Holding

A candidate with a benchmark disability cannot be disqualified from MBBS admission solely on quantified disability; the Board must conduct a functional assessment and provide reasonable accommodations, rendering the "both hands intact" clause unconstitutional.

Summary

Anmol, a candidate with 58% multiple disabilities, secured a rank of 2462 in the NEET‑UG 2024 PwD category but was denied admission to an MBBS course by the Disability Assessment Board, which relied solely on quantified disability and the "both hands intact" clause in Appendix H‑1 of the 2019 NMC regulations. The High Court dismissed his writ petition, prompting a Special Leave Petition before this Court. The Supreme Court directed AIIMS to form a six‑member committee, which produced a split report: five members upheld the Board's view, while Dr. Satendra Singh, an expert, concluded that Anmol could pursue MBBS with reasonable accommodations and assistive technologies. Relying on the principles of reasonable accommodation articulated in Omkar Ramchandra Gond and Om Rathod, the Court held that functional assessment, not mere quantification, is required and that the "both hands intact" requirement is over‑broad and violative of the RPwD Act and Article 41. Consequently, the Court accepted Dr. Singh’s report, confirmed Anmol’s admission, set aside the High Court order, and directed the NMC to revise its guidelines by 3 March 2025.

Issues considered

The validity of the "both hands intact" requirement in Appendix H‑1 of the 2019 NMC regulations for admission of PwD candidates to MBBS courses.
Whether a Disability Assessment Board can deny admission solely on the basis of quantified disability without functional assessment.
The scope and application of the concept of reasonable accommodation under Section 2(y) of the RPwD Act in medical education.
The duty of the National Medical Commission to revise its regulations in light of constitutional and statutory obligations.

Legislation cited

Constitution of Indias. Article 14, s. Article 21, s. Article 41
Graduate Medical Education Regulations (Amendment), 2019
Rights of Persons with Disabilities Act, 2016s. 2(h), s. 2(y)

Headnote

Issue for Consideration Appellant appeared in the NEET-UG 2024 Examination and secured a rank of 2462 in the Persons with Disability (PwD) category. The designated Disability Certification Centre found him ineligible to pursue medical course on the basis of his quantified disability. When Court in a writ petition, it was dismissed on the ground that the Court cannot substitute the opinion of the experts in the field of disability. Appellant approached the Supreme Court by filing SLP and this Court while issuing notice directed Director, All India Institute of Medical Sciences

Subjects

Disabled personNEET-UGDisability Assessment BoardsReasonable accommodation

Judgment

[2025] 2 S.C.R. 1142 : 2025 INSC 256

Anmol
v.
Union of India & Ors.
(Civil Appeal No. 14333 of 2024)
21 February 2025
[B.R. Gavai and K.V. Viswanathan,* JJ.]

Issue for Consideration
Appellant appeared in the NEET-UG 2024 Examination and secured
a rank of 2462 in the Persons with Disability (PwD) category. The
designated Disability Certification Centre found him ineligible to
pursue medical course on the basis of his quantified disability.
When appellant challenged the decision before the High Court
in a writ petition, it was dismissed on the ground that the Court
cannot substitute the opinion of the experts in the field of disability.
Appellant approached the Supreme Court by filing SLP and this
Court while issuing notice directed Director, All India Institute of
Medical Sciences (AIIMS) to constitute a six member Committee
with Dr. Satendra Singh (‘expert’) as a member. A report with two
parts was submitted by the Committee-one part by the five members
held that the Appellant is not fit under the present NMC Guidelines
to pursue MBBS and the second part by Dr. Singh held that the
Appellant is fit to complete MBBS with clinical accommodations
and assistive technologies.
The issue before the Supreme Court pertains to reasonable
accommodation that the National Medical Commission has to
provide in the Guidelines framed by it for medical admission to PwD.

Headnotes†
Rights of Persons with Disabilities Act, 2016 (‘RPwD Act’) –
In light of the decision in Omkar Ramchandra Gond v. Union
of India & Ors., 2024 SCC OnLine SC 2860 – Discussed and
relied on:
Held: In Omkar Ramchandra Gond case it was held that Article 41
of the Directive Principles of State Policy casts duty on the State
to make effective provision for securing the right to work and
education for the persons with disabilities within the limits of its

* Author
[2025] 2 S.C.R. 1143

Anmol v. Union of India & Ors.

economic capacity and development – Persons with Disabilities
(Equal Opportunities, Protection of Rights and Full Participation) Act,
1995 was enacted for furtherance of this duty – After signing United
Nations Convention on the Rights of Persons with Disabilities, 2008
a more comprehensive RPwD Act was enacted in 2016 to further
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 – Purposive interpretation
of the RPwD Act has to be employed and therefore 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 – No classification can be overbroad – In Sunanda Bhandare
Foundation v. Union of India, (2014) 14 SCC 383 it was held that
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. [Paras 15-16, 19]

Graduate Medical Education Regulations (Amendment), 2019
issued by National Medical Commission (‘NMC’) – Need for
revision – Based on Communication from Ministry of Social
Justice and Empowerment dated 25.01.2024 pursuant to
directions in Bambhaniya Sagar Vasharambhai v. Union of
India (Writ Petition (C) No. 856 of 2023) – Discussed:
Held: The Communication from Ministry of Social Justice and
Empowerment mandated the review of regulations by the NMC
to work out functional classifications and physical requirements
consistent with the requirements of medical profession like the
one prepared by Department of Personnel and Training (DoPT)
w.r.t. civil servants. [Paras 17, 18, 22, 25, 45]

Concept of ‘Reasonable Accommodation’ – Explained keeping
in mind the ratio in Omkar Ramchandra Gond v. Union of India
& Ors., 2024 SCC OnLine SC 2860:
Held: In Omkar Ramchandra Gond it was held that – Revised
regulations and guidelines which the National Medical Commission
will issue shall have an inclusive attitude towards persons with
disabilities from all categories, furthering the concept of reasonable
accommodation recognized in the RPwD Act – Section 2(y) RPwD
1144 [2025] 2 S.C.R.

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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 – Relied on Vikash Kumar v. Union Public Service
Commission & Ors., (2021) 5 SCC 370, wherein it was held that,
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. [Paras 18-20]

Role of Disabilities Assessment Board (‘DAB’) – Explained
in light of Omkar Ramchandra Gond v. Union of India & Ors.,
2024 SCC OnLine SC 2860:
Held: DAB is not monotonous automation to just look at the
quantified benchmark disability as set out in the certificate of
disability and cast aside the candidate – Such action will be violative
of Articles 14 and 21 of the Constitution – DABs are obliged to
examine as to whether the disability will or will not come in the way
of the candidate pursuing the course in question. [Paras 19, 22]

Appendix H-1 to NMC Regulations, 2019 – How it violates the
provisions of various laws:
Held: In the Appendix H-1 “both hands intact, with intact sensations,
sufficient strength and range of motion” are considered essential to
be eligible for the medical course – It 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 glorifies ‘ableism’ and
propagates that persons with typical abilities and with faculties
similar to what the majority may have or somehow superior – It 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. [Paras 16, 20-21,
25, 34-35]

Findings in Om Rathod v. Director General of Health Services
& Ors., 2024 SCC Online SC 3130 – Discussed, reiterated and
summarised:
Held: In Om Rathod, arising out of similar facts, the same expert
notwithstanding an adverse report filed by DAB, recommended
[2025] 2 S.C.R. 1145

Anmol v. Union of India & Ors.

admission of appellant therein to MBBS course after elaborately
considering functional assessment and successful completion of
it using clinical accommodations and assistive technologies – The
decision of Vidhi Himmat Katariya v. Union of India (2019) 10 SCC
20 was distinguished – Om Rathod summarised as:
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)…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… 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) …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) …
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. … Reasonable
accommodation is a facet of substantive equality and its failure
constitutes discrimination. (para 29)… 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) …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). [Para 28]
1146 [2025] 2 S.C.R.

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Whether the appellant is eligible for admission to medical
course – The separate Reports of the five member Committee
and Dr. Satyendra Singh tested on the touchstone of ratios
in Omkar Ramchandra Gond and Om Rathod:
Held: 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 – That part of the
Report of the 5 members Committee cannot be the basis to
deny the appellant’s admission to the MBBS Course because:
a) the report does not satisfy the test of functional assessment
as contemplated in the said two judgments; b) as mandated in
the said judgments reasons have not been assigned by the five
members of the Board for denying the appellant his right to pursue
the MBBS Course; c) 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 and also they have
recorded statements in the nature of disclaimer w.r.t. review of
NMC Guidelines – Report of Dr. Satyendra Singh complies with the
requirements laid down in the said judgments – He has employed
interactive processes to prepare the Report and put Appellant
through procedures to test his dexterity and perform psychomotor
skills in simulated environment – Based on these tests, certain
clinical accommodations for each phase of the MBBS Course
have been suggested which can be adopted by the authorities –
His Report concludes that we should not assume Appellant’s
incompetence without first providing him ample opportunities in
a simulation lab and ensuring the availability of accommodations
and assistive products – Courts are not experts in medical field
but are duty bound to enforce the fundamental rights. [Paras 16,
29-33, 36-39, 42-44]

Review of NMC Guidelines – Directions given in Omkar and
Om Rathod cases – Reiterated:
Held: NMC was directed to issue revised regulations and
guidelines keeping in mind the principles laid down of the said
judgments w.r.t admission of students with specified disabilities
under the RPwD Act to the MBBS Course and the communication
of the Ministry of Social Justice and Empowerment dated
[2025] 2 S.C.R. 1147

Anmol v. Union of India & Ors.

25.01.2024 – NMC also directed to constitute a new committee of
domain experts which will include persons with disability or one
or more experts conversant with the disability rights – NMC shall
file an affidavit explaining the current status before 03.03.2025.
[Paras 45-46, 48]

Case Law Cited
Omkar Ramchandra Gond v. Union of India & Ors. [2024] 10
SCR 673 : 2024 SCC OnLine SC 2860; Bambhaniya Sagar
Vasharambhai v. Union of India (Writ Petition (C) No. 856 of 2023);
Vikash Kumar v. Union Public Service Commission & Ors. [2021]
12 SCR 311 : (2021) 5 SCC 370; Om Rathod v. Director General of
Health Services & Ors., 2024 SCC OnLine SC 3130 – Relied on.
Vidhi Himmat Katariya and Others v. The State of Gujarat and
Others [2019] 12 SCR 821 : (2019) 10 SCC 20 – Distinguished.

List of Acts
Constitution of India; Rights of Persons with Disabilities Act, 2016;
Graduate Medical Education Regulations (Amendment), 2019.

List of Keywords
Disabled person; NEET-UG; Disability Assessment Boards;
Reasonable accommodation.

Case Arising From
CIVIL APPELLATE JURISDICTION: Civil Appeal No. 14333 of 2024
From the Judgment and Order dated 23.09.2024 of the High Court
of Punjab & Haryana at Chandigarh in CWP No. 24293 of 2024

Appearances for Parties
Advs. for the Appellant:
Atif Inam, Rishit Vimadalal, Ms. Shrutika Pandey, Ms. Karuvaki
Mohanty.
Advs. for the Respondents:
Gaurav Sharma, Sr. Adv., Ms. Pankhuri Shrivastava, Ms. Neelam
Sharma, Alekshendra Sharma, Aditya Kumar, Prateek Bhatia,
Dhawal Mohan, Paranjay Tripathi, Rajesh Raj, Shreekant Neelappa
Terdal, Krishna Kant Dubey.
1148 [2025] 2 S.C.R.

Supreme Court Reports

Judgment / Order of the Supreme Court

Judgment

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 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 10th grade and 12th 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
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.
[2025] 2 S.C.R. 1149

Anmol v. Union of India & Ors.

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.
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.
1150 [2025] 2 S.C.R.

Supreme Court Reports

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
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.

# Ed. Note: “Mr. Atif Inam” instead of “Mr. Atim Inam” in terms of subsequent corrigendum.
[2025] 2 S.C.R. 1151

Anmol v. Union of India & Ors.

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:

S. Disability Type of Specified Disability range
No. Type Disabilities Disability Eligible for Eligible for Not
Medical Medical eligible
Course, Course, for
not eligible Eligible for Medical
for PwD PwD Quota Course
Quota
1. Physical A. Locomotor a. Leprosy Less 40-80% More
disability disability, cured person* than 40% disability than
including disability 80%
Persons
specified
b. Cerebral with more
disabilities
Palsy** than 80%
(a to f)
disability
c. Dwarfism may also
d. Muscular be allowed
Dystrophy on case to
case basis
e. Acid attack
and their
victims
functional
f. Others*** competency
such as will be
Amputation, determined
Poliomyelitis, with the aid
etc. 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.
1152 [2025] 2 S.C.R.

Supreme Court Reports

* Attention should be paid to loss of sensations
in fingers and hands, 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 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
[2025] 2 S.C.R. 1153

Anmol v. Union of India & Ors.

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 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
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
1154 [2025] 2 S.C.R.

Supreme Court Reports

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)

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:-
“35. We have no reason to doubt that the National
Medical Commission will expeditiously comply with the
[2025] 2 S.C.R. 1155

Anmol v. Union of India & Ors.

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 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
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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, Constitutionally‡ 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
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.
‡ Ed. Note: “Constitutionally” instead of “onstituteionally” in terms of subsequent corrigendum.
[2025] 2 S.C.R. 1157

Anmol v. Union of India & Ors.

“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 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
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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.”
(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.
22. In Omkar Ramchandra Gond (supra), the following conclusion was
recorded and directions given:
[2025] 2 S.C.R. 1159

Anmol v. Union of India & Ors.

“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 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.”
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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
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 speaking for the Court in Om
Rathod (supra) distinguished the earlier judgment of this Court in
Vidhi Himmat Katariya v. The State of Gujarat ⁋ (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

⁋ Ed. Note: “The State of Gujarat” instead of “Union of India” in terms of subsequent corrigendum.
[2025] 2 S.C.R. 1161

Anmol v. Union of India & Ors.

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 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
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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
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
[2025] 2 S.C.R. 1163

Anmol v. Union of India & Ors.

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 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
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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 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
[2025] 2 S.C.R. 1165

Anmol v. Union of India & Ors.

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)
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
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to pursue a medical career with their disability. (para 36)
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
[2025] 2 S.C.R. 1167

Anmol v. Union of India & Ors.

that the sanctity of the principles in the RPWD Act and
in the 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
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
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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 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 was stated that there need to be “periodic revaluation of
[2025] 2 S.C.R. 1169

Anmol v. Union of India & Ors.

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.
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.
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• 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 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
[2025] 2 S.C.R. 1171

Anmol v. Union of India & Ors.

easily be adopted by the authorities. For example, for phase one
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 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
1172 [2025] 2 S.C.R.

Supreme Court Reports

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 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 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
[2025] 2 S.C.R. 1173

Anmol v. Union of India & Ors.

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

Result of the case: Appeal allowed.

†
Headnotes prepared by: Swathi H. Prasad, Hony. Associate Editor
(Verified by: Shadan Farasat, Sr. Adv.)