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Dr. Moss: "Having a disability is like not having a passcode to a room."
So other people can go into the room, but you just don't know it. And that doesn't mean you don't deserve to get the passcode. That just means you need someone to tell you or provide you that assistance in being able to attain that passcode.
"Providing accommodations to individuals with disabilities is not about receiving special treatment or privileges. It actually just removes the barriers to participation and engagement so all people can fulfill their fullest extent." so they can be successful. It also makes things more equitable, so all people can have the same opportunity to thrive.
Dr. Moss: Hello everyone, this is Doctor Moss. I know, I am officially saying that. If you're seeing this episode, that means I've officially graduated and have my fancy new MD behind my name
Thank you so much for being here. If this is your first episode, make sure you subscribe to Life as a Patient Doctor , wherever you listen to your podcast, or on YouTube
Navigating Disabilities and Accommodations in Medical Education
Dr. Moss: So today we'll be going over something that I had been talking about before, but let's just really get into requesting disabilities and accommodations and accessibility.
So I do want to mention that before medical school I did not identify with having a disability or even having a health condition. And it wasn't until my medical school years specifically as a second year medical student that I was diagnosed with mental health and chronic pain conditions
I want say that [00:02:00] we are human. Doctors have health conditions and I'm here to talk that anyone can have disabilities and have health conditions.
And so if this is something that you think you have, make sure you talk with a medical professional. Now, I am not an expert specifically on disabilities and accommodations. I am learning as fast and as much as I can, but this is the information that I have to date.
And I'll make sure to be updating information as I acquire it, both on my website, MedPsycMoss.com and specifically on the blog page and on the disabilities resource page.
Okay, so today I'll be going over the specific blog post where I broke down all the ways that you can get disability accommodations. Specifically, i'm going to focus on school And residency because that's where I am in my individual journey.
Disability Definition [00:03:00]
Dr. Moss: So I really like This definition of disability, and it is by the Disabled World article, and it says, "A disability is broadly defined as any condition of the body or mind, like an impairment that makes it more difficult for the person with the condition to do certain activities, activity limited, and interact with the world around them. Participation restriction.
There are many different types of disabilities, such as those that affect a person's vision, hearing, thinking, learning, movement, mental health, remembering, communication, and social relationships."
"Having a disability is like not having a passcode to a room." This insightful analogy resonates deeply with me, Dr. Moss, as I step into the world of medical education, both as a graduate and a lifelong learner. Disabilities, visible and invisible, shape experiences in unique ways, often acting as barriers to opportunities and experiences that are readily accessible to others. This journey through medical education, peppered with personal reflections and insights, aims to demystify the process of seeking accommodations and underline the importance of equitable access.
Learning I have a disability
Dr. Moss: So let's talk a little bit about my personal journey. When I was a second year medical student, like I said, I was diagnosed and I went through medical appointments, surgeries, and things like that, but like I said, I still didn't connect with the word disabilities, I was still trying to get through the concept of just what it means to have a health condition, what it means to maybe not be as able bodied as my peers.
That includes being able to walk around the hospital as quickly, or stand for long periods of time, or having to take days off because I was having health flares, things like that. And so that's how I was going. And it actually wasn't until my second year of medical school when I was trying to take the step one exam, which is the board exam, and I failed it.
And you can check on my other podcast episodes regarding me failing and that experience and it wasn't until I failed it that one of my friends was like, hey, did you know that you might be able to get accommodations?
Dr. Moss: Growing up I didn't like to accept help, is I guess a good way to say it. In the home, I spoke spanish and english.
So when I was in Kindergarten or first I think it was first grade I remember they had me do an english as a second language (ESL) test because they weren't sure if I was going to need to go to an ESL because I spoke Spanish in the home. And I remember that was the first time I realized like, Oh, people think that I'm different than other kids.
And so I worked really hard to not distinguish myself. And anytime I struggled in school, I just took it in as my responsibility and I needed to work harder. Put in more hours of studying, put in more effort, go to talk to upperclass, oh, in elementary school talk to my teachers more. I turned into the teacher's pet a little bit, and unfortunately, I never was really given a lot of extra resources, but anyway.
Going into middle school, high school, again, I struggled with IB and AP classes, but I did them because I was like, no, I'm not gonna let anyone tell me what I can and cannot do. I knew that I struggled with literature, like language arts, like reading and writing. I loved reading, but I was definitely slower than other kids.
So when I was in high school, I chose classes that I was good at, which ended up being science and math, which is interesting thinking about it.
My passions ended up being what I was interested in. And at that time I didn't really know I was going to go into medicine. I had no idea in a million billion years that I could ever have this doctor title, be able to go to medical school, graduate from medical school.
But this is from perseverance and anyone in that position know that. You can do anything if you try and if you believe that you can and try to get all the support that you need and that includes asking for help.
And that's a little bit what I did going forward as I Graduated high school, then go to college didn't do that well on the SAT, so didn't even go to any school that accepted the SAT, and then, I can't even remember what is required, the ACT, did well on the science and math, but again, not as well on the writing and literature.
Again, just was like, okay, that's just not my strong suit. Going through college, I did relatively well, always struggled, but at this point I've now learned where are my strengths and weaknesses, focus on my strengths, I got tutoring, I even became a tutor in college.
My journey through medical school was marked by discoveries and challenges. Initially not identifying with having a disability, my perspective shifted dramatically during my second year of medical school upon being diagnosed with mental health and chronic pain conditions.
This revelation was not just about adjusting to new labels but also about understanding and embracing the nuances of accessing accommodations.
Accommodations in education, particularly for individuals with disabilities, are not about granting special privileges. They serve to remove barriers, ensuring all students have the opportunity to reach their fullest potential.
As a newly minted MD, I've witnessed and experienced these barriers firsthand. This blog post is a beacon for those navigating the choppy waters of medical education while managing disabilities. It's about making things equitable, enabling every individual to thrive.
Premed Support System [00:08:00]
Dr. Moss: My husband, my boyfriend, my current husband, who is also
Dr. Moss, neurologist, or neurology resident he definitely was a big help for when I didn't understand something. We tried to take the same classes, especially for pre med.
And so we would help each other and same thing, I would help him when he didn't understand things. So that was definitely a big resource that even we implemented later on when we both went to medical school together.
Let me see. Finished pre med, MCAT .
Dr. Moss: It always was these standardized exams that I really struggled with. And, again, I thought it was just me not doing well in tests. But, thinking about it, I always did well in school tests. That was maybe because there wasn't really a strong time limit. There was, like you had to get it done in an hour or whatever the time.
I was always the last to finish, so I did definitely take longer on exams. And then MCAT comes around. Again, struggle. I actually ended up, the very first time I took the MCAT, I had an anxiety attack and I actually took it when my husband was . We were like, okay, let's do it the same day because we can travel and prepared the same.
And I remember one of the things I had a panic attack on was I'm doing my MCAT and he's like over there, but like diagonal in front of me, way over there. And as I'm doing the exam, I know we start at the same time and then I see him get up and go away. And I had in my mind been like, okay, we're going to hang out during the breaks.
That's how I'm going to manage my stress and anxiety. Because it's like a super long test. I can't remember how many hours. I'm sure it's six to eight hours or something like that. And, the fact that I kept seeing him leave, I would be like super stressed. I'm like, I have to finish this quicker and then obviously I can't.
But anyway, , that stress plus the stress of for the first time being like body patted, being on under cameras.
Having a testing, lady keep watching over our shoulder. Like I was just having so much stress and anxiety. And I remember leaving that exam and I did not do well. And I didn't realize how much I didn't do well.
They didn't have a fail, but it was definitely, it was like four seventies or four eighties and you need to get above 500 at least to be able to apply to medical school. There's always exceptions, different schools and whatever, and it's obviously changed I applied to medical school back in 2018, so it's obviously been a couple years.
Anyway, I failed, so we took some gap years. My husband, he didn't fail, but he didn't do as well, so we're like, okay, we'll take a gap year, we'll work full time, and then we'll study.
We even moved into his parents house. At that point, we were in first year of marriage. Another podcast episode. We'll talk about that later. And study for the MCAT. We couldn't afford to get tutoring, but we put in a lot of money to do like this specialized online. I think Kaplan or something like that, not sponsored by them, just telling my experience and eventually able to pass it, apply to medical school.
Here I am get into medical school. Hey, I thought I was good till step one comes around. Okay, second year of medical school I'm studying and I just can't pass the practice exams. Look at the other episode all about step one.
The realization that I might qualify for accommodations came as a surprise. Growing up bilingual and facing the challenges that come with it, like being subjected to an English as a Second Language (ESL) test, taught me to work harder to not distinguish myself due to perceived differences.
This persistence followed me through academia, from struggling in AP classes to facing the daunting MCAT, where I first encountered my limitations in a high-stakes testing environment.
The Power of Accessibility and Accommodations
Dr. Moss: Anyway, we're here to talk about disabilities So sorry, that was a bit like a background, but every single time I didn't get help in regards to accessibility and accommodations. That is still something that's very sad, that I wasn't given that opportunity for whatever reason, whether if it's ableism, stigma, racism, sexism it's really sad that none of the administration or tutoring.
Like no one ever reached out for help. But thankfully now that I had a diagnosis in second year medical school, I had failed step one. One of my friends actually told me about accessibility. And so this comes into learning about accessibility. Was going to the accessibility office at the school, which every school should have one and asked.
So I really want to say, if you do have struggle, especially with tests, or if you have a known medical or mental health condition, especially while in school, get accommodations letter from your disability office. It really isn't as scary as I originally thought. All those people want is to help you be as successful as you can.
And I remember when I first received that letter, I definitely felt more accepted and less self conscious to be able to take extra time in exam or be able to take a health break especially like during clinicals.
I had mental health. I have like my therapy appointments and doctor's office. I felt more empowered to be able to say " Hey, I'll be right back in an hour. I have an appointment." Go find a room that was not busy and then have my virtual appointment and then go back to clinicals.
Demystifying Disabilities
Okay, so if you heard of Docs with Disabilities, you can learn more about them on my website, on the resource page, on their disabilities, on their support groups, and different websites. They went through "Demystifying Disabilities" book by Emily Landau, and I loved reading along about this book.
At this time, I did the audio version, so I didn't really read. I was more listening while I was driving to and from school. Or actually, to and from clinicals at that point. And I'm going to read a little bit from that book, because some of the things that really stuck out to me. Some things that she said is, "having a disability is like not having a passcode to a room."
So other people can go into the room, but you just don't know it. And that doesn't mean you don't deserve to get the passcode. That just means you need someone to tell you or provide you that assistance in being able to attain that passcode. Some other things she says. "Providing accommodations to individuals with disabilities is not about receiving special treatment or privileges.
It actually just removes the barriers to participation and engagement so all people can fulfill their fullest extent." so like I said so they can be successful. It also makes things more equitable, so all people can have the same opportunity to thrive.
And it actually can cause trauma if someone is denied, being accepted by a group, or being seen as a burden.
So that is definitely a challenge. And hopefully your support system, especially the disabilities and accessibility office, that should be one of your resources and supports if someone isn't treating you fairly.
And we'll talk about this now, but it's actually a law to provide accessibility. And we'll go into that.
After a difficult encounter with the Step 1 board exam, a friend enlightened me about the possibility of receiving accommodations. This was a pivotal moment. Accessing accommodations through the school's disability office was transformative, allowing for a more inclusive and supportive learning environment.
My experiences underscore the critical role that accessibility plays in education, enabling students like myself to overcome obstacles and achieve success.
Exploring Legal Framework
Dr. Moss: So what are those laws? The Americans with Disabilities Act, you can also hear it as ADA. , it says that disability rights are both civil and human rights. Specifically, the title one of the ADA was from 1990, and it makes it unlawful for an employee 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 governments. The ADA defines an individual with disability as a person who has a physical or mental impairment that substantially limits major life activities.
Two, has a record or history of substantially limited, impairment.
Or, three, is regarded or perceived by an employer as having substantially limiting impairment.
I actually included a link by the U. S. Equal Employment Opportunity Commission, which enforces the Employment Commission and has a list of all the laws they work on enforcing.
So I then provided a video, which you'll see on the blog post, that really talks about equal access and what those laws really mean specifically regarding how students are qualified, whether or not they have a disability. So you can check that out there.
Equal access is not just a courtesy; it is a right. The Americans with Disabilities Act (ADA) plays a crucial role in protecting these rights, offering a legal framework that ensures fair treatment.
Practical Guide to Requesting Accommodations in Education
Dr. Moss: Next, I want to talk about how to request an accessibility, accommodation and accessibility at school.
So we talked about of going to your disability advocate. So , what normally happens if you meet, you email them or you fill out their form and you sit down with them, whether virtually or in person, with COVID, makes it interesting and you just talk, they get to know you, they talk about .
Why you think you might have a disability or why you've struggled. What have doctors said? What has maybe psychologists, therapists said? What has school counselors said? Do you have any failures in your academics? They kind of work with you to see what are all the challenges that you have and they usually ask for any evidence.
So any previous report cards, any letters from other employers or doctors and therapists, and I remember when asking for those letters, I definitely felt
I didn't like it. It felt and we'll talk about this a little bit later when I started to actually apply for accommodations for this step exam. It made me feel less than, and because I'm talking about my struggles, and like I talked about earlier, I'd worked so hard to showcase my strengths, and not showcase my challenges.
And I think this was very, the first time that, I had to articulate all the problems that I've had, all the struggles, and really reflect. And I remember Marie with accessibility, hopefully I'll get her in one of the podcast episodes . She told me to journal about it, and that was super helpful because I could really break it down, my experience, and see it from a different viewpoint, see it from a way of struggling like if it was someone else.
If I'm looking at this little girl who struggled and kept fighting to do as well as her classmates, even though she didn't have parents that were scientifically minded And that was helpful.
So I also included a video DWDI they had an access in medicine. So they talked about how to get accommodations for labs, for clinicals and for class. So make sure to check that out.
Sharing Personal Experiences with Accessibility in Medical Training
Dr. Moss: Next on the blog post I actually showed my disabilities and accommodation letter. Since I didn't get it for my first two years, because step one is between second and third year, this is for my third and fourth year rotations.
And this was the first time that I could really think, okay what do I need? What is helpful? And it was hard at first to ask for something that I didn't really know what the options were because I had never been in this type of medical school environment. I had been a medical assistant. I had been a case manager.
So I'd been in clinics. I'd been an EMT , phlebotomist. Like I've done things in clinical scenario.
But it was a little bit different. I've never rounded like they do for hours in the morning on clinical wards before. And so sometimes you do have to see what it's like, and then later go on and edit and ask for accommodations later.
And so I hope this episode and this blog post really helps.
Think of some ideas that you can come up with. So on the very bottom.
Requesting accommodations can be daunting. However, engaging with the disability advocate at your school is a crucial first step. Transparency about your challenges, backed by evidence such as medical reports, can pave the way for receiving the necessary support.
Reflecting on my experiences, it's clear that open communication and a willingness to seek help are fundamental in accessing the resources needed to succeed.
Examples of Accessibility Devices and Aids:
Dr. Moss: I really have tried to write down all the types of accessibility and accommodations that I've heard of, and I'm actively adding to.
So if you don't see any that are on there, let me know in the comments or email me at MedPsycMoss@gmail.com. And help me create a list because it is hard to know what type of help you'll need until you've been there and you have to know that it's an option.
Mobility Supports [00:21:00]
Dr. Moss: Some ideas, maybe some that people more think about when they think of accessibility are mobility devices, those things that maybe you can physically see, like a wheelchair, a walker, a cane, crutches, rails all these help with individuals who maybe can't walk as steadily or can't stand as much on their own or maybe they just need support Or they may be helped with limited visibility can't see as well. I need to also add chairs and stools because when I was in surgery that was so helpful being able to sit and some surgeons do sit during those long hours or when they have to have more stability and be closer to the body but I think that anyone should have that opportunity. So like at the beginning of your surgery I would Ask whoever was in charge, the charge nurses or the circulators asked "Hey, is there a stool I can use?"
And if there wasn't one, maybe I would go to an OR that wasn't being used or wasn't using the stool and I would come and bring it. And that was really helpful for me because I didn't want to risk danger of myself by falling over or fainting and the safety of the patient because if I fall into them or fall into an area or touch an area that is sterile,, that can be compromising to the patient.
So it's not just about me and my safety, these assessabilities, it's also the safety of the patients. So maybe if you think about it that way, you might be more willing to ask because They want to make sure that the patient is safe and gets the proper care and also on a legal sense the hospital doesn't want to Have a lawsuit.
So it benefits everyone for you to be able to get accessibilities.
Communication Tools [00:23:00]
Dr. Moss: Okay, some other things Headphones. Headphones can be to increase sound or decrease sound. Like noise canceling. So some ideas I thought about this is When we're writing notes, some people get very distracted if there's a lot of stuff going around them and they need something to keep them focused, whether if that is a beat or a music or even a TV show, like they need that type of brain stimulation in order to focus.
The opposite is having noise cancelling headphones to not hear anything because noise around them could be startling and prevent them from focusing. Another idea that headphones can be used is if you're talking on the phone a lot or if you're writing notes. So having that ability to speak into a microphone on your headphones.
Or instead of holding the phone all these are ways that can help. Communication aids, that could be like a hearing aid, a icochlear implant a Bluetooth wireless phone. So individuals who maybe can't hear as well or maybe don't [00:24:00] have any hearing. So an actual device that's connected to the head that allows them to hear.
Most people think about maybe the older adults, but this can be any individual that has hard of hearing or maybe can't hear certain volumes. And so , that allows them to be able to hear. Another thing that I thought was really cool about some of these hearing aids is they can actually connect to the speakers in some rooms.
Sometimes you might see pictures of this, that a device, like a lot of newer rooms or some churches, some conference centers are now implementing that the microphone that someone's using goes, is directly to the headphone or hearing aid. So that's a really cool way that a lot of places have become more accessible.
Another thing regarding communication aid, if you listen to the very first podcast episode with Dr. Bisgrove, she talks about when she was in her surgical rotations, they would have the Surgeons wear microphones because she has hard of hearing and especially with the masks and just all the things that you wear when you're in surgery that allowed her to hear what was happening, what they were asking her.
You can also hear another episode with Kruti The pharmacist, she also talked about she's hard of hearing so she uses a hearing implant so you can go and listen to those episodes. I think they're great use of how they've used accommodations throughout their medical career.
Other communication aids. Having a sign language interpreter. That uses their lip reading and then also their hands, a tablet or phone to type.
I'm going to also say like a whiteboard communication aid. We use that a lot in the hospital. And I really want to encourage you actually, if you have a patient that's intubated and that's awake provide them something to write on, especially like dry erase, something big, something they can hold on to.
It is so helpful to be able to communicate your needs and imagine having a tube down your throat that you want to ask something so simple like where is my family or what day of the week it is and you can't communicate that. So having that, being able to have the ability to write is really helpful.
Can also be, for individuals who can't hear as well, so same thing, writing or typing their answer, that's sometimes helpful.
A communication tablet. So I was a case manager for children with disabilities, and this was a common one that a lot of my individuals who couldn't have verbal communication, but , they could either type or they could click different pictures that would verbalize to someone listening what they meant.
So that's another communication tool. I've also seen people who use like pictures or like point to different things like bathroom, food. So these are all different ways that you can communicate. Or also emotions. I'm going to be a psychiatrist. So that will be something that I hopefully use is use different pictures to communicate emotions.
Because a lot of individuals In general, have struggle expressing emotions or putting a word or a face to it. So that's going to be really helpful.
Going back to school, like note taking. Sometimes it's really hard for some individuals to be able to focus in class and take notes. Or maybe the speaker is talking too fast.
So sometimes you can ask for a note taker or use someone else's notes. That's been designated. And then another rather great accommodation or even accessibility for anyone is just ask for the slide deck. So if you ever go to a presentation or before school, or like before class asking for the slide deck to be accessible.
Given beforehand, I remember I used this a lot when I was in college and I didn't even know it wasn't like an accessibility thing, but it is helpful to be able to write notes as a professor is speaking to write notes directly on it or to be able to read them beforehand and get an idea of what the presentation is about.
So next talking about reading. So that can be larger text that can be like on your cell phone, increasing the text or having the ability to increase text on a computer. Another reading aid is having braille or just having different languages available.
I love this concept of quiet rooms. I used them a lot when I was working with children with special needs, but specifically with autism. And There are a lot of different health conditions that can appreciate from quiet rooms, but this was like a big one that's really helpful is either a dark room or somewhere where they can go and decompress, feel safe. Sometimes it can have a couch to lay down.
Sometimes it can have like sensory toys, coloring books, music, white noise machine, candles, aromatherapy. It just can really help someone relax . It can also be used let's even say, for having that call with your therapist, a private room, or having your call with your doctor, or pumping, lactating.
So these accommodations can be used for so many things and can help so many people.
Dr. Moss: Okay, now I'm going to talk about animals. You might have heard of emotional support animals. For these, you have to get a, usually a psychiatrist that's been trained, to evaluate if you have a mental health condition and then allow Your dog like a card or certificate that can then be used to submit for going on a plane Or apartments.
You actually don't have to pay Dog rent so sometimes, like that monthly fee or that yearly fee if you have a dog with emotional support , so that's really helpful. Now that is let me make sure I mention that is different than service dogs are trained as in they go through a specific training to actually help for specific symptoms or specific qualities.
And some ways it could be like a notification, so like notification when their owner is about to have a seizure or low glucose, gonna have an anxiety attack. It can be for being able to see, like vision assistance. And can provide other emotional support or communication to others when that person's hurt.
I do want to put in there is if you do see a pet that does say service animal, please don't pet it or distract it from their training. I know it's really hard to, I always struggle, but I have to remind myself like , it's their job, they've been trained specifically and their job is to protect and support their owner.
So make sure that you keep that in the back of your mind. That's why you don't want to pet or distract them because that's their job.
Dr. Moss: Traveling, there are specific cars that can be outfitted to fit wheelchairs or can modify have ramps in them.I had a teacher in high school that. had their car specifically modified so they could use handles to drive instead of the pedals. That was really cool. When I was case manager for Children with Disabilities, I helped a couple times purchase and make modified vans. You can also get modified bicycles.
For the clinic and hospital because we're talking about medical school , some things that could be like the table. So being able to lift the table up and down, that's helpful. So individuals with different heights, or maybe if they're in a wheelchair, can access the patient easier, or do CPR.
Actually, When you do CPR, make sure you lower it to the lowest because it helps the person doing CPR. It helps protect their back. So that is a accommidation we provide for everyone.
Dr. Moss: Bathrooms. Make sure we don't call them handicapped bathrooms, but they're bathrooms that are maybe non-gendered that provides a private space for individuals. This is really important and helpful to have, especially for individuals with ostomies, since they have to change, or individuals who have medications, maybe have to take injections, have to have more space.
So I talked about the ostomy or colostomy bag that is connected to the outside of the body, so someone might not be able to go to the bathroom and has to actually change out the bag once it gets full
Another medical device that you could ask to be accommodated for is like a urine drainage bags, It can also be like a catheter. Some people have to self catheterize to remove the urine from their bladder.Or just like able to go to the bathroom in private . So helping people who have anxiety or people who have pain when going to the bathroom. All these are great reasons why you might need to request to have that type of bathroom accessible.
Medical devices like Continuous glucose monitoring, to check your sugar. And that includes like having to take some time aside to make sure they clean their hand or even just being able to change out the monitor, Medical devices like heart rate monitor, insulin pump, having an oxygen tank, spinal cord stimulator this modulates pain, having a TENS unit.You can see other pictures of some of the TENS units that I've used [00:34:00] that help with pain. So having maybe clothing that is wider, that you can have the TENS unit underneath.
So I've mentioned a lot of things maybe you do use these maybe you don't hopefully this helps provide like an idea of maybe you didn't think that These devices would be beneficial to have an accommodations. That's why I talk about them because sometimes even people with disabilities or with health conditions don't always associate that things that are their normal can be supported. So that's why I'm talking about all these.
Dr. Moss: Last ones, medicine . This can include medications like pills, tablets, having fluids. That's an odd thing, but it's so true. Like a lot of time in these testing environments, you're not allowed to drink water. And you might feeling very dry when you're taking tests, the anxiety, so that could be an accommodation of having the opportunity to have water closer or the opportunity to get up sooner than others.
We talked about, topical like skin, suppositories. Bandages, slings, braces, casts and I'm just going to name them because there's so many, cough drops, earplugs, EpiPen, eye drops, eye patches, eyeglasses, contacts magnifying glass. Ice pack, heating pack, inhalers, insulin pen, glucose tablet, medical alert bracelet, pillow, or different chair for lumbar support, stool for elevating limbs.
That's actually something that I do a lot that I never even thought about. I'm doing it right now. My legs are up. I can sit normally, but it helps my legs feel better when they're elevated. So sitting in long periods doing notes. Sometimes I have to grab another chair, but that is something you can actually ask for.
Surgical face mask, especially if you're immunosuppressant, so have an increased chance of getting infected, and walking boots. Obviously, if there's other ones that I forgot, please let me know, but hopefully this helped a little bit of things that maybe you didn't think about that could be accommodated for. And not just in school, also for residency and a job and you can see a video on that same blog post about navigating disability as a resident or fellow
Essential Job Functions and Accommodations
Dr. Moss: Last thing I'm going to talk about is essential job functions. What is essential?
According to accessibility. com, "essential functions are job duties that employees must have the ability to perform with and without a reasonable accommidation."
Dr. Jarrell, she's a disability advocate, she said this. In quotes, "oftentimes schools or programs will have technical standards that say you'll be able to stand for a certain period of time or lift something for a certain weight. In my mind, there's a big disconnect between those requirements. And meeting an essential function or job with accommodation. If a wheelchair is used, then the standing requirement is not valid."
This article says that employees need to lift what they deem to be essential functions. And I believe this would apply to residency programs as well.
Since I'm going on to residency. I was really proud of my institution for providing what they deemed are essential functions for their program. So what they want all their residents to be able to accomplish by the end of each year or by the end of their program.
And I really hope that other programs start doing this.
So check out your graduate medical education manual or your school accommidations see if they have anything written down or if they can write out what do they actually want you to learn or accomplish and sometimes they have stuff that maybe physical that you aren't able to do.
So that's where it's really important to grab your accessibility advocate to be able to work with them and see how can we do this in a way that's more accessible so I can still be successful and achieve what you want.
I'm going to give the example of CPR. There are individuals that are not physically capable of doing CPR for whatever reason. And some institutions have been able to change the language to say, you don't need to do CPR, but you need to be able to verbalize how someone else can do CPR. So as a doctor or leader, you can ask someone nearby.
Put your hands on top of the other, put your full weight into it, use your hips, go at this beat. That is one example. And again, talk with your accessibility team of how you can make it more accessible to meet your needs. Cause you deserve it. At the very end, I put in resources that hopefully will help, like the ADA network, job accommodations network, how to get testing [00:39:00]accommodations for NBME, USMLE, and then my resources, and then the Docs with Disabilities group.
I don't think I actually talked about USMLE, I skipped over that. So for the USMLE, It's very similar the school, but there's actually a specific document that you have to fill out, has to be signed by your school. You have to submit documentation those same letters that I talked about of, from a doctor, therapist, psychiatrist saying, yes, they have this specific disability or this specific need, and this is why they need this accessibility for the NBME or for the USMLE.
Some of the options is time, changing the time of breaks, changing the time of actually the test, changing to be in a separate room, changing to a black screen, because sometimes the lights can make individuals have headaches having food or water available, medication available shortening the time.
I had that option that I learned about. I didn't do it, but it was offered to me of doing it, having a break every 20 questions instead of every 40 questions. So that might be an option and I need to make sure I'll add that to the blog post. Make sure , I add more information on what you could do.
Check out my workbook on what to include in these letters & Personal Statement for an accomodations request
Reflecting on my journey, including the challenges of standardized exams and clinical rotations, highlighted the diversity of accommodations available. From mobility aids to communication tools, understanding and requesting the right accommodations are key to navigating medical education successfully.
Dr. Moss: Thank you so much. I really hope this was helpful to you. The next one I'm going to be talking about how to actually disclose because I had the opportunity to decide whether or not to disclose my own disability when I was applying to residency. So stay tuned for that episode.
Also check out my website, MedPsycMoss.com. You can follow me @MedPsychMoss on all social media. I would love to hear from you what you still need, what is helpful, what challenges have you had, so I can make sure I can address them and help. Thank you so much for listening in today. And just remember, you are not alone.
Message of Hope [00:41:00]
Dr. Moss: If you are struggling I'm here. I'm with you. Just don't give up hope because there's so many people that can't wait to meet you and support you and I really hope that I can impart any emotional support as someone who's struggled and made it.
Made that doctor. I can't believe it. It's surreal and I really hope that you can also be able to achieve your dreams, whatever your dream is.
So thank you again and I hope to see you next time. And subscribe!
For anyone embarking on a similar journey, know that you're not alone. Resources are available, and with determination and the right support, success is within reach. Let's continue to advocate for an inclusive and accessible future in medical education and beyond.