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A question from a recently accepted medical school applicant:
Disability and accommodation
- Thread starter Doodledog
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it would be highly illegal (and unethical) for them to give you problems d/t a disability.
you can ask for anything from more time on an exam, to a facilitator for your studies. No, acceptance cannot be revoked as a result of a disability. It would be illegal for that to be an issue when it comes to residency as well.
good luck. hope you get better.
you can ask for anything from more time on an exam, to a facilitator for your studies. No, acceptance cannot be revoked as a result of a disability. It would be illegal for that to be an issue when it comes to residency as well.
good luck. hope you get better.
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I can try to address this from a residency standpoint. The ADA requires that employers make "reasonable" accommodations for those with disabilities. I believe that both medical schools and residencies would be covered by the ADA (residencies for sure as they are a job, I'm not sure about the specifics of the ADA as it applies to school)
The definition of "reasonable" is left vague on purpose. Per your short description, the issue is wrist pain which makes it difficult for you to write/type for long periods. If you were to come to my program, I'd think this way:
Possible accommodations:
Not acceptable accomodations:
Not under my control:
Of note, the decision for Med School and Residency has one major difference. You can collect acceptances for med school, then disclose your disability, and see what each school offers, choose the best offer. In residency, you are bound by the match. So, you would either need to disclose before the match (which would make sure you know what programs are willing to offer you, but *might* affect your position on the rank list [Yes, yes, illegal, I know, but it might easily happen]) or match and then disclose, and be stuck with whatever is offered (you can always "appeal" this either through GME or through the courts, but it could horribly delay your start, etc).
My thoughts:
The definition of "reasonable" is left vague on purpose. Per your short description, the issue is wrist pain which makes it difficult for you to write/type for long periods. If you were to come to my program, I'd think this way:
- Typing and using a computer are essential aspects of a resident in my program, as we have a completely electronic record. Hence, you need to be able to use a computer, type notes / orders, and get your work done.
- If you wanted to be a surgeon, some higher level of functioning of your wrist could be considered an essential aspect of the job.
- I would have you evaluated by our Occupational Medicine department to evaluate your needs. This serves several purposes -- 1) it gives both of us an independent evaluation of your disability; 2) it separates the role of "program director" and "your work physician" across two people, who can act as checks and balances on each other (i.e. the Occ Med doc tells me what you will need, irrespective of what I think the program needs); and 3) it gives someone to follow your progress, assess if you get better/worse, etc.
- A detachable keyboard for you to use. Most wrist problems with keyboards are due to laptops, where the keyboard is way too high for comfortable use. By adding a separate keyboard to your laptop, you can control this.
- A special desk/work environment, in one location. We could certainly make sure that an ergonomic workspace is available to you. However, much of residency involves working on different floors (and sometimes different hospitals). Perhaps we could find a "portable" desk that could go to different floors with you, but often you will find yourself running between the ED, ICU, and several floors covering patients, and it would be unreasonable to think we could create a specific workspace for you in every location.
Possible accommodations:
- Speech recognition software. It works reasonbly well, and perhaps could help. It's reasonably affordable for a residency program.
Not acceptable accomodations:
- Assigning someone to you to write all your notes/orders.
- Decreasing your workload -- i.e. having you cover / admit / see less patients so there is less to write.
- Dictation -- this is simply too expensive.
- Choosing some rotations that you "don't do" -- residency involves working at a satisfactory level on all rotations.
- Allowing you more time to write notes such that you violate ACGME work hour restrictions.
Not under my control:
- More time on the USMLE, in training exam, or the Board Certification exam.
Of note, the decision for Med School and Residency has one major difference. You can collect acceptances for med school, then disclose your disability, and see what each school offers, choose the best offer. In residency, you are bound by the match. So, you would either need to disclose before the match (which would make sure you know what programs are willing to offer you, but *might* affect your position on the rank list [Yes, yes, illegal, I know, but it might easily happen]) or match and then disclose, and be stuck with whatever is offered (you can always "appeal" this either through GME or through the courts, but it could horribly delay your start, etc).
My thoughts:
- I agree that taking care of yourself always comes first.
- There is no reason you can't be an MD with a wrist problem. There are plenty of MD's with only one hand. You might not be able to / want to be a surgeon if this is a persistant problem.
- You should consider asking to be evaluated by the Occ Med department of whatever school / hospital / program you are working for. This brings internal legitimacy to your problem.
- Before asking for an accomodation, I highly recommend you think about what you would want. If someone comes into my office and says "I have this problem, so what are you going to do about it?" vs. "I have this problem. I want to pull my weight here, and with a little help I think I can perform a completely satisfactory job. What I think I might need is...." The first is needy / confrontational / maladaptive, the latter is collaborative.
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As always, aProgDirector has provided a thorough reply. In terms of medical schools, speaking only as a member of the adcom, not as an official of the school, I would suggest the following additional thoughts.
Timing of disclosure and nature of the accommodation would depend on the details of your ability to write/type. Really the key time period would be during your clinical years, presumably other methods could work for most writing during the preclinical years. If you couldn't write at all, there might be some issues related to exams, but otherwise this won't be a major issue until your clinical years. At most schools, this means nearly 3 years from now, so things might change a lot.
The schools will not (unilaterally) revoke your acceptance based on what you've told us and it is certainly reasonable to discuss the issue with them sooner rather than later. This is especially true if you are seriously considering deferring a year. Schools usually will agree to this, but they don't have to and the sooner you let them know the better.
As far as whether to defer, again, I recommend that you speak with a member of your medical team who is thoroughly familiar with not just your condition, but the nature of what the first year of medical school consists of. Certainly, if there is significant likelihood of a change or major intervention for your condition, deferral is a reasonable idea.
Best of luck
Timing of disclosure and nature of the accommodation would depend on the details of your ability to write/type. Really the key time period would be during your clinical years, presumably other methods could work for most writing during the preclinical years. If you couldn't write at all, there might be some issues related to exams, but otherwise this won't be a major issue until your clinical years. At most schools, this means nearly 3 years from now, so things might change a lot.
The schools will not (unilaterally) revoke your acceptance based on what you've told us and it is certainly reasonable to discuss the issue with them sooner rather than later. This is especially true if you are seriously considering deferring a year. Schools usually will agree to this, but they don't have to and the sooner you let them know the better.
As far as whether to defer, again, I recommend that you speak with a member of your medical team who is thoroughly familiar with not just your condition, but the nature of what the first year of medical school consists of. Certainly, if there is significant likelihood of a change or major intervention for your condition, deferral is a reasonable idea.
Best of luck
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While you have piled up the acceptances, most schools want to know ASAP so that you can both determine if you have a future at that institution. Many schools will send a copy of the Tech Standards with the Acceptance Letter and ask you to respond to the acceptance and whether you may need an accomodation. Other schools will ask for the Tech Standards response form during orientation (which I believe is too late for both parties).
Both the program and the applicant are responsible to one-another to make sure that neither of us are wasting time and money, but this must occur after the acceptance decision by the program. The most effective way is to talk early to determine what is needed. In theory the applicant discloses a need for accomodation to the tech standard and also are responsible for suggesting method of accomodation. The program then begins to decide, according to ADA and school directives, whether the suggested accomodation is appropriate and suggests alternatives. Once all is negotiated both parties have an answer. If you wait until you are several months into the program to disclose a need for accomodation, the answer wont be any different, but both parties will have expended time and money which could be lost to both. Since you have several acceptances, I would urge you to make your disclosure and begin the negotiations.
Both the program and the applicant are responsible to one-another to make sure that neither of us are wasting time and money, but this must occur after the acceptance decision by the program. The most effective way is to talk early to determine what is needed. In theory the applicant discloses a need for accomodation to the tech standard and also are responsible for suggesting method of accomodation. The program then begins to decide, according to ADA and school directives, whether the suggested accomodation is appropriate and suggests alternatives. Once all is negotiated both parties have an answer. If you wait until you are several months into the program to disclose a need for accomodation, the answer wont be any different, but both parties will have expended time and money which could be lost to both. Since you have several acceptances, I would urge you to make your disclosure and begin the negotiations.
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I noticed that none of the more qualified posters addressed your topic, but this seems like a highly simplified version of the law. Of course you could be blocked from a residency due to a disability. There are no blind surgeons, and if the original poster's problem was extended to something like paralysis of both hands, that would (and should) keep you from being a surgeon as well. You could be a blind psychiatrist, which is what I believe the blind medical student decided to pursue.
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From the OP
I've registered with the office of students with disabilities office at one of the schools i've been accepted to, and have been approved for more time to take regular tests and scantron/writer's assistance for other tests. This actually only addresses the first two years, and brings up questions about the ability to complete clinical years/residency. On the other hand, my status may be different a few years down the line. Are possible accommodations for clinical years something I should take care of now, or deal with when they come up?
I've registered with the office of students with disabilities office at one of the schools i've been accepted to, and have been approved for more time to take regular tests and scantron/writer's assistance for other tests. This actually only addresses the first two years, and brings up questions about the ability to complete clinical years/residency. On the other hand, my status may be different a few years down the line. Are possible accommodations for clinical years something I should take care of now, or deal with when they come up?
