Monday, April 4, 2016

Medical Student Seeking Feedback on AMA Resolution "Accommodations for Disabled Physicians and Medical Students"

We have a second year medical student who is working on submitting a resolution to the AMA - "Accommodations for Disabled Physicians and Medical Students."

To read the response and to provide your input, please go here (for members only, but it is free to sign up and join)

Sunday, March 27, 2016

U.S. Medical Schools' Compliance With the Americans with Disabilities Act: Findings From a National Study

Earlier this year, researchers published:

U.S. Medical Schools' Compliance With the Americans with Disabilities Act: Findings From a National Study.

Purpose: Physician diversity improves care for underserved populations, yet there are few physicians with disabilities. The authors examined the availability of technical standards (TSs) from U.S. medical schools (MD- and DO-granting) and evaluated these relative to intent to comply with the Americans with Disabilities Act (ADA).

Method: Document analysis was conducted (2012-2014) on U.S. medical schools' TSs for hearing, visual, and mobility disabilities. Primary outcome measures were ease of obtaining TSs, willingness to provide reasonable accommodations, responsibility for accommodations, and acceptability of intermediaries or auxiliary aids.

Results: TSs were available for 161/173 (93%) schools. While 146 (84%) posted these on their Web sites, 100 (58%) were located easily. Few schools, 53 (33%), had TSs specifically supporting accommodating disabilities; 79 (49%) did not clearly state policies, 6 (4%) were unsupportive, and 23 (14%) provided no information. Most schools, 98 (61%), lacked information on responsibility for providing accommodations, 33 (27%) provided accommodations, and 10 (6%) had students assume some responsibility. Approximately 40% allowed auxiliary aids (e.g., motorized scooter), but < 10% allowed intermediaries (e.g., sign language interpreter). Supportive schools were more likely to allow accommodations (P < .001), assume responsibility for accommodations (P < .001), and accept intermediaries (P < .002). DO-granting schools were more supportive for students with mobility disabilities.

Conclusions: Most medical school TSs do not support provision of reasonable accommodations for students with disabilities as intended by the ADA. Further study is needed to understand how schools operationalize TSs and barriers to achieving ADA standards.

Zazove P, Case B, Moreland C, Plegue MA, Hoekstra A, Ouellette A, Sen A, Fetters MD. U.S. Medical Schools' Compliance With the Americans with Disabilities Act: Findings From a National Study. Acad Med. 2016 Jan 19.

PMID: 26796093

Wednesday, March 16, 2016

Invisible disability, or hidden disability

Invisible disability, or hidden disability, are defined as disabilities that are not immediately apparent. Some people with visual or auditory disabilities who do not wear glasses or hearing aids, or discreet hearing aids, may not be obviously disabled. Some people who have vision loss may wear contacts.

Invisible Disabilities are certain kinds of disabilities that are not immediately apparent to others. It is estimated that 10% of people in the U.S. have a medical condition which could be considered a type of invisible disability.

According to the Americans with Disabilities Act of 1990 (ADA) an individual with a disability is a person who: Has a physical or mental impairment that substantially limits one or more major life activities; has a record of such an impairment; or is regarded as having such an impairment.

Invisible Disabilities: List & Information - Disabled World

Wednesday, January 20, 2016

Submit an abstract for the International Conference on Physician Health

This year, the theme for the International Conference on Physician Health is "Increasing Joy in Medicine." There's an opportunity to submit an abstract for the conference.

Authors are invited to submit abstracts for consideration as part of the 2016 ICPH. Seeking abstracts that identify solutions for increasing joy in medicine. Interested in abstracts that deal with issues relating to the personal and professional ways that physicians are increasing joy in medicine—from medical school through retirement—and the effect of these practices on physicians’ health, including both physical and psychological aspects of wellness. Relevant submissions dealing with any aspect of physicians’ health and well-being are also welcome.

Learn more and submit an abstract here.

Tuesday, December 8, 2015

Depression among medical residents - JAMA 2015 study

Physicians know that residency can be grueling and can lead to depressive thoughts. What is the prevalence of depression vs. depressive symptoms? This question was recently answered by the Dec 8, 2015 JAMA article titled, "Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis." There was also a corresponding editorial on JAMA titled, "Resident Depression: The Tip of a Graduate Medical Education Iceberg."

Here is the abstract from the 2015 systemic review:

Importance:  Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies.

Objective:  To provide a summary estimate of depression or depressive symptom prevalence among resident physicians.

Data Sources and Study Selection:  Systematic search of EMBASE, ERIC, MEDLINE, and PsycINFO for studies with information on the prevalence of depression or depressive symptoms among resident physicians published between January 1963 and September 2015. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used a validated method to assess for depression or depressive symptoms.

Data Extraction and Synthesis:  Information on study characteristics and depression or depressive symptom prevalence was extracted independently by 2 trained investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression.

Main Outcomes and Measures:  Point or period prevalence of depression or depressive symptoms as assessed by structured interview or validated questionnaire.

Results:  Data were extracted from 31 cross-sectional studies (9447 individuals) and 23 longitudinal studies (8113 individuals). Three studies used clinical interviews and 51 used self-report instruments. The overall pooled prevalence of depression or depressive symptoms was 28.8% (4969/17 560 individuals, 95% CI, 25.3%-32.5%), with high between-study heterogeneity (Q = 1247, τ2 = 0.39, I2 = 95.8%, P < .001). Prevalence estimates ranged from 20.9% for the 9-item Patient Health Questionnaire with a cutoff of 10 or more (741/3577 individuals, 95% CI, 17.5%-24.7%, Q = 14.4, τ2 = 0.04, I2 = 79.2%) to 43.2% for the 2-item PRIME-MD (1349/2891 individuals, 95% CI, 37.6%-49.0%, Q = 45.6, τ2 = 0.09, I2 = 84.6%). There was an increased prevalence with increasing calendar year (slope = 0.5% increase per year, adjusted for assessment modality; 95% CI, 0.03%-0.9%, P = .04). In a secondary analysis of 7 longitudinal studies, the median absolute increase in depressive symptoms with the onset of residency training was 15.8% (range, 0.3%-26.3%; relative risk, 4.5). No statistically significant differences were observed between cross-sectional vs longitudinal studies, studies of only interns vs only upper-level residents, or studies of nonsurgical vs both nonsurgical and surgical residents.

Conclusions and Relevance:  In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among resident physicians was 28.8%, ranging from 20.9% to 43.2% depending on the instrument used, and increased with calendar year. Further research is needed to identify effective strategies for preventing and treating depression among physicians in training.