Patients Benefit When Medical Schools Remove Barriers for Students With Disabilities, Study Says

Study isn’t just about fairness but shows ‘these students actually have strengths,’ Canadian researcher says Bobby Hristova, CBC News
Posted: Jan 21, 2024

She had the highest grade point average (GPA) at the University of Ottawa and a perfect score on her medical exams, but Shira Gertsman had little chance of getting into numerous medical schools across Canada – because of a disability.

“When I was in my undergrad, I went to a career counsellor and they looked at my transcript … they saw some of [my course load] was part-time and told me not to bother applying because there wouldn’t be hope for me,” said Gertsman, who lives with Crohn’s disease, an autoimmune disease that causes inflammation of the lining of the gastrointestinal tract.

“I’m lucky I didn’t take it to heart.”

Now, she’s a final-year medical student at McMaster University in Hamilton and part of a research team that published a paper analyzing the barriers people with disabilities face when applying to Canadian medical schools.

The paper, published in late 2023 in the Canadian Medical Association Journal, says schools “systematically exclude” students with disabilities – and taking action to remove those barriers would benefit patients.

“We’re not just saying we should admit students with illness and disability because it’s fair to them, but that these students actually have strengths,” Gertsman told CBC Hamilton.

“Strengths translatable to patient care and –
having these people in positions of leadership in hospitals, informing decisions – has ripple effects, benefits to our entire society.”

Barriers in application process

The team reviewed publicly available, accessibility-related admission policies for the 2022-2023 admission cycle at all English-speaking Canadian medical schools.

The paper points to a culture of stereotyping and ableism, inflexible admission criteria, and a lack of information about accommodations as some of the contributors to the problem.

It states, for people with disabilities, requiring a minimum grade point average, a full undergraduate course load and standardized testing can be “poor predictors of future performance as a physician in a properly adapted workplace.”

In Gertsman’s case, she had to take a part-time course load due to her disability flaring up, which meant she was no longer eligible to apply to many schools.

Gertsman added many applications don’t have a space for people to share the strengths that come with their disability and lived experience.

“I think I showed a lot of resilience by, while I was sick, continuing with my studies,” she said.

The paper also states a requirement to meet technical standards, like hearing a patient’s heartbeat, can be a barrier, especially when deaf doctors have been successfully trained with access to interpreters, the paper states.

“Medical school has long been structured around the notion that to be any type of physician, you must be capable of being every type of physician. In this way, generic technical standards deny students entry into fields in which they may excel,” according to the paper.

The research team noted how Ontario medical schools recently debuted a section for disability-based consideration requests in its applications – but only to students who didn’t have accommodations during their undergraduate years.

The researchers say that requirement makes an assumption that the accommodations were actually sufficient.

How to make things better

The researchers offer multiple recommendations for medical schools, including:

  • The creation of a guideline, supported by the Association of Faculties of Medicine of Canada (AFMC), for accessibility and inclusion for students with disabilities.
  • Revise some of the requirements, like having a full course load, to not disadvantage students with disabilities and revise wording of technical standards to clarify alternatives.
  • Publicize accessibility options for applicants and have trained professionals not part of the application process manage accommodation questions.
  • Improve representation of people with disabilities in medicine.
  • Have data on the prevalence and experiences of Canadian medical students with disabilities.

The most important recommendation, the paper states, is to “approach accessibility with creativity, openness and willingness to change.”

The paper also includes how some schools also have some good measures in place like interview accommodations or essays and sections where applicants can share more about their disability and how it has impacted them.

Medical schools making progress, association says

AFMC declined an interview but spokesperson Angélique Simpson replied in an email, saying equity, diversity and inclusion has been a priority for medical schools for many years.

Simpson said the Future of Admissions in Canada Think Tank made recommendations in 2020 to ensure admissions processes are inclusive to people with disabilities.

“The AFMC has been working for the past two years to help all members move the needle on this important area of work,” she said.

Simpson also said AFMC is supporting the Re-Envisioning Technical Standards Working Group, which has a mandate to get Canadian technical standards in line with the Accessibility Canada act and human rights legislation.

“We are very close to publishing this group’s final recommendations on our website for all medical schools to use,” she said.

Simpson noted some medical schools have been developing their own strategies to improve fairness in admissions.

Gertsman said she is optimistic AFMC will support the paper and may work with the researchers in the future.

ABOUT THE AUTHOR

Bobby Hristova is a journalist with CBC Hamilton. He reports on all issues, but has a knack for stories that hold people accountable, stories that focus on social issues and investigative journalism. He previously worked for the National Post and CityNews in Toronto. You can contact him at bobby.hristova@cbc.ca.

Original at https://www.cbc.ca/news/canada/hamilton/medical-school-students-disabilities-1.7086634