Last year, Professor Bill Reid, Chair of our health and disability review, introduced our work to update Gateways to the professions – our guidance setting out how disabled medical students and doctors should be supported. Since then, we’ve held roundtables to hear views from across the UK, and we’ve published independent research which looks at how the guidance could be developed, ahead of a consultation on a new draft in the coming months. Here, Policy Manager Ioanna Maraki provides an update on what we’ve learned.
Disability in medicine
There are 13.3 million people with a disability in the UK – 20% of the population. How many of them do you think are medical students or doctors?
Of the 40,000 medical students studying in the UK, 3,727 (9.3%) are disabled. And 1,174 doctors completing our national training survey in 2014 (2.3%) said their day-to-day activities were limited a little or a lot by a health condition or disability.
In the UK, disability is defined as something that has a substantial and long-term effect on carrying out normal day-to-day activities. Many disabilities are invisible and not all are physical. They include conditions like multiple sclerosis, HIV/AIDS, visual or hearing impairments, autism-spectrum disorders, mental health conditions like depression, and learning difficulties like dyslexia.
Championing disabled students and doctors
Disabled medical students and doctors should be able to pursue a career in medicine, and have access to support they may need to achieve this. We believe people with long-term health conditions and disabilities have a great deal to contribute to the medical profession and we want to make sure they feel welcomed and valued by us, their educators and their employers.
We’re responsible for overseeing all stages of medical education in the UK. Our standards – Promoting excellence – require organisations to support all learners to meet professional competences and give them the resources they need to achieve these. And our Gateways to the professions guidance provides advice for organisations on how they can support disabled learners.
We are currently reviewing Gateways and drafting revised guidance for a public consultation in the coming months. We’re doing this to make sure our advice meets the needs of disabled doctors and students, as well as educators; and to ensure it gives practical examples on how learners can be supported to fulfil their potential.
Identifying unmet needs
To hear how our revised guidance could better help disabled medical students, doctors, and organisations that provide training, we ran nine roundtables across the UK. We are very grateful to those who joined us for their honesty and openness, in highlighting areas where things are working well, and identifying issues that need addressing.
We commissioned independent research seeking information from medical schools, deaneries and HEE local teams, and employers to understand how they support learners. The researchers also interviewed medical students, who spoke about their experiences and what they would like to see in our guidance.
What did people tell us?
The roundtables and research identified key principles for supporting disabled learners that apply across undergraduate and postgraduate training. These included fostering a positive culture, having clear established processes, and supporting information sharing. Information sharing was considered to be particularly crucial because medical students and doctors sometimes hesitate to do this, because they are worried about what their supervisors will think, and how it may affect their future career.
Students and doctors also talked to us about an ethos that they can never suffer from ill health. One consultant was told they had ‘used up the good will of their colleagues’ when returning from sickness leave.
Both students and doctors told us it was difficult enough studying and practising medicine without having to fight to receive the support they are entitled to. This is not to say there aren’t many incredibly helpful and supportive educators, but the first person the student or doctor discusses their health with often has a great effect on what they will do next. A positive conversation can be hugely empowering for that person’s future.
And medical schools and postgraduate providers want to give students and trainees the support that they need, but in order to do this, it’s crucial that they receive the appropriate information at each transition point. Educators also want to empower medical students and doctors to make informed decisions about their studies and career.
Recognising the contribution of disabled students and doctors
From our research and roundtables it is clear that what students and doctors want above all is to be seen as individuals, in the same way they are taught to treat each patient. This includes recognising their abilities, and what they bring to the profession.
A doctor who’d been through multiple operations felt they understood the importance of pain control much more than their colleagues.
A doctor with mobility issues had to plan every single part of their day in advance, so they believed they were more organised and knew to effectively manage their time and energy.
A doctor in a wheelchair told us they always arrive first for a crash call.
Patients we spoke to also felt that a doctor with a lived experience of ill health can identify more closely with them.
What are we doing next?
We are working with a group of external experts, chaired by Professor Bill Reid, and using the findings from the research and roundtables to inform the review of our Gateways guidance. You’ll have a chance to let us know what you think when we launch our public consultation on the revised version. We are looking forward to hearing your views.
Beyond our expert group, we have also engaged with a community of over 250 people and disability-related organisations. If you’d like to sign up to join the community, or if you have any questions about our review, you can get in touch at firstname.lastname@example.org