Courtney Perkes
Disability advocates are pushing for a requirement that all medical schools specifically train future doctors to treat people with intellectual and developmental disabilities, but they’re hitting roadblocks.
Two proposals to establish a mandate as part of the standard curriculum that medical schools adhere to were rebuffed earlier this year by the Liaison Committee on Medical Education, or LCME, a group jointly sponsored by the Association of American Medical Colleges and the American Medical Association that accredits medical schools in the U.S. and Canada.
But the committee, which is responsible for setting minimum curriculum standards, is now set to discuss a revised version of one of the recommendations — sought by the National Council on Disability, or NCD — at a meeting later this month.
Amged Soliman, attorney advisor for NCD, said research has shown that large numbers of doctors have never received training in caring for such patients, and many say they would benefit.
“Some providers incorrectly assume that people with disabilities don’t have a good quality of life or people with intellectual and developmental disabilities don’t experience pain,” Soliman said. “We think the recommendation we’re making could help rectify that.”
The council has called for instructing students in “basic principles of disability competent healthcare.” Medical students would be required to demonstrate proper clinical practice skills and sensitivity, including respectful nomenclature, supported decision-making and knowledge of living arrangements that might affect compliance, according to letters sent by the National Council on Disability to the committee.
Donna Waechter, assistant LCME secretary, said in a statement that medical students are already required to learn to recognize and address disparities in health care, which include disability status. She said graduates must “exhibit general professional competencies that are appropriate for entry to the next stage of their training.”
“As such, the LCME accreditation standards and associated elements are relatively broad,” she said.
The accreditation committee first reviewed the NCD recommendation in February, along with a request spearheaded by the Association of University Centers on Disabilities, or AUCD, to include developmental disabilities in undergraduate medical education.
After the meeting, LCME sent a letter to AUCD that said it’s up to medical schools to determine how specific topics, such as developmental disabilities, are covered.
“While the LCME agreed that developmental disabilities is an important area, LCME elements do not reach that level of specificity,” the letter said.
Soliman of NCD said the committee also cited level of specificity in response to the council, which he said NCD disagrees with. LCME and the National Council on Disability declined to provide a copy of that February letter to Disability Scoop.
Last month, NCD wrote a reply that will be considered by the committee next week.
Advocates and physicians say they have been successful in helping medical schools develop and incorporate training on a voluntary basis, though the goal remains to see every graduating doctor prepared to treat patients with intellectual and developmental disabilities. In one effort, 11 schools including Harvard, the University of Louisville and Georgetown, are participating so far.
Physicians said even a small amount of training over four years of medical school could be instrumental in helping future doctors treat and communicate with patients who have disabilities.
“What we would hope to see is a long-term improvement in not only the ability of people with intellectual and developmental disabilities to access care, but an improvement in the quality of care,” said Dr. Matthew Holder, who founded the National Curriculum Initiative in Developmental Medicine which is partnering with the 11 medical schools. “We know, for example, that by changing attitudes and at least having a willingness to see this population and not being intimidated, you won’t turn people away, or you won’t make it uncomfortable for them in your office so they go away.”