Creative Approaches to the Inclusion of Medical Students With Disabilities

Journal of Medical Education and Curricular Development

Plegue

et al. 2020

Self Cite

Background: This study aimed to evaluate and report the national prevalence of disability across undergraduate medical education (UME) and examine differences in the category of disability, and accommodation practices between allopathic (MD)- and osteopathic (DO)-granting programs. Methods: Between May 20 and June 30, 2020, 75% of institutional representatives at eligible DO schools responded to a web-based survey. The survey assessed the aggregate prevalence of disabled DO students, prevalence of DO students by category of disability, and prevalence of accommodations granted. Descriptive statistics were used to summarize results. Using 2019 MD data, comparisons were made between MD and DO programs to calculate overall prevalence and differences in accommodation practices across undergraduate medical education. Results: DO-granting programs reported a disability prevalence of 4.27% of the total enrollment. Attention-deficit/hyperactivity disorder (ADHD), psychological disabilities, and chronic health disabilities were reported most frequently. DO-granting programs reported higher rates of ADHD than the MD-granting program. The national pooled prevalence of disability across MD- and DO-granting programs was 4.52%. MD-granting programs reported a higher number of students with disabilities and higher rates of psychological disabilities when compared with DO-granting programs. One hundred percent of DO students disclosing disability received some form of accommodation. General clinical accommodations were more frequently provided in MD-granting programs when compared to DO-granting programs. Conclusions: This study provides the first comprehensive prevalence of US medical student disability and accommodations. Additionally, these data may serve as a benchmark for DO programs, with implications for curricular development, instructional planning and disability support, and resource allocation in medical education.

Section: Discussionmentioning

confidence: 99%

National Prevalence of Disability and Clinical Accommodations in Medical Education

Journal of Medical Education and Curricular Development

Plegue

et al. 2020

Self Cite

“…Medical leaders emphasize the importance of increasing diversity in medical education, including individuals with disabilities. 1 - 6 Despite this emphasis on inclusion, students with disabilities face significant and well-documented barriers. In particular, barriers arise when the structures for student disclosure and provision of accommodation are uninformed .…”

Section: Introductionmentioning

confidence: 99%

“…When uninformed structures are in place, students face additional burdens. 1 , 3 , 7 - 9 Indeed, studies show that students with disabilities often avoid disclosing their disability and requesting accommodations for fear of bias, stigma, and misperceptions about performance. 7 , 8 , 10 - 14 These concerns are fueled by the need to substantiate requests with confidential documentation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Journal of Medical Education and Curricular Development

Stergiopoulos

et al. 2021

Self Cite

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

“…Inclusive policies with institution-wide messaging that communicates a commitment to disability inclusion is needed to cultivate an environment where disability disclosure is a normalized and protected process. [16][17][18][19][20][21]…”

Section: Confidentiality Statementmentioning

confidence: 99%

The Unexamined Diversity: Disability Policies and Practices in US Graduate Medical Education Programs

Taylor

Journal of Graduate Medical Education

et al. 2020

Self Cite

Background Graduate medical education (GME) institutions must ensure equal access for trainees with disabilities through appropriate and reasonable accommodations and policies. To date, no comprehensive review of the availability and inclusiveness of GME policies for residents with disabilities exists. Objective We examined institutions' compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements and alignment with Association of American Medical Colleges (AAMC) policy considerations. Methods Between June and August 2019, we conducted a directed content analysis of GME institutional policies using the AAMC report on disability considerations and the ACGME institutional requirements as a framework. Results Of the 47 GME handbooks available for review, 32 (68%) included a disability policy. Forty-one of the 47 (87%) handbooks maintained a nondiscrimination statement that included disability. Twelve of the 32 (38%) handbooks included a specific disability policy and language that encouraged disclosure, and 17 (53%) included a statement about the confidential documentation used to determine reasonable accommodations. Nineteen of the 32 (59%) maintained a clear procedure for disclosing disabilities and requesting accommodations. Conclusions While disability policies are present in many of the largest GME institutions, it is not yet a standardized practice. For institutions maintaining a disability policy, many lack key elements identified as best practices in the AAMC considerations.