CHICAGO — The American Medical Association (AMA) announced policies adopted by physician and medical student leaders from all corners of medicine during the second day of voting at the Special Meeting of the AMA House of Delegates.
The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
The policies adopted by the House of Delegates include:
Addressing barriers to medical education for students experiencing disabilities
Though the estimated number of U.S. medical students with disabilities has been growing in recent years, structural and cultural barriers for this group continue to persist throughout medical education and into medical practice. To help remedy this issue, the AMA adopted policy today focused on strategies to create an equitable environment for medical school learners and residency trainees experiencing disabilities.
Specifically, the new policy urges medical schools and graduate medical education (GME) institutions to take actions that include: creating standards that place emphasis on abilities rather than limitations; highlighting information about the process for requesting disability accommodations; providing a designated liaison knowledgeable in the Americans with Disabilities Act (ADA) and related resources; and fostering a supportive, inclusive environment where students feel comfortable accessing disability support services.
In addition, the policy encourages the development of transparent, equitable processes for evaluating disability accommodation requests during required testing and initial board certification examinations. Studies show that testing accommodations–such as providing extra time or low-distraction environments – are the most frequently requested among medical school students.
“The AMA strongly supports efforts to increase the diversity of our future physician workforce. By examining the roadblocks that medical students and trainees with disabilities often face, we can prioritize inclusion, eliminate stigmatization, and change the medical education experience,” said AMA Board of Trustees Member Drayton Charles Harvey, fifth-year M.D./Ph.D. student.
Support of further research on the most effective disability accommodation models in the medical learning environment is also encouraged by the policy to assist in determining future strategies.
Protecting access to abortion education training for medical students and residents
Against a backdrop of challenges to abortion restriction legislation, updated policy adopted by the AMA today reinforces its support for availability of medical education and training on termination of pregnancy.
The expanded policy safeguards access to training on pregnancy termination procedures for medical students and residents, and explicitly states AMA’s support for the availability of abortion education including the medical, ethical, legal, and psychological principles associated with termination of pregnancy. The policy opposes efforts that interfere with or restrict the availability of this training, while not suggesting that it should be required for trainees.
“The AMA recognizes the value of an immersive and comprehensive educational experience for residents and medical students in the provision of abortion care – while still respecting personal, religious, and moral convictions of all trainees,” said AMA President Gerald E. Harmon, M.D. “Protecting access to such training equips the next generation of physicians with the crucial skills needed to ensure our patients have access to their choice of safe, high-quality reproductive care – which is essential for improving the health of the nation.”
The policy also encourages the Accreditation Council for Graduate Medical Education (ACGME) to consistently enforce compliance with the standardization of abortion training requirements for obstetrics and gynecology residency programs as outlined by the American College of Obstetricians and Gynecologists (ACOG).
In telehealth, ensuring confidentiality for adolescents
The American Medical Association will be encouraging physicians caring for adolescents in a telehealth setting to offer examinations and counseling apart from others to ensure the adolescent is in a private space.
The policy, adopted at the Interim meeting, recognizes the unique confidentiality concerns surrounding telehealth visits for adolescents and their parents. Adolescents need sufficient opportunities to discuss sensitive issues with physicians without a parent present. Yet, privacy is sometimes difficult to determine in a telehealth visit as others can be in the room or listening nearby.
“Telehealth utilization has skyrocketed during the COVID-19 pandemic, providing opportunities for ongoing patient care. We must keep in mind that adolescents need privacy to engage in confidential patient-physician communications. Physicians, patients and parents all need guidance on how best to address confidentiality concerns,” said Willie Underwood III, M.D, M.Sc., M.P.H., a member of the AMA Board of Trustees.
In PDMPs, calling for limited information on medical cannabis
The American Medical Association will support efforts to limit information about medical cannabis in states’ prescription drug monitoring programs (PDMPs) to only whether a patient has been certified to receive medicinal cannabis in keeping with AMA principles safeguarding patient privacy and confidentiality.
Nearly every state has a PDMP that includes information about controlled substances dispensed to patients, as well as the prescribing history from physicians and other health care professionals. Nearly every state has the ability to share PDMP data across state lines.
“If a patient has been certified as having a medical condition qualifying that patient for medical cannabis, that information should be available to other physicians,” said Thomas J. Madejski, M.D., a member of the AMA Board of Trustees “But it’s equally important to protect the privacy of medical information in a PDMP from law enforcement and others. That’s why it’s best that PDMPs contain limited information about a patient’s medical cannabis use.”
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