Emergency Medicine Resident Education on Caring for Patients With Disabilities: A Call to Action

Abstract

People with disabilities constitute a marginalized population who experience significant health care disparities resulting from structural, socioeconomic, and attitudinal barriers to accessing health care. It has been reported that education on the care of marginalized groups helps to improve awareness, patient-provider rapport, and patient satisfaction. Yet, emergency medicine (EM) residency education on care for people with disabilities may be lacking. The goal of this paper is to review the current state of health care for patients with disabilities, review the current state of undergraduate and graduate medical education on the care of patients with disabilities, and provide suggestions for an improved EM residency curriculum that includes education on the care for patients with disabilities.

The Prevalence of Disability Health Training and Residents With Disabilities in Emergency Medicine Residency Programs

“…11 Resources such as these could be useful to modify ACGME milestones, as recently described in a call to action paper. 14 Limited information exists about the prevalence of physicians with disabilities throughout all stages of their career. Available data suggest that the prevalence of medical students with disabilities has been increasing from less than 2% prior to 2016 32,33 to 2.7% in 2016 34 to 4.6% in 2019.…”

“…[9][10][11][12] This lack of undergraduate medical education leaves students ill-prepared to care for patients with disabilities as they enter residency and is further perpetuated by the lack of established disability curricula within graduate medical education programs. 11,13,14 Adults with disabilities utilize the Emergency Department (ED) more frequently than the general population, accounting for as many as 40% of annual ED visits, 15 and are twice as likely to require emergency services. 16 Given the frequency with which Emergency Medicine (EM) physicians will encounter patients with disabilities, it is imperative to teach EM residents about disability topics in residency training programs.…”

“…However, the Residency Review Committee (RRC) for Emergency Medicine does not require education and training on care for patients with disabilities. 14,17 Moreover, when the Council of EM Residency Directors in Emergency Medicine (CORD) previously examined residency curricula specific to the care of underserved minorities, they did not include patients with disabilities in their report. 18 Recent studies emphasize the importance of and need for comprehensive EM resident education regarding the care of patients with disabilities.…”

“…These organizations emphasize the need for improved physician education on disability health through disability health curricula, yet many U.S. medical schools lack a dedicated curriculum 9–12 . This lack of undergraduate medical education leaves students ill‐prepared to care for patients with disabilities as they enter residency and is further perpetuated by the lack of established disability curricula within graduate medical education programs 11,13,14 …”

“…The Accreditation Council on Graduate Medical Education (ACGME) Program Requirements for Emergency Medicine requires that residents demonstrate competence in respect and responsiveness to diverse patient populations, including but not limited to diversity in gender, age, culture, race, religion, disabilities, national origin, socioeconomic status, and sexual orientation as part of their core requirements. However, the Residency Review Committee (RRC) for Emergency Medicine does not require education and training on care for patients with disabilities 14,17 . Moreover, when the Council of EM Residency Directors in Emergency Medicine (CORD) previously examined residency curricula specific to the care of underserved minorities, they did not include patients with disabilities in their report 18 .…”