The Performance and Trajectory of Medical Students With Disabilities: Results From the Pathways Project

Abstract

The number of medical students disclosing disabilities and requesting accommodations is increasing, [1][2][3] prompting new questions about performance of students with disabilities (SWD) on United States Medical Licensing Exam (USMLE) examination scores and to match into residency. Historical data on SWD suggest lower performance and extended time to graduation, 4,5 but little is known about whether category of disability and accommodation on the Step 1 examination impact performance, time to graduation, and match rates. Our aim was to determine performance outcomes and match to residency of medical SWD by category of disability and whether they received accommodations on Step 1. Conclusions:Barriers remain for medical students with cognitive/learning disabilities, which are partially mitigated by accommodations on board exams.

Barriers in Medical Education: A Scoping Review of Common Themes for Medical Students With Disabilities

“…In contrast, those who receive accommodations are 6 points lower than the average population ( 14). This information further proves that barriers remain for competent students when not given their proper accommodations (14,16,12). Therefore, there is a need to investigate the medical education learning environment to ensure robust support systems for these students (16).…”

“…A recent 2021 study by Meeks et al addressed the lack of information about whether or not accommodations on USMLE Step 1 impact performance, time to graduation, and match rates. The information discussed in the Searcy and Tehrani articles left the area of students being accommodated within the medical school and on USMLE Step exams open for more investigation (14,22,25). Within the study, 69% of students were identi ed as having cognitive/learning disabilities (14).…”

“…The information discussed in the Searcy and Tehrani articles left the area of students being accommodated within the medical school and on USMLE Step exams open for more investigation (14,22,25). Within the study, 69% of students were identi ed as having cognitive/learning disabilities (14). Although these students had lower Step 1 scores and were less likely to graduate on time, no accommodated SWD Step 1 scores were lower than the rest of the population.…”

“…Although these students had lower Step 1 scores and were less likely to graduate on time, no accommodated SWD Step 1 scores were lower than the rest of the population. When SWD are accommodated, they perform better than their no accommodated SWD peers, which indicates that barriers remain, and students are not being rightfully accommodated (14).…”

Impact of USMLE Step-1 accommodation denial on US medical schools: A national survey

“…Indeed, obtaining approval for accommodations on USMLE exams can be difficult, as evidenced by recent litigation [ 14 – 17 ]. SWD score lower on Step-1 than their non-disabled peers [ 6 , 18 , 19 ], A recent multi-site study suggested that approximately 25% of students with disabilities in their sample were approved for accommodation on Step-1. Students in this study who received accommodation on Step-1 performed better than those without accommodation, by an average of 6 points.…”