Disability prevalence, disclosure, and accommodation use in pediatric residency: results from a pilot study

Disability inclusion in residency is essential to building a diverse and equitable physician workforce. Recent Accreditation Council for Graduate Medical Education requirements mandate that programs maintain formal disability policies and provide reasonable accommodations. However, residents with disabilities continue to face barriers, including stigma, complex documentation processes, and limited institutional infrastructure, challenges that differ from medical school settings. Specialty-specific data are necessary to identify gaps in inclusion, especially given that national data show higher rates of disability among trainees entering pediatrics. This pilot study reports the prevalence and accommodation practices of four pediatric residency programs.

In collaboration with the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network, we conducted the first pilot survey examining disability prevalence, disclosure patterns, and accommodation use among pediatric residents. The survey was distributed to four programs between April and October 2024. Data were analyzed descriptively, with Fisher's exact tests used to examine group differences.

Of the sixty-nine respondents, 36% self-identified as having a disability, more than triple the national average for residents with disabilities. ADHD, chronic health conditions, and psychological disabilities were the most reported. Fear of stigma and lack of documentation issues emerged as barriers to requesting accommodations. First-generation college graduates were significantly more likely to be unsure of their disability status.

This pilot study provides preliminary and important insights into disability prevalence, disclosure, disability uncertainty, and accommodation use in pediatric residency programs. While these findings suggest encouraging rates of accommodation receipt among disabled residents, they also highlight stigma and uncertainty around disability identity and disclosure. Findings should be interpreted in the context of the small sample size, the self-selected participation of programs, and potential response bias.