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A dearth of disability-related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0
Amy J Houtrow1,2, Max B Hurwitz1,3
1Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Background:
Despite the high prevalence of disability and the frequency with which people with disabilities encounter the health care system, physicians report inadequate knowledge regarding caring for their patients with disabilities.
Objective:
To determine the number and type of disability-related competencies in the Accreditation Council for Graduate Medical Education's Milestones 2.0.
Design:
Cross-sectional analysis of publicly available data to identify, via key word search, the presence of disability-related competencies using disability-related terms derived from the World Health Organization's International Classification of Functioning Disability and Health.
Setting:
Accreditation Council for Graduate Medical Education's Milestones 2.0.
Participants:
N/A INTERVENTIONS: N/A MAIN OUTCOME MEASURE: Presence of disability-related competencies.
Results:
Over one-third (37.5%) of specialties had zero disability-related competencies. Nineteen (59.4%) included an Interpersonal and Communication Skills Milestone that mentions disability as a potential barrier to communication. No specialties had Systems-Based Practice or Practice-Based Learning and Improvement disability-related competencies. Physical medicine and rehabilitation (PM&R) had six disability-related competencies, preventive medicine occupational and environmental medicine had three, and otolaryngology and transition year each had two.
Conclusions:
A minority of medical and surgical specialties had disability-related competencies outside of the Interpersonal and Communication domain. With the rising prevalence of disability and the lack of physicians with expertise in the care of people with disability, the time is now to integrate disability competencies into residencies, especially for the primary care specialties.
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