A session at the 2025 ACGME Annual Educational Conference focused on enhancing inclusion of learners with disabilities, providing opportunity for discussion about and broader understanding of the challenges, misconceptions, and potential solutions related to disability inclusion in graduate medical education (GME). Presenters included Lisa Meeks, PhD, MA, Clinical Professor, Department of Medical Education, University of Illinois College of Medicine; Nalinda Charnsangavej, MD, FAAP, pediatrics residency program director and associate professor of Pediatrics at Dell Medical School at the University of Texas at Austin; and Zoie C. Sheets, MD, MPH, a resident physician at the University of Chicago.
The session, entitled Strategies to Enhance Inclusion of Learners with Disabilities in GME, emphasized that disability is not just a medical diagnosis or condition, but rather a social, emotional, and political experience that shapes individuals’ interactions with their environment.
The Americans with Disabilities Act (ADA) defines disability as “a physical or mental impairment that substantially limits one of more major life activities.” However, the speakers encouraged attendees to go beyond this legal definition and recognize disability as a natural part of the human condition. They highlighted that disability is:
- Common—more prevalent that many assume
- Intersectional—experiences vary widely across people
- A source of identity and pride—not something to be “fixed”
To further frame the conversation and to better understand disability, presenters identified what is considered “ableism.” Dr. Sheets referenced Ashley Eisenmenger from Access Living, stating that, “like racism and sexism, ableism classifies entire groups of people as less than, and includes harmful stereotypes, misconceptions, and generalizations of people with disabilities.” She added that she believes that “…ableism is rampant because we are often taught through the medical model, which very much understands disability as a diagnosis, and therefore causes us to build harmful misconceptions about disability for our patients that naturally carry over to our learners and our support of our learners as well.”
Barriers to Disclosure and Accommodations
A key takeaway from the session was the discrepancy between the number of learners with disabilities and those who request accommodation. While 11 percent of learners self-disclose a disability, only 50 percent of those who need accommodations request them, as identified in a data set coming out of the University of Michigan. The reasons for this gap, the presenters explained, can include fear of bias and stigma, uncertainty about how to request accommodation, and lack of required documentation.
Additionally, the type of disability disclosed has an impact on the area of medicine learners pursue. Dr. Meeks shared there’s an often-unspoken belief that, “It’s okay to be disabled, but only if you enter X specialty,” underscoring the prevalence of this perceived stigma. However, she explained, “that’s actually not true [as] learners with disabilities are entering a number of different specialties.”
At the same time, many program directors are unsure how to handle accommodation requests because of limited experience, lack of guidance, and overarching ableist attitudes within medical education.
The presenters shared that the lack of both disclosure and understanding come from limited practical tools and experience with and exposure to personal stories. Drs. Sheets and Charnsangavej shared their own personal testimonies of disability experience in GME. Dr. Sheets shared her lived experience of being a resident with a disability and requesting accommodations and Dr. Charnsangavej provided her perspective as a program director supporting learners with disabilities. Their stories and the way they were received by the session’s audience support Dr. Meeks’ sentiment that “stories are the biggest disruptors of bias and assumption.”
Coming Soon! Disability Inclusion Resource Hub Resource
Funded through a Josiah Macy Jr. Foundation Catalyst Award and developed as a partnership between the ACGME and Docs With Disabilities Initiative, the forthcoming Disability Inclusion Resource Hub, which will be housed on the ACGME’s digital learning platform Learn at ACGME, will provide the medical education community with information to enhance inclusion of learners with disabilities.
The Hub includes a number of resources that will provide tangible tools to use in their programs. Three main areas of the Hub are:
- Current Resources, including literature review and videos/podcast episodes from DocsWithDisabilites
- Toolkits that cover topics including the UME-to-GME transition and policy
- Case Studies that highlight real-life stories from the community about experiences of disability within GME
Session attendees at the conference expressed their excitement for the launch of this tool, the work for which has been completed by various committees. The Hub is expected to launch during the summer of 2025.