Doctors in the United States have expressed feeling unprepared to care for individuals with disabilities, revealing significant negative biases toward this population. A new study by Northwestern Medicine suggests that these issues may originate from their medical school training.
The study indicates that medical curricula often portray disability as a problem, leading trainees to form negative assumptions about the health and quality of life of people with disabilities. This lack of comprehensive training perpetuates ableism and leaves future doctors inadequately prepared, according to Carol Haywood, assistant professor at Northwestern University Feinberg School of Medicine.
“Doctors do not know how to care for people with disabilities because they never learned,” Haywood stated. “Ultimately, our work reveals how medical education may be playing a critical role in creating and perpetuating ideas that people with disabilities are uncommon and unworthy in health care.”
Published on January 15 in the Journal of General Internal Medicine, the study highlights disparities faced by over one in four U.S. adults with some type of disability. These include negative attitudes from physicians, inaccessible exam rooms, and inadequate communication methods.
“Often, physicians think of disability as something important to certain specialties (e.g., physical medicine and rehabilitation), but if this isn’t their specialty, they assume they do not have to think about disability access and quality of care for their patient panel,” Haywood explained.
Co-author Dr. Tara Lagu emphasized the need for medical schools and regulatory bodies like the ACGME and LCME to educate future physicians about caring for people with disabilities.
Interviews conducted between September 2021 and February 2022 revealed several themes related to shortfalls in medical education:
- Disability is often neglected in curricula. Participants noted it was mentioned only sporadically or relegated to elective courses.
- Disability is framed as an individual "problem" rather than being linked to societal barriers.
- Negative perceptions affect workforce diversity, suggesting a "hidden curriculum" that marginalizes disability.
- There is an overreliance on ad hoc efforts by faculty and students to address curricular gaps.
Advancing disability-related education requires systemic reform. At Northwestern's Feinberg School of Medicine, Dr. Leslie Rydberg is leading efforts to transform how trainees learn about disability through various hands-on experiences and interactions with disabled individuals.
The study titled “‘The forgotten minority:’ Perpetuation of ableism in medical education” received funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.