Disability in US medical education: Disparities, programmes and future directions

Abstract

As of 2010, 19% of the US population lives with a disability, and with the average lifespan of persons with disability increasing, this number is expected to rise. This has prompted the identification of a need for disability-based education by the US Institute of Medicine, the Surgeon General of the United States, the Association of American Medical Colleges (AAMC) and several other academic policymaking institutions. Despite the identification of disability education as an area of need, many physicians and other medical professionals lack the training to effectively communicate and treat patients with disabilities. There also exists heterogeneity among medical schools in the level of incorporation of disability education and training into curricula, leaving physicians to learn about disability on an ‘exposure-based’ model. The AAMC has recommended that medical schools begin to prepare their students to care for persons with disabilities, but the formal disability education programmes that have developed have wide variability in delivery. Currently, medical school disability education models range from lectures, didactic teaching, bedside teaching, objective structured clinical examination and simulated patient-based teaching and assessment – with only a minority of programmes using a longitudinal model. The systemisation of disability-based education stands to prepare more culturally responsive physicians and address an area of need in a population that faces significant barriers in health care. This review serves to assess the current state of disability education in US medical schools, highlight published efforts in the field and identify future directions in medical education.