Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

Lisa M Meeks; Ben Case; Erene Stergiopoulos; Brianna K Evans; Kristina H Petersen

doi:10.1177/23821205211018696

Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools

J Med Educ Curric Dev. 2021 May 26:8:23821205211018696. doi: 10.1177/23821205211018696. eCollection 2021 Jan-Dec.

Authors

Lisa M Meeks^{1

2

3}, Ben Case^{1

2}, Erene Stergiopoulos⁴, Brianna K Evans⁵, Kristina H Petersen⁶

Affiliations

¹ Department of Psychiatry, The University of Colorado, Aurora, CO, USA.
² Department of Family Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA.
³ Center for a Diverse Healthcare Workforce, University of California, Davis, School of Medicine, Sacramento, CA, USA.
⁴ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁵ Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶ Department of Biochemistry & Molecular Biology, New York Medical College, Valhalla, NY, USA.

Abstract

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied.

Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size.

Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size.

Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.

Keywords: AAMC; Disability; best practices; disability resource provider; disclosure; medical education; resources; structural barriers.