Are medical students adequately trained to care for persons with disabilities?

Context: Insufficient medical education/training results in physicians being un- or under- prepared to provide care for people with disabilities (PWD). This contributes to the substantial health disparities that are evident in this population.

Objective: Determine if medical training provides students with the knowledge necessary to provide high quality, comprehensive healthcare for PWD in future practice.

Study Design: Survey.

Dataset: STFM CERA Medical Student Survey. 53 total questions, 10 of which specifically addressed disability health training in medical school. The “Core Competencies on Disability for Healthcare Education” were used as the gold standard to develop the 10 questions. The “Core Competencies” were developed in 2019 by the Alliance for Disability in Health Care Education, a collaboration of 152 people with disabilities, health educators and health care providers, and established the baseline expertise required to provide quality healthcare for PWD.

Population Studied: 5,000 1st-4th year students currently enrolled in U.S. Osteopathic or Allopathic medical schools and members of the AAFP.

Outcome Measure: Medical students who were provided any type of learning experience regarding PWD felt approximately 30%-40% more prepared to provide healthcare for PWD in their future practice compared to medical students whose curriculum was missing disability health education (p<0.001 to 0.004).

Results: 146 (2.94%) surveys were returned, limiting the power of this study, however the data is statistically significant. PWD constitute ~25% of the population, yet 66.4% of medical students did not participate in any type of PWD patient simulation experience. Of the students who had simulation encounters with PWD, 47.6% reported learning how to make accommodations to complete a physical exam appropriately for PWD vs only 22.9% of those without simulation encounters (p= 0.005). 59.5% of students who had simulation encounters reported feeling prepared to care for PWD in future practice vs 24.4% of those without simulation encounters (p <0.001). Overall, 97% of students responded they need to learn more in order to provide high quality, comprehensive healthcare for PWD.

Conclusions: Exposure to disability health curriculum in medical school better prepares students to care for PWD in future practice. The Core Competencies on Disability for Health Care Education should be universally included in medical school curriculum.