Bridging the Gap: Medical Disability Education

Authored By: Mia Hsu

Medical education in the U.S. has made significant strides in addressing disparities faced by patients due to their race, gender, and socioeconomic status. However, one important demographic remains overlooked: patients with disabilities (PWD).

Disabilities are conditions that limit an individual’s ability to interact with others and their environment. They can be physical or mental, ranging from more evident ones like paralysis to less apparent ones, such as autism spectrum disorder and traumatic brain injuries [1]. Though disabilities affect 26% of the U.S. population, medical schools in the U.S. struggle to effectively train physicians to care for PWD [1]. Medical students often receive minimal formal education on caring for PWD and are expected to learn through field exposure. Additionally, many medical school students lack awareness of the Americans with Disabilities Act (ADA) of 1990, which protects individuals with disabilities from discrimination in various areas of public life, such as jobs, transportation, and public places [2]. This gap in medical education not only perpetuates misconceptions about PWD, but also directly impacts the quality of care they receive.

Many physicians remain unaware of their implicit biases toward PWD [3]. For example, they often view disabilities as the defining characteristic of PWDs and falsely assume that their patients’ quality of life is inherently poor. Consequently, physicians often overlook many treatment options, especially more aggressive interventions, that could effectively address patient concerns. Due to the significant challenges they face in accessing quality healthcare with disability-competent providers, PWD tend to use fewer preventative services, experience more secondary conditions, and overall have poorer health outcomes. Additionally, a study at the University of South Carolina School of Medicine showed better student performance in clinical examinations when the patients did not have any mental or physical disabilities, highlighting the tangible consequences of inadequate disability education in U.S. medical education programs on an extremely significant patient population [2].

In recent years, U.S. authorities and policymakers, including the Surgeon General and the Association of American Medical Colleges (AAMC), have recognized the need for disability-focused education in medical training. However, the extent and format of instruction remains highly inconsistent [3]. Very few schools offer longitudinal, four-year disability education programs; these programs are particularly impactful, providing students with opportunities to engage directly with PWD through home visits, small group meetings with PWD and their families, and clinical rotations in rehabilitation wards. Other schools require shorter 6-week or 1-year clerkships, or limit instruction to didactic lectures and singular courses [2]. Many more medical education institutions have no disability education requirement at all.

The limited opportunities for disability education in U.S. medical education programs and high variability among existing disability programs cannot continue. The presence of a “champion”—a faculty member dedicated to developing and raising awareness of disability course materials—can contribute to the integration of disability competency training into medical curricula [3]. However, the limited number of faculty with expertise in disability studies or experiences with disabilities makes reliance on champions an inadequate long-term solution. Medical education programs should also consider partnering with and securing external funding from disability organizations or content experts to provide longitudinal disability-based education. Rehabilitation team members such as physical therapists, occupational therapists, and speech language pathologists can provide valuable insight into the assessment and treatment of PWD [4]. Additionally, allowing students to work with inpatient rehabilitation teams through participation in patient rounds, physical exams, and clinical decision-making would help them develop a deeper understanding of how to provide medical care for PWD.

The Liaison Committee on Medical Education (LCME), the accrediting body for medical education programs, should also require the integration of disability competency training as a Core Competency, incentivizing disability education regardless of the presence of champions [3]. Lessons and resources that can be taught by instructors of any level should also be provided to schools to ensure implementation of disability competency training regardless of available expert resources. Lesson topics could include ableism, disability history, systemic disparities, and more. The use of disabled standardized patients should also be required in all medical education programs. Standardized patients are individuals who are trained to act as patients in medical scenarios; they are significant resources for teaching and evaluating the clinical skills of future healthcare providers. In June 2024, the American Academy of Developmental Medicine and Dentistry (AADMD) issued a statement emphasizing the importance of increasing standardized patient diversity, which would allow future physicians to become more knowledgeable and comfortable interacting with PWD, especially those with intellectual and developmental disabilities, in an environment that poses no risk to actual patients [5].

Bridging the gaps in U.S. medical disability education ultimately requires commitment, collaboration, and systemic change. Integrating disability competency training as a required Core Competency, incorporating disabled standardized patients, and involving disability experts and rehabilitation professionals are three key steps toward preparing future physicians to serve this often overlooked population with the respect and quality of care they deserve. It is time to take the necessary strides to ensure equitable healthcare for PWD.

References:

1. Keller, M. A. (2022). Doctors and Disability: Improving Inclusion in Medical Education. HCA Healthcare Journal of Medicine, 3(3). https://doi.org/10.36518/2689-0216.1393

2. Santoro, J. D., Yedla, M., Lazzareschi, D. V., & Whitgob, E. E. (2017). Disability in US medical education: Disparities, programmes and future directions. Health Education Journal, 76(6), 753–759. https://doi.org/10.1177/0017896917712299

3. Lee, D., Pollack, S. W., Mroz, T., Frogner, B. K., & Skillman, S. M. (2023). Disability competency training in medical education. Medical Education Online, 28(1). https://doi.org/10.1080/10872981.2023.2207773

4. Samuelson, K. (2025, January 15). Disability is often neglected in medical school curricula, new study finds. Northwestern; Northwestern Now. https://news.northwestern.edu/stories/2025/01/disability-often-neglected-in-medical-school-curricula-new-study-finds/

5. Johnson, E., Kit-Wells, D. C., & Tyler, C. (2024). Incorporate Disability Curricula into U.S. Medical Schools via Standardized Patients. American Academy of Developmental Medicine and Dentistry. https://static1.squarespace.com/static/5cf7d27396d7760001307a44/t/6688620c690e5c2d9b083a08/1720214049064/AADMD-PolicyStatement-Med-School-Curriculum.pdf