Disability Accommodation Access and Requests in US Internal Medicine Residents With Disabilities

Area of Science:

• Medical Education
• Disability Studies
• Health Equity

Background:

• Equitable access to medical training accommodations is crucial for residents with disabilities.
• Little is known about factors influencing accommodation access and requests among internal medicine residents.

Purpose of the Study:

• To investigate demographic, training, and disability-related factors associated with program access and accommodation requests in internal medicine residency.
• To identify disparities in accommodation access and utilization among residents with disabilities.

Main Methods:

• A national cross-sectional study of accredited internal medicine residency programs in the US and Puerto Rico.
• Analysis of data from the 2023 Internal Medicine In-Training Examination, including residents reporting disabilities.
• Multivariable logistic regression models to assess factors associated with program access and accommodation requests.

Main Results:

• 9.5% of internal medicine residents reported a disability.
• Residents with cognitive disabilities, women, and those from Asian and underrepresented racial/ethnic groups had lower odds of program access.
• Fear of stigma and unclear institutional processes were primary reasons for not requesting accommodations, particularly among those with cognitive disabilities and marginalized identities.

Conclusions:

• Substantial inequities persist in accommodation access and requests for internal medicine residents with disabilities.
• Cognitive disabilities and marginalized identities are associated with significant disparities in accommodation access and utilization.
• Institutions must implement inclusive, transparent policies to promote psychological safety and disability inclusion in medical training.