Medical School Curricula Neglect Disability, Study Finds
Author: Northwestern University
Published: 15 Jan 2025 - Updated: 13 Oct 2026
Publication Details: Peer-Reviewed | Findings
Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content
Synopsis
This research, a peer-reviewed qualitative study from Northwestern University Feinberg School of Medicine published in the Journal of General Internal Medicine, looks at how U.S. medical schools teach - or fail to teach - disability, and finds that gaps in training may be a root cause of the bias and unpreparedness doctors report when treating disabled patients. Disability tends to appear only in scattered lectures or optional electives, and it is usually framed as a condition inside the individual to diagnose and fix rather than as something shaped by physical barriers, stigma and social bias. That matters for the more than one in four U.S. adults living with a disability, along with many seniors, who already face inaccessible exam rooms, poor communication and negative physician attitudes. The findings give medical educators and accrediting bodies such as the LCME and ACGME a clear, evidence-based reason to make disability care a required core subject instead of leaving it to interested faculty and students.*
At a Glance
- 1 - Students heard directly from guest speakers with disabilities about their experiences in the medical system.
- 2 - Researchers interviewed medical school faculty and students across the U.S. between September 2021 and February 2022.
- 3 - Trainees with disabilities are often seen as weak or incapable, which participants said tells them from day one they are not welcome.
- 4 - Participants described a hidden curriculum that reduces disability to pathology and teaches students that disabled people do not belong in society.
Topic Definition
- Ableism in Medical Education
Ableism in medical education refers to the ways medical training, both formal and informal, treats disability as a defect to be cured rather than a normal part of human life, leading future doctors to undervalue the health, abilities and quality of life of disabled people. It shows up in curricula that cover disability only through diagnosis and pathology, in the absence of required training on accessible care and communication, and in a hidden curriculum that signals disabled patients and disabled trainees are outside the mainstream of medicine. The result is physician bias, unequal care and fewer people with disabilities entering the medical profession.
Overview
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.
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: Overreliance 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 physical 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".
Frequently Asked Questions
NOTE: Researched FAQs by Disabled World (DW)
What is the difference between the medical model and the social model of disability?
The medical model treats disability as an impairment within a person that needs diagnosis, treatment or cure. The social model holds that people are disabled mainly by barriers in society, such as inaccessible buildings, equipment, communication and attitudes, and that removing those barriers is the main goal.
How confident are U.S. doctors in caring for patients with disabilities?
A national survey of more than 700 U.S. physicians published in Health Affairs in 2021 found that only about 41 percent were very confident they could provide the same quality of care to patients with disabilities. More than 82 percent believed people with significant disability have a worse quality of life than people without disabilities.
Are there recognized core competencies for disability education in health care?
Yes. The Alliance for Disability in Health Care Education published the Core Competencies on Disability for Health Care Education in 2019. They cover areas such as contextual and conceptual frameworks of disability, professionalism and patient-centered care, legal obligations, teams and systems-based practice, clinical assessment and clinical care.
Do federal laws require medical offices to be accessible to people with disabilities?
Yes. The Americans with Disabilities Act and Section 504 of the Rehabilitation Act require health care providers to offer equal access, including physical access, effective communication and reasonable changes to policies. Rules issued in 2024 also set enforceable standards for accessible medical diagnostic equipment such as exam tables and weight scales for many providers.
What can patients with disabilities ask for at a medical appointment?
Patients can request reasonable accommodations such as a longer appointment, an accessible exam table or scale, help with transfers, a sign language interpreter, or materials in large print, braille or plain language. It helps to ask when booking so the office can prepare.
Why does having doctors with disabilities matter for patient care?
Physicians with disabilities bring lived experience that can improve communication, trust and understanding with disabled patients. They also help challenge bias within the profession, yet they remain underrepresented compared with the general population.
What is the hidden curriculum in medical school?
The hidden curriculum is the set of values, attitudes and norms students absorb through the culture of training rather than through formal lessons. Examples include how faculty talk about certain patients, which topics are treated as core or optional, and who is seen as belonging in medicine.
How can medical schools improve disability training?
Schools can make disability content required across all years rather than elective, teach the social model alongside clinical knowledge, and include disabled patients and educators as teachers. Hands-on experience with accessible exams, communication methods and rehabilitation teams also builds practical skills.
Insights, Analysis, and Developments
Editorial Note: What stands out in this study is how much of the burden for disability education falls on the people who care most about it - faculty and students running mentorships, affinity groups and side projects because the formal curriculum leaves a gap. That approach depends on goodwill, and it leaves out most future doctors. Disabled patients are not a niche population. They make up a large share of every primary care panel, and they are seen by every specialty, not just rehabilitation medicine. Programs like the one at Feinberg, where students take histories from disabled patients, work alongside therapists and join inpatient rehabilitation rounds, show that the fix is practical and can be taught. The bigger question is whether accreditors will require it, because until disability is treated as core knowledge, doctors will keep entering practice with the same blind spots their teachers had.*
Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Northwestern University and published on 15 Jan 2025, this content may have been edited for style, clarity, or brevity.
* Editorial additions by Ian C. Langtree.