Medical schools do not prepare doctors to care for people with disabilities

Doctors aren't trained to care for people with disabilities: ©Prazis Images -stock.adobe.com

A study by Northwestern Medicine found that medical school curricula in the U.S. may contribute to physicians feeling unprepared to care for people with disabilities and harboring significant negative biases about this population. Published in the Journal of General Internal Medicine, the study identifies critical gaps in medical education as a key factor in perpetuating ableism in healthcare.

Disability often overlooked in medical education

Despite more than one in four U.S. adults living with some form of disability, the study highlights how medical training neglects to adequately address disability-related care. Interviews conducted with medical students and faculty across the U.S. between September 2021 and February 2022 revealed several concerning themes:

• Minimal integration of disability in curricula: Participants reported that disability was rarely included in required coursework, often relegated to elective classes or isolated lectures. This omission reinforces the perception that disability care is not integral to general medical practice.
• Framing disability as an individual problem: Disability is frequently taught as a condition to be diagnosed and treated, rather than as a complex interaction involving physical barriers, societal bias, and stigmatization.
• Negative effects on workforce diversity: The lack of meaningful training and the framing of disability as pathology contribute to a “hidden curriculum” that discourages inclusion of people with disabilities in medicine. This mindset may also lead to biases against patients with disabilities.
• Reliance on ad hoc efforts: Many students and faculty described seeking mentorship or self-directed learning to fill gaps in their training. One student noted, “It’s hard to blame physicians … because they weren’t taught how to do it.”

Carol Haywood, assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine and corresponding author of the study, emphasized the systemic nature of these issues: “Doctors do not know how to care for people with disabilities because they never learned. Medical education may be playing a critical role in perpetuating ideas that people with disabilities are uncommon and unworthy in health care.”

Impacts on patient care

The lack of disability-focused training has direct consequences for patient care. Negative attitudes from physicians, inaccessible exam rooms, and insufficient communication methods contribute to significant health disparities for people with disabilities. Tara Lagu, co-author and adjunct professor at Northwestern, called for action: “Medical schools and regulating bodies such as the ACGME and LCME must take responsibility for educating future physicians about the care of people with disabilities.”

One school’s efforts for reform

Northwestern’s Feinberg School of Medicine is spearheading efforts to reform disability education. Leslie Rydberg, M.D., associate professor of physical medicine and rehabilitation, is leading initiatives to better integrate disability-related training into the curriculum. These include:

• Learning from guest speakers with disabilities who share their experiences navigating the health care system.
• Collaborating with rehabilitation professionals such as physical therapists and speech-language pathologists to understand comprehensive care.
• Hands-on experiences with inpatient rehabilitation teams, focusing on patient histories, clinical decision-making, and documentation.

The study authors say that systemic reform is critical to ensuring medical trainees are “disability-competent” and “ableism-aware.” By transforming medical education, they hope to foster a health care environment that values and serves people with disabilities more effectively.