Adapting Neurology Residency: A Case Study and Practical Guide for Accommodations for a Disabled Resident

Area of Science:

• Medical Education
• Disability Studies
• Neurology

Background:

• Physicians with disabilities are underrepresented in the US workforce.
• Graduate medical education programs often lack structured accommodation processes.
• Existing legal protections like the Americans with Disabilities Act are insufficient without operational implementation.

Purpose of the Study:

• To describe the adaptation of a neurology residency for a resident with a spinal cord injury.
• To develop a practical and replicable framework for accommodating physicians with disabilities in residency training.
• To illustrate the evolution from ad hoc accommodation to proactive institutional design in medical education.

Main Methods:

• Case study methodology involving a neurology program director and resident with spinal cord injuries.
• Identification of accessible clinical sites and design of equivalent rotations.
• Audits of clinical spaces and implementation of alternative solutions for environmental or scheduling barriers.
• Documentation of anticipated and unanticipated barriers to refine a structured workflow.

Main Results:

• A neurology residency was successfully adapted to ensure equivalent training and patient safety.
• A structured workflow emphasizing early engagement, environmental review, and iterative reassessment was developed.
• A practical, replicable framework and accompanying Practical Guide were created based on the experience.

Conclusions:

• Inclusive neurology training is achievable through proactive institutional design.
• Accommodation processes can be integrated into graduate medical education to align inclusion with educational excellence.
• This case study provides a model for enhancing diversity and equity in medical residency programs.