How Should We Build Disability-Inclusive Medical School Admissions?

Abstract

Students with disabilities add rich diversity to medical education and help motivate health equity. Unjust obstacles faced by many of these students along pathways to medicine begin during medical school admissions. Deeply embedded ableist notions of what it means to be a physician keep archaic practices in place that serve as systemic barriers to the admission of members of this population. This article summarizes the prominent obstacles for applicants with disabilities and suggests ways in which thoughtful, inclusive admission policies and practices can ultimately contribute to a clinical workforce that is more appropriately diverse and prepared to provide just and patient-centered health care. Diversity and DisclosurePhysicians of the 21st century need the skills and knowledge that are fostered in diverse learning and work environments. 1 Research shows that diversity contributes to creativity and development of problem-solving skills, with more diverse groups outperforming more homogeneous ones, 2,3,4 a fact that should influence how we select members of medical school classes. In 2016, 25.7% of the US adult population included persons with a disability. 5 Medical students with disabilities, training among diverse faculty and colleagues, would positively contribute to the preparedness of physicians and their colleagues to meet the unique needs of patients with disabilities, facilitate shared decision making, and contribute to innovation-and do so with greater empathy.

Revolutionizing Health Professions Admissions to Achieve an Inclusive Workforce

“…• Steadily increase the proportion of students from historically underrepresented groups admissions process including: the requirement to disclose disability status to obtain equitable access, inflexible technical standards, and a lack of mentors familiar with students with disabilities. 24 To make health professions education more accessible to such students, all faculty and students should receive anti-ableist training; and admission processes should be re-examined for potential exclusionary practices. 24 Technical standards (eg, observation, motor function) frequently exclude students with disabilities.…”

“…24 To make health professions education more accessible to such students, all faculty and students should receive anti-ableist training; and admission processes should be re-examined for potential exclusionary practices. 24 Technical standards (eg, observation, motor function) frequently exclude students with disabilities. Entrance exams can be a barrier for individuals with disabilities and obtaining the required documentation for accommodations can be quite costly.…”

“…For students with disabilities, feelings of belonging are tied to student services and available accommodations; 50% of students with disabilities do not request for accommodations. 39 In addition an infrastructure to support students with disabilities within health professional schools, 24 there should be a clear and readily available process for requesting accommodations without stigma. 39 The learning environment is an area of unmet need for students from minoritized groups.…”

AAIM Recommendations to Promote Equity and Inclusion in the Internal Medicine Residency Interview Process

“…The true number is likely underreported given students may not feel safe disclosing their disabilities. 35 , 36 Learners with disabilities form a heterogeneous group with varying degrees of impairment. 36 During the interview process, applicants with disabilities may face stress and logistical challenges associated with in-person travel, 37 with these challenges being mitigated with virtual interviews.…”

“… 35 , 36 Learners with disabilities form a heterogeneous group with varying degrees of impairment. 36 During the interview process, applicants with disabilities may face stress and logistical challenges associated with in-person travel, 37 with these challenges being mitigated with virtual interviews. In addition, applicants with disabilities may have concerns about disclosing their disabilities during interviews, leading them to hesitate to ask about accommodations that could be important in their decision-making.…”