Efforts to increase diversity among the physician workforce include removing the obstacles people with disabilities face when pursuing a career in medicine.
But while physicians and medical students may become more comfortable treating patients with disabilities, they are too often ill at ease when interacting with colleagues or fellow medical students with the same conditions.
According to the speakers at an educational session hosted by the AMA Medical Student Section, it’s a hurdle that can be overcome.
“If you don't know how to act with an accommodation, just ask,” said Davy Ran, MD, MSc, MPH, who is hard of hearing and has other disabilities.
“There's no shame in being disabled,” said Dr. Ran, an internal medicine resident at Montefiore Medical Center Einstein Campus in Bronx, New York. “That means there's no shame in asking them what it's like to have a disability.”
Courtney Franz, a third-year student at the Texas Christian University Burnett School of Medicine, had her left leg amputated above the knee to address a genetic condition that she struggled with her entire life. Her amputation was the 21st surgery she had on her leg.
“Something I want to say right out: ‘Disabled’ is not a dirty word; amputation is not a bad thing,” Franz said during the session, held during the 2023 AMA Annual Meeting. “Amputation improved my life.”
Her parents cried with joy when they first saw Franz walk with her prosthesis, because they hadn’t seen her walk that well in years.
“I was always disabled, but I didn't embrace it,” Franz said. “Everybody talked to me like: ‘You're not disabled because that's a dirty word. We're not going to call you that.’ But I was.”
Disability means more work
For Franz, embracing her disability has meant attending extra meetings to address accommodations only to have preceptors who don’t discuss the issue with her. During rotations at the hospital, her classmates often suggest taking the stairs because the elevator is too crowded, overlooking the fact that, if you’re missing a knee, the elevator is always faster.
Taylor Hill, MD, an internal medicine resident at East Carolina University in Greenville, North Carolina, also had a leg amputated below the knee after an all-terrain vehicle accident when she was 15. She said the experience pushed her toward a career in medicine—something she had never considered before. And life as a health professional turned into a family matter with two sisters becoming nurses and another going into health care administration.
“To say it was a pivotal moment in our lives would be an understatement, but it kind of brought me here today,” Dr. Hill said. But it’s not always easy—especially at airports, despite being enrolled in the Transportation Security Administration PreCheck program.
“I don't take my shoes off, I take my pants off,” she said. “They have to examine my entire leg before I get on the plane.”
The experience is part of a pattern.
“You spend so much time trying to prove that you belong in spaces and none of these spaces are built for you,” Dr. Hill said. She recalled being told that she would be a “liability in med school” because she couldn’t run to administer cardiopulmonary resuscitation to a patient—even though doctors are usually not the ones performing it.
Coaching and accommodating
Being almost completely deaf in one ear since she was 11 hasn’t stopped Heidi Ventresca, a third-year medical student at Louisiana State University Health Sciences in Shreveport, from becoming speaker of the AMA Medical Student Section.
“I didn't realize when I went to college how deaf I was,” Ventresca said. “I never really thought much of it. I actually went to school as a music major.”
As a clarinet performance major and classical musician, she performed or rehearsed for four to 12 hours a day. Her deafness didn’t become an issue until she was almost kicked off the rowing team for being “uncoachable.”
“I didn't know she was talking to me, I had no idea she was coaching anyone on my boat,” Ventresca said. “The irony is that getting a music major half deaf was easier than getting a medical degree half deaf—which is unexpected.”
Dr. Ran noted that research shows the main reasons people with disabilities fail in medicine is a lack of coaching, guidance and career advice.
“That is what holds people back, not the disabilities themselves,” Dr. Ran said.
“I want to really highlight here that conditions are not disabilities, they are two different things,” Dr. Ran added. “A person's interaction with their condition is what defines if it’s disabling or not.”
Connecting with patients
Franz noted that it was her disability that helped her connect with a patient when no one else could.
A man needed to have his leg amputated to save his life, but he was reluctant to do it.
“I told him: ‘You're going to join an incredible community of people and it's going to look different than your current life, but it does not mean you will be lesser than you are,’” Franz said. “’Your leg does not define who you are.’
“The man absolutely broke down, because—what the doctors missed, what the residents missed, what everybody missed—was this man was more afraid of losing a leg than losing his life,” she recalled. “So always ask: Who is this patient beyond their medical conditions?”
