Disability Among US Medical Students

Be sure to read the December 6, 2016 JAMA article titled:

Prevalence of Self-disclosed Disability Among Medical Students in US Allopathic Medical Schools
by Lisa M. Meeks, PhD; Kurt R. Herzer, PhD, MSc

From December 2014 through February 2016, an electronic, web-based survey was sent to institutionally designated disability administrators at eligible allopathic medical schools who have a federally mandated duty to assist qualified students with disabilities. Eligible schools were identified through a registry maintained by the Association of American Medical Colleges (AAMC).

Respondents identified 1547 students with disabilities (43.3% male), representing 2.7% of the total enrollment and ranging from 0% to 12%. Of these students, 97.7% received accommodations.

ADHD was the most common disability (33.7%), followed by learning disabilities (21.5%) and psychological disabilities (20.0%). Mobility and sensory disabilities were less common.

Meeks LM, Herzer KR. Prevalence of Self-disclosed Disability Among Medical Students in US Allopathic Medical Schools. JAMA. 2016;316(21):2271-2272. doi:10.1001/jama.2016.10544

AMA Adopts Policies to Support Physician Wellness, Mental Health

On Nov 15, 2016, the AMA announced the following:

AMA Adopts Policies to Support Physician Wellness, Mental Health

ORLANDO, Fla. – The American Medical Association (AMA) adopted new policy today aimed at ensuring medical students and resident and fellow physicians have timely and confidential access to the medical and mental health services they need during their medical training. The new policies will help physicians-in-training maintain their personal health and well-being and reduce burnout so they can provide the highest quality patient care.

“Many physicians-in-training do not seek out treatment for physical, mental health or addiction issues because they are concerned about confidentiality, the possible negative impact that receiving treatment could have on their future career in medicine, or burdening colleagues with extra work,” said AMA Board Member and medical student Omar Z. Maniya. “With a high number of medical students and residents experiencing depression, burnout and suicide, and too many physicians overlooking their own health needs, we must do everything we can to reduce the barriers and stigmas that keep them from receiving care.”

Medical Schools' Willingness to Accommodate Medical Students with Sensory and Physical Disabilities

The following article was published in Oct 2016:

1: McKee M, Case B, Fausone M, Zazove P, Ouellette A, Fetters MD. Medical Schools' Willingness to Accommodate Medical Students with Sensory and Physical Disabilities: Ethical Foundations of a Functional Challenge to "Organic" Technical Standards. AMA J Ethics. 2016 Oct 1;18(10):993-1002. doi: 10.1001/journalofethics.2016.18.10.medu1-1610. PubMed PMID: 27780023.

Abstract

Students with sensory and physical disabilities are underrepresented in medical schools despite the availability of assistive technologies and accommodations. Unfortunately, many medical schools have adopted restrictive "organic" technical standards based on deficits rather than on the ability to do the work. Compelling ethical considerations of justice and beneficence should prompt change in this arena. Medical schools should instead embrace "functional" technical standards that permit accommodations for disabilities and update their admissions policies to promote applications from qualified students with disabilities. Medical schools thus should focus on what students with disabilities can do, rather than what they cannot do, because these students further diversify the health care profession and improve our ability to care for an expanding population of patients with disabilities.

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

The following article was published in July, 2016:

1: 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 Jul;91(7):979-86. doi: 10.1097/ACM.0000000000001087. PubMed PMID: 26796093.

Abstract

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.

Surgical resident becomes paralyzed and not allowed to complete training at SUNY Downstate

The story about the surgical resident Svetlana Kleyman can be found on the New York Post here and on PIX11 here.

According to the New York Post story, titled, "SUNY wouldn’t let me finish medical training after I became paralyzed":

Svetlana Kleyman was paralyzed by a spinal infection. After months of rehabilitation and learning to live life in a wheelchair, she reached out to SUNY about resuming her place in the program. But, SUNY would not take her back. So, Kleyman has filed a lawsuit against SUNY Downstate.

Her attorney is Daniel Kaiser (Kaiser Saurborn & Mair, P.C.).

Inviting students, residents, physicians with disabilities for AAMC/UCSF Lived Experience Study

In partnership, the American Association for Medical Colleges (AAMC) and the University of California San Francisco (UCSF) School of Medicine are conducting a qualitative research study of physicians and learners (residents and medical students) with disabilities to better understand their lived experiences during medical training. All forms of disability (learning, psychological, physical, sensory, chronic health, and AD/HD) will be included in this research. The research will culminate in a joint AAMC/UCSF special report scheduled for release in 2017, as well as further scholarly publications.

To learn more, please view this forum discussion (sign-in required).

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)

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

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
www.disabled-world.com/disability/types/invisible/

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.