Assessment of Accommodation Requests Reported by a National Sample of US MD Students by Category of Disability

Meeks, Lisa M.; Pereira-Lima, Karina; Plegue, Melissa; Stergiopoulos, Erene; Jain, Neera R.; Addams, Amy; Moreland, Christopher J.

doi:10.1001/jama.2022.12283

Cited by 9 publications

(14 citation statements)

References 6 publications

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“…We also included the question about why residents did not receive disability accommodations with additional response choices to allow participants to provide more information about possible drivers of nonrequests, including stigma, bias, unclear institutional policies and procedures, and lack of documentation (survey questions are available in eMethods in Supplement 1). In keeping with prior studies, interns who indicated they requested accommodations (ie, those who requested and had accommodations provided or denied or those whose request was under review) and those who indicated they did not request accommodations for reasons other than not needing accommodations were coded as needing accommodation.…”

Section: Methodsmentioning

confidence: 99%

“…While prior studies demonstrate that a large proportion of medical trainees do not request accommodations when needed, little is known about drivers of nonrequests. Herein, using data from the University of Michigan Intern Health Study, a longitudinal cohort study of first-year resident physicians, we aimed to assess the frequency of disability reporting and request for accommodations among resident physicians with disabilities and to identify possible drivers of nonrequest for disability accommodations in this population.…”

Section: Introductionmentioning

confidence: 99%

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Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US

et al. 2023

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ImportanceEnsuring access to accommodations is critical for resident physicians and their patients. Studies show that a large proportion of medical trainees with disabilities do not request needed accommodations; however, drivers of nonrequests are unknown.ObjectiveTo assess the frequency of accommodation requests among first-year resident physicians (ie, interns) with disabilities and to identify possible drivers of nonrequest for needed accommodations.Design, Setting, and ParticipantsAs part of the Intern Health Study, a longitudinal cohort study of first-year resident physicians, residents at 86 surgical and nonsurgical residency programs in 64 US institutions provided demographic and training characteristics 2 months prior to matriculation (April-May 2021). At the end of their intern year (June 2022), participants completed a new survey with questions about disability-related information, including disability status, disability type, whether they received accommodations, and if not, reasons for nonaccommodation. Poststratification and attrition weights were used to estimate the frequency of accommodation requests and reasons for not requesting accommodations. Interns reporting at least 1 disability were included in the analysis.Main Outcomes and MeasuresPrevalence of reported disabilities, residency specialties distribution, frequency of accommodation requests, and reasons for nonaccommodation among resident physicians with disabilities.ResultsAmong the 1486 resident physicians who completed the baseline survey, 799 (53.8%) replied to the disability questions. Of those, 94 interns (11.8%; weighted number, 173 [11.9%]) reported at least 1 disability and were included in the present study (weighted numbers, 91 [52.6%] men, 82 [47.4%] women, mean [SD] age, 28.6 [3.0] years). Among interns with reported disability and need for accommodations (83 of 173 [48.0%]), more than half (42 [50.6%]) did not request them. The most frequently reported reasons for not requesting needed accommodations were fear of stigma or bias (25 [59.5%]), lack of a clear institutional process for requesting accommodations (10 [23.8%]), and lack of documentation (5 [11.9%]).Conclusions and RelevanceProgram directors should investigate cultural and structural factors within their programs that contribute to an environment where residents do not feel safe or supported in disclosing disability and requesting accommodation and review their disability policies for clarity.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US

et al. 2023

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“…Those who replied ‘no’ were further asked the question ‘Which of the following best describes why your medical school did not or has not provided accommodations?’ Responses included: ‘my request for accommodations was denied’, ‘my request for accommodations is under review’, ‘I have not requested accommodations because I feel I do not need accommodations’ and ‘I have not requested accommodations for other reasons’. In keeping with previous studies, 56,60 we coded program access to include students reporting receiving accommodations or not needing accommodations. All other responses were coded as lack of program access.…”

Section: Methodsmentioning

confidence: 99%

Disability, program access, empathy and burnout in US medical students: A national study

et al. 2022

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Objective The objective of this study is to investigate whether self‐disclosed disability and self‐reported program access are associated with measures of empathy and burnout in a national sample of US medical students. Methods The authors obtained data from students who responded to the Association of Medical Colleges (AAMC) Year 2 Questionnaire (Y2Q) in 2019 and 2020. Data included demographic characteristics, personal variables, learning environment indicators, measures of burnout (Oldenburg Burnout Inventory for Medical Students), empathy (Interpersonal Reactivity Index) and disability‐related questions, including self‐reported disability, disability category and program access. Associations between disability status, program access, empathy and burnout were assessed using multivariable logistic regression models accounting for YQ2 demographic, personal‐related and learning environment measures. Results Overall, 23 898 (54.2%) provided disability data and were included. Of those, 2438 (10.2%) self‐reported a disability. Most medical students with disabilities (SWD) self‐reported having program access through accommodations (1215 [49.8%]) or that accommodations were not required for access (824 [33.8%]). Multivariable models identified that compared with students without disabilities, SWD with and without program access presented higher odds of high exhaustion (1.50 [95% CI, 1.34–1.69] and 2.59 [95% CI, 1.93–3.49], respectively) and lower odds of low empathy (0.75 [95% CI, 0.67–.85] and 0.68 [95% CI, 0.52–0.90], respectively). In contrast, multivariable models for disengagement identified that SWD reporting lack of program access presented higher odds of high disengagement compared to students without disabilities (1.43 [95% CI, 1.09–1.87], whereas SWD with program access did not (1.09 [95% CI, 0.97–1.22]). Conclusions Despite higher odds of high exhaustion, SWD were less likely to present low empathy regardless of program access, and SWD with program access did not differ from students without disabilities in terms of disengagement. These findings add to our understanding of the characteristics and experiences of SWD including their contributions as empathic future physicians.

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“…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.…”

Section: Holistic Supportmentioning

confidence: 99%

“…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. In a national cohort study, Black, Asian, Multiracial, and female medical students were most likely to have experienced microaggressions at least weekly.…”

Section: Holistic Supportmentioning

confidence: 99%

Revolutionizing Health Professions Admissions to Achieve an Inclusive Workforce

Nguyen

Dent²,

Fancher³

et al. 2023

Ann Fam Med

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This article describes the "The Admissions Revolution: Bold Strategies for Diversifying the Healthcare Workforce" conference, which preceded the 2022 Beyond Flexner Alliance Conference and called for health professions institutions to boldly reimagine the admission process to diversify the health care workforce. Proposed strategies encompassed 4 key themes: admission metrics, aligning admission practices with institutional mission, community partnerships to fulfill social mission, and student support and retention. Transformation of the health professions admission process requires broad institutional and individual effort. Careful consideration and implementation of these practices will help institutions achieve greater workforce diversity and catalyze progress toward health equity.

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Assessment of Accommodation Requests Reported by a National Sample of US MD Students by Category of Disability

Abstract: This cross-sectional study of US second-year medical students examines the proportion of accommodation requests made across disability categories.

Cited by 9 publications

References 6 publications

Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US

Barriers to Disclosure of Disability and Request for Accommodations Among First-Year Resident Physicians in the US

Disability, program access, empathy and burnout in US medical students: A national study

Revolutionizing Health Professions Admissions to Achieve an Inclusive Workforce

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