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BLOGBY STEPHANIE MOSS, MD

Guide to Disability Accommodations in Medical School & Residency

My Journey getting Diagnosed in Medical School

Laws regarding Accommodations

How to Request in Medical School

How to Request in Residency

Reasonable Accommodations List

Watch Video Below of this Blog Post:

See my Full Accommodations Request

Per the Disabled World Article on the Disability Flag: "A disability is broadly defined as any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions)."

"There are many types of disabilities, such as those that affect a person's:

HearingThinkingLearningMovementMental healthRememberingCommunicatingSocial relationships"

Per "Demystifying Disabilities" by Emily Landau

Having a disability is like not having a passcode to a room

Providing accommodations to individuals with disabilities:

It is “not about special treatment or privileges”

“Remove barriers to participation and engagement so all people can fullest extent possible”

“Making things more equitable” so all people can have the same opportunity to thrive

Cause trauma when denied and seen as a burden

It is the law to provide accessibility

One does not need to explain or answer to anyone about their disability

My journey as a medical student with Disabilities:

At first, I was nervous to tell my residents and attending physicians that I had health accommodations. However, every time I told my team they would say it was no big deal and to just remind them that morning. For example, one resident told me: “Oh ya no worries! Get up and take a break whenever you need!” As long as I tell them in advance about my medical appointments and COMMUNICATE that day, then all is well!Per recommendation from the clinical director I scheduled my weekly health appointments consistently late in the afternoons since we usually round in the mornings. However, in some teams we are frequently dismissed before my set appointments so it works out that I don't even miss clinic or time on rotation.

If you have a medical or mental health condition while in medical school- get an accommodations letter from the disability’s office! It is not as scary as I once thought. This letter has made me feel more accepted and less self conscious to take the time to address my physical and medical health needs.

What are the Laws Regarding Disabilities?

Disability rights are both civil and human rights.

The Americans with Disabilities Act (ADA) is a law that protects people with disabilities from discrimination across multiple aspects of their daily lives.

Title I of the Americans with Disabilities Act of 1990 (ADA) makes it unlawful for an employer or educational establishment to discriminate against a qualified applicant, student, or employee with a disability. The ADA applies to private employers with 15 or more employees and to state and local government employers.

The ADA defines an individual with a disability as a person who:

(1) has a physical or mental impairment that substantially limits a major life activity,

(2) has a record or history of a substantially limiting impairment, or

(3) is regarded or perceived by an employer as having a substantially limiting impairment.

The U.S. Equal Employment Opportunity Commission (EEOC) enforces the employment provisions of the ADA and has a list of all the laws it enforces here.

How to Request Accommodations in Medical School

1. Contact your disability advocate or department

2. Write a letter about your journey including your struggles and challenges in previous educational environments.

3. Prepare any evidence of your challenges - grades, report cards, letters from teachers/doctors/therapists

Download my Medical School Workbook with Email Templates and Worksheets

Clinical Year Accommodations letter:

Email to all the Clerkship Directors by the Disability Office right before each new rotation.

Each letter is different and tailored to each individual's health care needs.

Ideas of Accommodations in ClerkshipsBreaks during the day Time off each week for therapy/doctor appointmentsSitting during roundsSitting during SurgeryTime Extension for Clinical Exams

Time off each week for therapy/doctor appointments

Time Extension for Clinical Exams

Guide to Accommodations in USMLE/COMLEX

How to Request Accommodations in Residency:

Read: Disability Disclosure in Medicine: Residency Applications

What are truly Essential Job Functions?

Check out this article by Accessibility.com Per this article: "Essential functions are job duties that employees must have the ability to perform, with or without a reasonable accommodation."

Per this article: "Essential functions are job duties that employees must have the ability to perform, with or without a reasonable accommodation."

Disability Advocate Dr. Jarrell Stated in regards to this: "Often times, schools or programs will have technical standards that say you need to be able to stand for a certain period of time or lift something of a certain weight. In my mind, there is a big disconnect between those requirements and meeting an essential function of a job with or without accommodation. If a wheelchair is used, then the standing requirement may not be valid. This article says that employers need to list what they deem to be the essential functions and I believe this would apply to residency programs as well."

The US Equal Employment Opportunity Commissioner (EEOC) created a Facts Sheet with the following information:

"The ADA prohibits employers from asking questions that are likely to reveal the existence of a disability before making a job offer (i.e., the pre-offer period). This prohibition covers written questionnaires and inquiries made during interviews, as well as medical examinations. However, such questions and medical examinations are permitted after extending a job offer but before the individual begins work (i.e., the post-offer period)."

What are "Reasonable Accommodations?"

Per the EEOC: "A reasonable accommodation can help a person with a disability apply for a job, perform the duties of a job, or enjoy the benefits and privileges of employment."

Do they HAVE to provide?Yes! But the company/organization can be picky if it is too much $$ or causes too much "hardship" for the company....

But the company/organization can be picky if it is too much $$ or causes too much "hardship" for the company....

Here is a resource page by the US Equal Employment Opportunity Commission (EEOC)

Examples of Reasonable Accommodations:

Mobility devices and assistants:

Stool - helpful during clinical walking rounds & surgery rotation

RailsHelp for limited visibility, balance needs, and support to not fall

Help for limited visibility, balance needs, and support to not fall

Hearing aid/cochlear implant with Bluetooth/wireless

Sign language interpreter

A tablet or phone to type

Pictures of items or emotions

Need Slide Deck before hand to review

Assist with sensory overload

Can have padding on walls to prevent harm to individual if they are moving around and hitting the wall

Can contain:BlanketCuddle pillowSensory toolsColoring bookMusicWhite noise machineCandles or aromatherapySpace for sitting or laying on the floor

Space for sitting or laying on the floor

Emotional support animalsNeed a letter from a trained Psychiatrist in your stateRental Properties can not charge a "pet fee" for ES animals

Need a letter from a trained Psychiatrist in your state

Rental Properties can not charge a "pet fee" for ES animals

Service Animals:Notify of an illness flare (seizure, low glucose) Visual assistanceDon’t pet because distracts themProvide emergency Support

Notify of an illness flare (seizure, low glucose)

Don’t pet because distracts them

Provide emergency Support

Modified vehicles and bikes

Parking Spots closer to the entrance

Privacy for medical device use

Medical Device Attached to a Person’s Body

Continuous glucose monitor Including testing strips and packaging

Urine Drainage Bag Including cleaning supplies

Medicine and Medical Device

Medicine as pills, tablets, fluid, injections, topical, suppositories, etc.

BandagesMedical Arm/ Shoulder SlingBraces (Neck, Back, Wrist, Leg or Ankle) Cast/Cervical Collar -

Medical Arm/ Shoulder Sling

Braces (Neck, Back, Wrist, Leg or Ankle)

Handled Magnifying Glass Non-electric, no case

Insulin Pen, Glucose Tablets

Guide to Requesting Accommodations on USMLE/Comlex

MedPsycMoss Blog Posts with tag: disability

Requesting accommodations for Step1KevinMD Post and Podcast

Podcast "Life as a Patient-Doctor"

Disability Disclosure in Medical School Workbook

MedPsycMoss Disabilities Resource CollectionsSupport GroupsBooksVirtual Trainings

"MSDCI Guide to Accessing Disability Accommodations During Undergraduate Medical Education"

EQUAL ACCESS FOR STUDENTS WITH DISABILITIES: The Guide for Health Science and Professional Education

Disability as Diversity A Guidebook for Inclusion in Medicine, Nursing, and the Health Professions

Docs with Disability Guide on USMLE Accommodations

ADA national network- https://adata.org

Job Accommodation Network https://askjan.org

A to Z of Disabilities & Accommodations: https://askjan.org/a-to-z.cfm

Disability as Diversity Book

Click here to download my disability disclosure in medicine workbook, my accommodations request personal statements, and sign up for individual advising!

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