most importantly, this Court commended the Union of India

through the Ministry of Social Justice and Empowerment for having

come out with a communication of 25.01.2024 pursuant to the

directions of this Court in Bambhaniya Sagar Vasharambhai v.

Union of India (Writ Petition (C) No. 856 of 2023). It should be

noted that this communication of 25.01.2024 which mandated the

review of regulations by the National Medical Commission (NMC)

was issued after the extant regulations of 13.05.2019 had come into

force. In fact, the communication issued by the Ministry of Social

Justice and Empowerment dated 25.01.2024 drew the attention of the

NMC to the position that obtained in the Department of Personnel and

Training (DoPT) wherein functional classification and physical

requirements consistent with requirements of the identified

service/posts were being worked out for the Civil Services and the

NMC was directed to work out functional classifications and physical

requirements consistent with the requirements of medical profession

and the NMC was directed to review its regulations.

18.In fact, in Omkar Ramchandra Gond (supra), after setting out

the directives of the Union of India, it was held as under:-

12

“35. We have no reason to doubt that the National Medical

Commission will expeditiously comply with the requirements

in the communication of the Ministry of Social Justice and

Empowerment dated 25.01.2024. In any event, we direct that

the needful be done by the National Medical Commission

before the publication of the admission brochure for the

academic year 2025-2026.

38. We are hopeful that in the revised regulations and

guidelines which the National Medical Commission will issue,

an inclusive attitude will be taken towards persons with

disabilities from all categories furthering the concept of

reasonable accommodation recognized in the RPwD Act. The

approach of the Government, instrumentalities of States,

regulatory bodies and for that matter even private sector

should be, as to how best can one accommodate and grant the

opportunity to the candidates with disability. The approach

should not be as to how best to disqualify the candidates and

make it difficult for them to pursue and realize their

educational goals.”

19.Relying on the judgment in Vikash Kumar v. Union Public

Service Commission & Ors., (2021) 5 SCC 370 and expanding on the

concept of reasonable accommodation elucidated therein, this Court in

Omkar Ramchandra Gond (supra) held as under :

“40. …Section 2(y) of the RPwD Act, defines “reasonable

accommodation” to mean necessary and appropriate

modification and adjustments, without imposing a

disproportionate or undue burden in a particular case, to ensure

to persons with disabilities the enjoyment or exercise of rights

equally with others. The concept of reasonable accommodation

would encompass within itself the deployment of a purposive

13

and meaningful construction of the NMC Regulations of

13.05.2019 read with the Appendix H-1 guidelines in a manner

as to further the objectives of the RPwD Act. The reasonable

accommodation as defined in Section 2(y) of the RPwD Act

should not be understood narrowly to mean only the provision

of assisting devices and other tangible substances which will

aid persons with disabilities. If the mandate of the law is to

ensure a full and effective participation of persons with

disabilities in the society and if the whole idea was to exclude

conditions that prevent their full and effective participation as

equal members of society, a broad interpretation of the concept

of reasonable accommodation which will further the objective

of the RPwD Act and Article 41 of the Directive Principles of

State Policy is mandated.

41. This concept of reasonable accommodation has come in for

judicial interpretation in Vikash Kumar v. UPSC, (2021) 5

SCC 370 wherein this Court held that the principle of

reasonable accommodation captures the positive obligation of

the State and private parties to provide additional support to

persons with disabilities to facilitate their full and effective

participation in society. In Para 44, it was held as under.

“44. The principle of reasonable accommodation captures

the positive obligation of the State and private parties to

provide additional support to persons with disabilities to

facilitate their full and effective participation in society.

The concept of reasonable accommodation is developed in

section (H) below. For the present, suffice it to say that, for

a person with disability, onstituteionally guaranteed

fundamental rights to equality, the six freedoms and the

right to life under Article 21 will ring hollow if they are not

given this additional support that helps make these rights

real and meaningful for them. Reasonable accommodation

is the instrumentality—are an obligation as a society—to

enable the disabled to enjoy the constitutional guarantee of

14

equality and non-discrimination. In this context, it would

be apposite to remember R.M. Lodha, J’s (as he then was)

observation in Sunanda Bhandare Foundation v. Union

of India, (2014) 14 SCC 383, where he stated : (SCC p.

387, para 9)

“9. … In the matters of providing relief to those who are

differently abled, the approach and attitude of the executive

must be liberal and relief oriented and not obstructive or

lethargic.”

42. Thereafter, in the said judgment, this Court held in para 62,

63 and 65 as under.

“62. The principle of reasonable accommodation

acknowledges that if disability as a social construct has to

be remedied, conditions have to be affirmatively created

for facilitating the development of the disabled. Reasonable

accommodation is founded in the norm of inclusion.

Exclusion results in the negation of individual dignity and

worth or they can choose the route of reasonable

accommodation, where each individuals’ dignity and worth

is respected. Under this route, the “powerful and the

majority adapt their own rules and practices, within the

limits of reason and short of undue hardship, to permit

realisation of these ends”.

63. In the specific context of disability, the principle of

reasonable accommodation postulates that the conditions

which exclude the disabled from full and effective

participation as equal members of society have to give way

to an accommodative society which accepts difference,

respects their needs and facilitates the creation of an

environment in which the societal barriers to disability are

progressively answered. Accommodation implies a positive

obligation to create conditions conducive to the growth and

15

fulfilment of the disabled in every aspect of their existence

— whether as students, members of the workplace,

participants in governance or, on a personal plane, in

realising the fulfilling privacies of family life. The

accommodation which the law mandates is “reasonable”

because it has to be tailored to the requirements of each

condition of disability. The expectations which every

disabled person has are unique to the nature of the

disability and the character of the impediments which are

encountered as its consequence.

65. Failure to meet the individual needs of every disabled

person will breach the norm of reasonable accommodation.

Flexibility in answering individual needs and requirements

is essential to reasonable accommodation. The principle

contains an aspiration to meet the needs of the class of

persons facing a particular disability. Going beyond the

needs of the class, the specific requirement of individuals

who belong to the class must also be accommodated. The

principle of reasonable accommodation must also account

for the fact that disability based discrimination is

intersectional in nature.

46. Disabilities Assessment Boards are not monotonous

automations to just look at the quantified benchmark

disability as set out in the certificate of disability and cast

aside the candidate. Such an approach would be

antithetical to Article 14 and Article 21 and all canons of

justice, equity and good conscience. It will also defeat the

salutary objectives of the RPwD Act. The Disabilities

Assessment Boards are obliged to examine the further

question as to whether the candidate in the opinion of the

experts in the field is eligible to pursue the course or in

other words, whether the disability will or will not come in

the way of the candidate pursuing the course in question.”

16

(Emphasis supplied)

20.As would be clear from the above, flexibility in answering

individual needs and requirements is an essential component of

reasonable accommodation. There cannot be a “one size fits all”

approach. However, in the guidelines appendix H-1 to regulations of

13.05.2019 of “both hands intact, with intact sensations, sufficient

strength and range of motion” are considered essential to be eligible

for the medical course.

21.In our view, this prescription of “both hands intact…” is

completely antithetical to Article 41 of the Constitution; the principles

enshrined in the United Nations Convention on the Rights of Persons

with Disabilities and the salutary provisions of the RPwD Act. It also

indicates a classification which is overbroad and glorifies ‘ableism’. It

propagates that persons with typical abilities and with faculties similar

to what the majority may have or somehow superior. This is precisely

what the Directive Principles of State Policy, the United Nations

Convention and the RPwD Act abhor.

17

22.In Omkar Ramchandra Gond (supra), the following conclusion

was recorded and directions given:

“53. For the reasons set out hereinabove,

(i) We hold that quantified disability per se will not dis-entitle

a candidate with benchmark disability from being considered

for admission to educational institutions. The candidate will be

eligible, if the Disability Assessment Board opines that

notwithstanding the quantified disability the candidate can

pursue the course in question. The NMC regulations in the

notification of 13.05.2019 read with the Appendix H-1 should,

pending the re-formulation by NMC, be read in the light of the

holdings in this judgment.

(ii) The Disability Assessment Boards assessing the candidates

should positively record whether the disability of the candidate

will or will not come in the way of the candidate pursuing the

course in question. The Disability Assessment Boards should

state reasons in the event of the Disability Assessment Boards

concluding that the candidate is not eligible for pursuing the

course.

(iii) The Disability Assessment Boards will, pending

formulation of appropriate regulations by the NMC, pursuant

to the communication of 25.01.2024 by the Ministry of Social

Justice and Empowerment, keep in mind the salutary points

mentioned in the said communication while forming their

opinion.

(iv) Pending creation of the appellate body, we further direct

that such decisions of the Disability Assessment Boards which

give a negative opinion for the candidate will be amenable to

challenge in judicial review proceedings. The Court seized of

the matter in the judicial review proceedings shall refer the

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case of the candidate to any premier medical institute having

the facility, for an independent opinion and relief to the

candidate will be granted or denied based on the opinion of the

said medical institution to which the High Court had referred

the matter.”

23.The above discussion would clearly highlight why the five

members of the board, in the present case, in their report incorporated

the following disclaimer:-

“the current NMC Guidelines perhaps need revision, and

with respect to the current Guidelines, this Medical

Board is not able to declare the candidate FIT to join the

MBBS course.”

24.Even otherwise, we find that the report of the five members has

not set out any reasons and does not indicate as to how the functional

assessment of the appellant was carried out. No doubt, it mentions that

a functional assessment was carried out, but the five members are

completely silent on how the appellant failed in the functional

assessment test. Obviously, they felt shackled by the “both hands

intact…” theory which we have discarded relying on the Union of

India’s directive as approved in Omkar Ramchandra Gond (supra).

Accepting the report of five members and denying the admission of

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the appellant would be upholding the theory of ableism which we are

not prepared to do.

25.The “both hands intact…” prescription has no sanctity in law as

it does not admit of a functional assessment of the individual

candidate, a matter which is so fundamental in protecting the rights of

persons with disabilities. In fact, it was the Union of India through the

Ministry of Social Justice and Empowerment which took the lead in

issuing the communication of 24.01.2024 pursuant to the directions of

this Court in Bambhaniya Sagar Vasharambhai (supra).

26.Another important judgment which needs to be noticed at this

stage is Om Rathod v. Director General of Health Services & Ors.,

2024 SCC Online SC 3130 (delivered on 25.10.2024) which

reinforced the holding in Omkar Ramchandra Gond (supra). Om

Rathod (supra), like the present case, was also a case where

notwithstanding the reports of disability assessment board which

denied relief to the appellant therein, the court called for an

assessment by Dr. Satendra Singh, the same expert, who was also co-

opted in the present matter. Chief Justice Dr. D.Y. Chandrachud

20

speaking for the Court in Om Rathod (supra) distinguished the earlier

judgment of this Court in Vidhi Himmat Katariya v. Union of India

(2019) 10 SCC 20 by holding as follows:

“38. At this point, it is imperative to deal with the holding of

this Court in Vidhi Himmat Katariya v. Union of India. In that

case, persons with disabilities who had appeared for the NEET

UG Exam 2019 had moved this Court against their

disqualification by the Medical Board. Appendix “H” had been

issued midway through the process for admitting candidates

from the NEET UG 2019. The primary contention of the

petitioners was that since the new guidelines were issued in the

middle of the admission process, they must not apply to the

ongoing process. The petitioners prayed to be tested against

the rules as they existed at the time of the application process

for the examination, namely, the MCI guidelines of 2017. On

this count, the Court ruled against the petitioners. The

demurrer argument of the petitioners was that they have not

been tested on relevant parameters. This Court while rejecting

the argument noted that the petitioners were disqualified for

not meeting the eligibility criteria of having “both hands intact,

with intact sensation, sufficient strength and range of motion.”

Accordingly, the Court refused to sit in appeal over the expert

body's opinion. The judgment of the Court in Vidhi Himmat

Katariya (supra) was specific to the facts of that case and did

not involve any question of interpretation or Constitutional

analysis. The Court was not examining any criteria and did not

scrutinise the guidelines to inspect their validity. The Court did

not have the benefit of looking at the firm roots which

reasonable accommodation has grown within the fold of the

Constitution. Further, the judgments of this Court in Vikash

Kumar (supra), Avni Prakash (supra), Ravinder Dhariwal

(supra) and Omkar Gond (supra) were not available to the

21

Court while dealing with the case of Vidhi Himmat Katariya

(supra). Therefore, the opinion in Vidhi Himmat Katariya

(supra) is inapplicable.”

(Emphasis supplied)

27.Like in Om Rathod (supra), the report of Dr. Satendra Singh,

who was also a member of the board appointed, pursuant to our

direction, elaborately considers the functional assessment and gives

detailed reasons to conclude as to how the appellant can successfully

navigate the MBBS course with clinical accommodations and assistive

technologies. The report also indicates as to how the choice should be

left to the appellant after completing the MBBS Course to decide

whether he wishes to specialize in a non-surgical or medical branch or

continue as a general duty medical officer. The report rightly sets out

as to how, at this stage, one should not assume incompetence without

providing ample opportunities after ensuring clinical accommodations

and assistive technologies. The report of Dr. Satendra Singh is similar

to the report provided by the said Doctor in Om Rathod (supra).

28.Before we discuss the report of Dr. Satendra Singh submitted in

the present case in detail, we propose to summarize certain crucial

22

holdings in Om Rathod (supra) which have direct bearing to the case

at hand.

“a) The use of the term ‘brought below 80%,’ as well

intentioned as it may be, fails at this foundational premise.

One cannot assume that all persons with more than 80%

locomotor disability are incompetent to pursue medicine

when their functional abilities have not been assessed.

The medical model of disability apparent in the phrase

must give way to a social model of disability which

takes into account the variety of experiences and

outcomes which persons with disabilities have when

they interact with different kinds of societies and

accommodations. (para 23)

b). In Nipun Malhotra v. Sony Pictures, this Court opined

that words cultivate institutional discrimination and that

the language of our discourse ought to be inclusive rather

than alienating. When it comes to rights - language

matters. Words may not always adequately reflect the

intention of the drafter. Some words may be used

unwittingly, without knowledge of their harmful

consequences. Nevertheless, these words influence the

thinking of others who hear them. Words are the tools one

deploys to formulate thoughts. An expansive vocabulary

allows people to think and articulate their thoughts better.

When we use appropriate and sensitive language, we

aspire for the quality of our thought to be broadened and

evolve towards being emancipatory and inclusive. (para

24)

c) The requirement of assessing the functional

competence of a medical aspirant with over eighty

percent locomotor disability recognises that

assessment must be done on a case to case basis. The

method of assessment by designated Disability

Assessment Boards must therefore reflect the approach

and intent of the legal framework within which the Boards

operate. An assessment for functional competency entails

23

an analysis of the skill set which a person with disability

must learn in order to compete and pursue the medical

course. This is a marked difference from requiring a

specific manner which a candidate must use to achieve the

outcome. For example, a functional competency model

would require a candidate to effectively communicate

with patients but would not require them to have

speech or intact hands. By focusing on the end points,

the approach avoids any ableism to seep into the

assessment and avoids reifying that there is one and

only one manner to achieve desired outcomes. (para 26)

d) A failure to create a conducive environment is a failure

to provide reasonable accommodation. Section 2(h) of the

RPWD Act defines discrimination in the context of

disability as “any distinction, exclusion, restriction on the

basis of disability which has the purpose or effect of

impairing or nullifying the recognition, enjoyment or

exercise on an equal basis with others of all human rights

and fundamental freedoms in the political, economic,

social, cultural, civil or any other field and includes all

forms of discrimination and denial of reasonable

accommodation.” The denial of reasonable

accommodation is expressly recognised as discrimination

under the RPWD Act. For the proper realisation of

reasonable accommodation, a person with disability

must be identified using correct parameters and

thereafter the accommodations necessary have to be

determined on a case by case basis. (para 27)

e) In Omkar Gond (supra) has applied a purposive

interpretation to the guidelines (Appendix “H-1”) in the

context of a medical aspirant with dialectic incapacity.

This Court held that the principle of reasonable

accommodation in Section 2(y) of the RPWD Act read

with Article 41 of the Constitution necessarily means that

(i) a person cannot be disqualified merely on the basis of a

benchmark quantification. Such a criteria would be

unconstitutional for being overbroad; (ii) the Disability

Assessment Board must not act as monotonous

automations looking at the quantified disability and

24

disqualifying candidates. The Board must examine if the

candidate can pursue the course with their disability; and

(iii) in doing so, the Board is not merely obliged to

provide assistive devices and other substances which will

help the candidate. The true role of the Board is to assess

the competence of a candidate. (para 28)

f) The principle of reasonable accommodation is not

only statutorily prescribed but also rooted in the

fundamental rights guaranteed to persons with

disabilities under Part III of the Constitution.

Reasonable accommodation is a fundamental right. It is

a gateway right for persons with disabilities to enjoy all

the other rights enshrined in the Constitution and the law.

Without the gateway right of reasonable accommodation,

a person with disability is forced to navigate in a world

which excludes them by design. It strikes a fatal blow to

their ability to make life choices and pursue opportunities.

From mundane tasks of daily life to actions undertaken to

realise personal and professional aspirations - all are

throttled when reasonable accommodations are denied.

Reasonable accommodation is a facet of substantive

equality and its failure constitutes discrimination.

(para 29)

g) Therefore, this Court has in the past opined on the

pattern of conduct in medical boards and sought to align it

with legal and Constitutional guarantees so as not to

render the fundamental rights of persons before these

boards nugatory. In Bambhaniya Sagar Vashrambhai v.

Union of India, this Court has held that Disability

Assessment Boards must not adopt the approach of a

recluse by confining themselves to only quantifying the

disability of a candidate. In that case, the medical board

had reported an unreasoned opinion that the

candidate was ineligible to continue his MBBS course

on account of being more than 80% disabled. Like in A

(Mother of X) (supra), the Court in Bambhaniya

(supra) also emphasised the need for elaborate reasons

by the medical board while reporting their opinions.

(para 34)

25

h) In Purswani Ashutosh v. Union of India, this Court

was deciding if a medical aspirant who had appeared for

the NEET UG Exam 2018 was eligible for the reservation

earmarked for persons with disabilities. Despite having

low vision impairment - the Medical Board had opined

that the petitioner in that case was ineligible for

reservation. While rejecting the opinion of the

committee, this Court held that a medical board

cannot be allowed to override the statutory mandate of

providing reservation to persons with disabilities. No

committee has primacy over the law. We must

emphasize that the opinions of medical boards and

committees are not only required to adhere to legal

standards but must also embody core principles of the

rule of law within their processes. This Court,

following a consistent line of precedent, has

underscored the need for reasoned and transparent

decisions by such boards, given the profound impact

these opinions have on the life trajectory of individuals

before them. (para 35)

i) At its core, the rule of law demands predictable rules,

equitable application, unbiased adjudication and fair,

transparent treatment of individuals. In cases of

assessment, this entails informing individuals about the

procedures, standards, tools, and all pertinent aspects of

the assessment in advance. Such transparency is essential

to avoid any arbitrary uncertainty arising from obscure or

inconsistent procedures. The procedures must be

inherently fair and bear a rational and cogent nexus with

the purpose which is sought to be achieved. A committee's

role goes beyond mere quantification of disability;

disability is a factual condition. The key question for a

Disability Assessment Board is whether an individual

with a disability, aided by modern scientific tools and

devices, can enter the MBBS program. Put differently,

the board must assess whether it is infeasible for the

candidate to pursue a medical career with their

disability. (para 36)

26

j) Courts are not expert bodies in matters of medicine. The

competent authority to adjudge the eligibility of a person

to pursue a medical course is the Disability Assessment

Board. However, courts have the jurisdiction to ensure

that the manner in which the Board proceeds and

functions is in compliance with established principles

of law. Ultimately, the Court will have to rely on the

opinion of the Board to adjudicate the legal remedies

of a person with disability. The interference of Courts

is not to supplant its opinion for that of the experts but

to ensure that a holistic evaluation of competence is

conducted and that no person's career is set at naught

with the stroke of a pen. (para 39)

k) The Courts cannot be stupefied into inaction by the

lack of adequate framework or expertise when questions

of fundamental rights emerge. No person forfeits their

claim to education or other pursuits of life on account

of their disability. The flurry of cases concerning

medical aspirants with disability which has come

before this Court shows that the overarching issue is a

sense of over medicalization of disabled bodies by the

Assessment Boards. The approach often taken, due to

inertia or unwittingly, is to assume that a person with

disability may not be eligible for pursuing the course

and then to put the candidates under tests to prove the

assumption. The approach focuses more on the

disability of a person than their ability. This turns the

principle of reasonable accommodation on its head.

The question instead that the Board ought to ask itself

is this - what measures can be taken to ensure that the

candidate with disability can start their MBBS course

on an equal footing with their prospective classmates?

The change in question brings a change in perspective.

The only negative answer to the question would be that

- in line with contemporary scientific advancements,

no devices or accommodations can enable the person

with disability before them to compete at a level

playing field. Courts must ensure that the sanctity of

the principles in the RPWD Act and in the

27

Constitution are not violated by the conduct or the

outcome of the assessment. (para 40)

l) The second respondent has submitted that in light of

the judgment of this Court in Omkar Gond (supra), it

will be constituting a new committee of domain experts

to comply with the directions in that judgment. We

note the assurance of the second respondent and direct

that this committee shall include persons with

disability or one or more experts who are well

conversant with disability rights. The committee shall

recommend fresh guidelines to replace the existing

guidelines. The above suggestions shall be duly

considered by the government on its own merits. The

recommendations so formulated shall comply with this

judgment. (para 58)

m) 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. The guidelines shall comply with the

judgments of this Court and contemporary advancements

in disability justice;” (para 60(a))

(Emphasis supplied)

29.Having set out the legal position governing the situation, we

have no hesitation in concluding that the report of the five members

of the All India Institute of Medical Sciences cannot be the basis to

deny the appellant’s admission to the MBBS Course. Firstly, the

report does not satisfy the test laid down in Omkar Ramchandra

Gond (supra) and Om Rathod (supra). The functional assessment as

28

contemplated in the said two judgments is not borne out by the report

of five members. Secondly, as mandated or required in both Omkar

Ramchandra Gond (supra) and Om Rathod (supra), reasons have

not been assigned by the five members of the Board for denying the

appellant his right to pursue the MBBS Course. Thirdly, the need to

assess beyond the quantified disability and the need to opine whether

the individual with a disability aided by modern scientific tools and

devices can enter the MBBS program has not been fulfilled by the

five members of the Board. This is apart from the fact that the five

members of the Board have recorded statements in the nature of

disclaimers as set out hereinabove.

30.While we are conscious that courts are not expert bodies in the

matters of medicine, as held in Om Rathod (supra) courts have the

jurisdiction to ensure that the manner in which the Board proceeds

and functions are in compliance with the established principles of law.

We will only add that it is not just a question of jurisdiction of the

court but a duty cast upon the Court; since it is the Courts which

enforce the fundamental rights.

31.For all these reasons, we reject the report of the five-member

29

Board. Like in Om Rathod (supra), Dr. Satendra Singh, the Member

of the Board has furnished a separate report, that fulfils the parameters

laid down in Omkar Ramchandra Gond (supra) and Om Rathod

(supra).

32.Dr. Satendra Singh has, at the very outset, set out the parameters

for his consideration as under:-

“Considering quantification of disability was deemed

redundant, the focus of the assessment was on functional

competence along with potential reasonable accommodation,

assistive technology and adaptive equipment to see whether

petitioner (“Anmol”) can fulfil the national Medical

Commission (“NMC”) norms of Competency based Medical

Education (“CBME”) and can pursue the MBBS degree

course.”

33.Dr. Satendra Singh has also set out detailed justification and

summarized the two primary factors which resulted in his

disagreement with the other members in the following terms:

“(i) AIIMS has yet to revise its curriculum to align with the

NMC-based CBME framework. Certain competencies deemed

essential by AIIMS board are, in fact, not core competencies

(AS 2.1, AS 2,2) in the NMC’s revised curriculum issued on

12.09.2024 (Annexure A1)

(ii) Another point raised pertains to the controversial issue of

“both hands intact”. Even in the first released 2018 report, it

30

was stated that there need to be “periodic revaluation of this

guideline” (Annexure A2, p.34). The same thing was

highlighted by Delhi HC in Neha Pudil v UOI 2022 where

they directed NMC to reframe guidelines in line with the

Rights of Persons with Disabilities Act (RPDA) 2016 and new

technological advances by 18 Oct 2022.”

34.We may only add that the need to revise the guidelines as

emphasized by the NMC was directed in the 15.10.2024 judgment of

Omkar Ramchandra Gond (supra) and reiterated in the 25.10.2024

judgment of Om Rathod (supra). Further in para 26 of Om Rathod

(supra) extracted hereinabove the “both hands intact…” requirement

has been expressly rejected. We have also held hereinabove that such

an insistence in a statutory regulation is absolutely antithetical to the

objectives of Article 41 and the principles set out in the United

Nations Convention and the rights guaranteed under the RPwD Act.

35.A prescription such as “both hands intact…” reeks of ableism

and has no place in a statutory regulation. In fact, it has the effect of

denuding the rights guaranteed under the Constitution and the RPwD

Act and makes a mockery of the principle of reasonable

accommodation.

36.In our considered view, the correct approach is the one that Dr.

31

Satendra Singh has adopted viz.- to not bar a candidate at the

threshold but grant the candidate the choice after completing the

MBBS Course, to decide whether he whishes to specialize in a non-

surgical or medical branch or continue as a General Duty Medical

Officer. As rightly set out by Dr. Satendra Singh, it will be unfair to

presume incompetence at the threshold without first providing an

opportunity to the candidate and ensuring the availability of

accommodations and assistive products.

37.Dr. Satendra Singh also adopted an interactive process which he

highlights in the report in the following terms:

“Accommodation decisions are not made based on diagnosis,

per se. I used an interactive process to review his functional

limitation (restrictions that prevent him from fully performing

an activity) and barriers which may be educational, physical or

attitudinal in nature.

Disability: Benchmark Multiple Disability with two half

grown fingers in both hands and toes (mobility-related

physical disability, phocomelia) and speech impairment.

Potential Functional Limitations: Some areas involving full

dexterity

Potential Barriers to learning: Few practical procedures

which might require full dexterity

What is being assessed: Cognitive, psychomotor and affective

skills in line with NMC’s five roles of an Indian Medical

Graduate in CBME

Appropriate and reasonable accommodation: Physical

32

intermediary to assist in a few procedures as part of medical

team and appropriate assistive technology in final year and

internship.”

38.Dealing with Functional Assessment, the appellant was put

through certain procedures to test his dexterity and ability to perform

psychomotor skills in simulated environment. The report concludes as

follows:

“The following procedure skills was tested to see his dexterity

and ability to perform psychomotor skills in simulated

environment: holding glass slides; wearing gloves; holding

scissors; putting suture into needles; locking scissors, making

sutures; making single incisions with blade; making

curvilinear incisions; holding syringe, filling it, withdrawing

water in syringe; cutting sutures; doing lifesaving

cardiopulmonary resuscitation (CPR) – chest compressions

and artificial respiration; urinary catheterization.

The experience showed that despite loss of two fingers in

either hands his thumb in both was intact showing grasp and

ability to use his both hands (he is left-handed). With the

advent of Competency Based Medical Education (CBME), it

may also be noted that attainment of the highest level of

competency needs to be obtained through steps spread over

several subjects or phases and not necessarily in the subject or

the phase in which the competency has been identified. (page

3969 of NMC CBME 2024 released on 12.09.2024).”

(Emphasis supplied)

39.Based on these tests, certain clinical accommodations for each

of the phases in the MBBS Course have been suggested which can

easily be adopted by the authorities. For example, for phase one

33

MBBS Course, it is suggested that compensatory time in theory and

practical examination and provision of facility of scribes have been

suggested to improve efficiency. Similarly, for phase three, part-I,

certain assistive technology measures have been suggested like

speech to text technology, antivibration gloves and so on.

40.Thereafter, Dr. Satendra Singh posed to himself the following

four questions:

“a) Would the proposed accommodation result in a failure to meet

the NMC CBME’s inherent requirements?

b) Would the accommodation legitimately jeopardize patient

safety?

c) Would the proposed accommodation result in the improper

waiver of a core requirement of the CBME?

d) Would the proposed accommodation pose an undue hardship on

the medical college (budgets wise)?”

The answer to all these was in the negative, as has been duly recorded

in the report.

41.The report has an interesting reference about how in an age

when robotic surgeries are relied upon, the NMC norms still insist on

the “both hands intact with intact sensations” norm. Dr. Satendra

34

Singh quotes the father of neurosurgery Harvey Cushing, who as early

as in November 1911, emphasized that motor skills are often “the

least part of the work”.

42.The report addresses issues of patient’s safety and concludes as

under:

“In my opinion, Anmol can successfully navigate the

MBBS course with clinical accommodations, and later

internship with assistive technologies, and thereafter

practice as a doctor. It is up to him, after completing

MBBS, to decide whether he wishes to specialize in a non-

surgical or medical branch or continue as a general duty

medical officer. At this stage, we should not assume his

incompetence without first providing him ample

opportunities in a simulation lab and ensuring the

availability of accommodations and assistive products.”

(Emphasis supplied)

43.We find that the report of Dr. Satendra Singh satisfies the

parameters of the law laid down by this Court in Omkar

Ramchandra Gond (supra) and Om Rathod (supra). It makes a

detailed individual analysis of the case and makes a functional

assessment; it states elaborate reasons and it suggests measures for

providing clinical accommodation and assistive technology. Above

all, the conclusion of Dr. Satendra Singh that incompetence to pursue

35

the MBBS Course cannot be presumed at the threshold stage, on the

facts of the present case, appeals to us for the reasons set out

hereinabove.

44.For the aforesaid reasons, we accept the report of Dr. Satendra

Singh and confirm the admission granted to the appellant by our order

dated 12.12.2024 in the Government Medical College, Sirohi,

Rajasthan.

45.Before we part, there is one important aspect which needs to be

considered. In the judgment of 15.10.2024 in Omkar Ramchandra

Gond (supra) a direction was given to the National Medical

Commission to issue revised regulations and guidelines in

supersession of the guidelines of 13.05.2019 with regard to admission

of students with specified disabilities under the RPwD Act with

respect to the MBBS Course. This Court had also directed the NMC

to consider the communication of the Ministry of Social Justice and

Empowerment dated 25.01.2024. Pursuant to the judgment in Omkar

Ramchandra Gond (supra), the National Medical Commission

assured this Court during the course of hearing in Om Rathod (supra)

that it will constitute a new committee of domain experts to comply

36

with the judgment in Omkar Ramchandra Gond (supra). Noting the

assurance of the NMC, this Court directed that the Committee to be so

constituted will include persons with disability or one or more experts

conversant with the disability rights. A further direction was given

that fresh guidelines will be put in place applying the principles set

out in the judgments.

46.We direct this matter to be posted on 03.03.2025 to consider

whether the National Medical Commission has formulated the revised

guidelines in accordance with the judgments of this Court, as directed

in Omkar Ramchandra Gond (supra) and Om Rathod (supra) and

further direct that the NMC shall file an affidavit explaining the

current status before the said hearing date.

47.In view of what is held hereinabove, the appeal is allowed. The

judgment and order dated 23.09.2024 passed by a Division Bench of

the High Court of Punjab and Haryana at Chandigarh in CWP No.

24293 of 2024 (O&M) is set aside and the admission granted to the

appellant by virtue of our order dated 12.12.2024 in the Govt.

Medical College, Sirohi is confirmed. No order as to costs.

37

48.List the matter on 03.03.2025 for consideration of the affidavit

of NMC.

……….........................J.

[B.R. GAVAI]

……….........................J.

[K. V. VISWANATHAN ]

New Delhi;

21

st

February, 2025.

* corrected in terms of Corrigendum No. F. 3/Ed. B. J./6/2025 dated 27.02.2025

38