Disability inclusion in medical education: Towards a quality improvement approach

The Issue The shift to a more diverse workforce that includes physicians with disabilities has gained considerable international traction. Indeed, disability inclusion is experiencing a renaissance in medical education. However, the philosophy of disability inclusion must be adjusted from one where disabled trainees are viewed as problematic and having to 'overcome' disability to one where institutions anticipate and welcome disabled trainees as a normative part of a diverse community. Observations Most trainees with disabilities will enter an unregulated, uninformed system leaving them vulnerable to under-accommodation, systems barriers and lack of informed support. Further, the perception of the super human good doctor creates disincentives for candidates to disclose their disability, creating structural barriers that the system needs to address. A less often discussed contributor to health care inequities is the inadequate training of health professional educators on disability rights and disability competencies. Indeed, the lack of education, coupled with minimal exposure to disability outside of the hierarchical patient-provider relationship, perpetuates to stereotypes and biases that impact clinical care. Approach Disability inclusion has not been reviewed through the lens of quality improvement. To close this gap, we examine the state of the science through the lens of disability inclusion and offer considerations for a quality improvement approach in medical education that addresses the global revised trilogy of World Federation for Medical Education standards of quality improvement at all three levels of education, training and practice. Conclusion We propose a vision of systems-based disability-inclusive, accessible and equitable medical education using 9 of Deming's 14 points as applicable to medical education.

Automated summary

The inclusion of disabled trainees in medical education has gained international attention, but there are still many challenges and barriers they face. The lack of proper accommodation, system barriers, and inadequate support leave them vulnerable. Additionally, the perception of the ideal doctor discourages candidates from disclosing their disabilities, creating structural barriers that need to be addressed. Furthermore, healthcare professionals' inadequate training on disability rights and competencies perpetuates stereotypes and biases that impact clinical care.