New research indicates the prevalence of disability among U.S. medical students may be as much as nine times higher than previously estimated. The study also assessed the accommodations schools have in place, points to the need for more research to inform better interventions and notes the challenges of collecting data on this frequently stigmatized group.
The research letter, published in the Dec. 6 medical education theme issue of JAMA, analyzed survey responses from designated disability administrators at 89 allopathic medical schools. These administrators have a federally mandated duty to assist qualified students with disabilities. Respondents identified more than 1,500 students with disabilities, representing 2.7 percent of the total enrollment. Prior studies estimated the prevalence at between 0.3 percent and 0.6 percent.
Attention-deficit/hyperactivity disorder (ADHD) was the most common disability, disclosed by 33.7 percent of identified students, followed by learning disabilities, 21.5 percent, and psychological disabilities, 20 percent. Less common were mobility and sensory disabilities. Students who did not disclose were not captured in the study’s data set.
“The preponderance of students with ADHD, learning disabilities and psychological disabilities suggests that these disability subtypes should be included in future research efforts, such as studies assessing the performance of appropriately accommodated students,” wrote the authors, Lisa M. Meeks, PhD, of the University of California, San Francisco School of Medicine, and Kurt R. Herzer, PhD, , of the Johns Hopkins School of Medicine, Baltimore.
The survey was designed by experts in medical school disability administration based on provisions of the Americans with Disabilities Act and prior research. It assessed the following domains:
- Total number of self-disclosed or registered students with disabilities receiving accommodations
- Demographic characteristics of students with disabilities
- Categories of disabilities
- Approved accommodations
Of the students identified, 98 percent received accommodations. The most frequently used accommodation was testing, which includes extra time, breaks and use of low-distraction or private environments. Less than 40 percent of schools used clinical accommodations.
The accuracy of the data is supported by the fact that medical schools are under a federal mandate to document communication and decision-making regarding students with disabilities, the authors noted. Still, they commented, more research is needed.
“It remains unclear how many medical students have disabilities; prior estimates are out of date and psychological, learning and chronic health disabilities have not been evaluated,” the authors wrote. They added, “Given the stigma surrounding psychological disabilities, it is plausible that these disabilities were underrepresented. Schools responding to the survey may not be representative of all allopathic medical schools, and the results may not generalize to osteopathic schools.”