Disability Often Neglected In Medical School Curricula
Author: Northwestern University
Published: 2025/01/15
Publication Type: Findings
Peer-Reviewed: Yes
Topic: Disability Information - Publications List
Page Content: Synopsis - Introduction - Main - Insights, Updates
Synopsis: A call for reform in medical education to address ableism, improve disability training, and ensure equitable, compassionate care for all patients.
Why it matters: This article offers valuable insights into the pervasive issue of ableism in medical education, highlighting how negative perceptions of disability, insufficient training, and outdated curricula contribute to healthcare disparities for people with disabilities. It underscores the urgent need for systemic reforms in medical education to foster "disability-competent" and "ableism-aware" training. By revealing the impact of neglecting disability in curricula, the article provides a compelling case for medical schools to integrate comprehensive disability education, as exemplified by Northwestern University's innovative efforts. This analysis is essential for improving physician preparedness, reducing bias, and advancing equitable healthcare access - Disabled World (DW).
Introduction
Negative perceptions of disability negatively impact workforce diversity in the medical field. Within medical school curricula, disability is frequently presented as a "problem" for doctors to diagnose and treat. As a result, some faculty and trainees take it upon themselves, either individually or within affinity groups, to develop disability-related content.
Main Item
Doctors in the U.S. have reported feeling unprepared to care for people with disabilities and have revealed significant negative bias about this population, according to previous research. A new Northwestern Medicine study has found much of this could be rooted in their medical school training.
Medical school curricula often view disability as a problem, leading medical trainees to make negative assumptions about people with disabilities' health and quality of life, the study found. A lack of sufficient medical school training about disabilities and disability-related care across settings perpetuates ableism and leaves medical trainees inadequately prepared, said corresponding author Carol Haywood, assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine.
"Doctors do not know how to care for people with disabilities because they never learned," Haywood said. "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."
The study was published in the Journal of General Internal Medicine.
Negative Attitudes, Inaccessible Exam Rooms
More than one in four U.S. adults have some type of disability, according to the U.S. Centers for Disease Control and Prevention. People with disabilities experience significant disparities in their health care quality, access and outcomes, such as negative attitudes from physicians, inaccessible exam rooms and a lack of appropriate 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 said.
"While we have known about physician bias and discrimination against people with disabilities in health care for some years now, this new work emphasizes the need for medical schools and regulating bodies such as the ACGME (Accreditation Council for Graduate Medical Education) and LCME (Liaison Committee on Medical Education) to take on the responsibility of educating future physicians about the care of people with disabilities," said co-author Dr. Tara Lagu, adjunct professor of medicine and medical social sciences at Feinberg.
Critical Shortfalls in Medical Education
Interviews with faculty and students from medical schools across the U.S. between September 2021 and February 2022 revealed the following prominent themes related to critical shortfalls in medical education:
1: Disability is Often Neglected in Medical Education Curricula
Participants said disability was only mentioned in select lectures across all years of medical school, and/or disability was incorporated only into elective coursework, largely relegating the essential training to students or faculty who already had familiarity and/or interest in disability. A faculty participant said;
"The fact that disability training is not required, and it's not seen as a core part of the medical school curriculum reinforces the idea that these aren't really your patients or they're not important enough for you to learn about."
2: Disability Being Framed as a "Problem" Within Individuals
Most medical schools define disability as a condition within an individual to be diagnosed and treated, rather than something rooted in physical barriers, social bias and stigmatization. One student said;
"Just seeing how biases can be sort of continued on through generations of doctors whether that means that thinking of disability as a tragedy or a medical condition."
3: Negative Ideas About Disability Have a Direct, Negative Effect on Workforce Diversity in Medicine
Participants described a neglect of disability training and a reduction of disability to pathology as being part of a "hidden curriculum" in medical education that ultimately teaches medical students that disability does not belong in society. By extension, trainees with disabilities are often viewed as weak or incapable of excelling in their medical practice. One participant said;
"We're just sending the message from the get-go that you're not welcome, which is so damaging in every possible way."
4: Over Reliance On Ad Hoc, Faculty And Student-Led Efforts to Cultivate Curricular Change
When their own training fell short, faculty and students sought personal mentorship and communities of practice to discuss and understand disability-related health care. One student said;
"It's hard to be mad at physicians because they weren't taught how to do it or taught to ask the questions, or it wasn't emphasized. That's why it comes back to this medical education piece."
How Northwestern is Addressing These Gaps in Curricula
Advancing disability-related medical education will require systemic reform, the scientists said. There has increasingly been a push for "disability-competent" and "ableism-aware" medical education.
At Feinberg, Dr. Leslie Rydberg, associate professor of physician medicine and rehabilitation and of medical education, has been charged with transforming how medical trainees learn about disability.
For example, medical students elicit a history from individuals with a disability, focusing on asking about the patient's disability and their function; learn directly from guest speakers who are individuals with a disability who share their journey in the medical system; learn from various rehabilitation team members including a physical therapist, occupational therapist and speech language pathologist, who discuss their roles in the assessment and treatment of people with disabilities; and work with an inpatient rehabilitation team and participate in the medical care of people with disabilities, including inpatient rounds, physical exams, clinical decision making, documentation in the medical record and more.
The study is titled "The forgotten minority: Perpetuation of ableism in medical education".
Editorial Insights, Analysis, and Developments
This study serves as a wake-up call for medical educators, policymakers, and healthcare institutions to address the critical gaps in disability-related education. By perpetuating ableism and neglecting the diverse needs of people with disabilities, medical schools risk failing both their students and the broader patient population. The innovative efforts at institutions like Northwestern University illustrate that meaningful change is possible, but widespread reform is essential. Ensuring that future physicians are equipped to provide equitable, compassionate care to all patients is not only a professional obligation - it is a moral imperative - Disabled World (DW).
Attribution/Source(s):
This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its significant relevance to the disability community. Originally authored by Northwestern University, and published on 2025/01/15, the content may have been edited for style, clarity, or brevity. For further details or clarifications, Northwestern University can be contacted at northwestern.edu. NOTE: Disabled World does not provide any warranties or endorsements related to this article.