Students with disabilities qualify for physician residency programs at reduced rates

Medical students who report having a disability are less likely to enter a residency program, according to a new Yale study of residency programs across the United States.

The findings suggest that students with disabilities may experience barriers to education and career opportunities, especially in certain medical specialties.

“Physicians with disabilities are underrepresented in the medical field,” said Mytien Nguyen, MD-Ph.D. student at the Yale School of Medicine and lead author of the study. “Lower match rates can contribute to that disparity, which ultimately has negative consequences for the field and patient care.”

For the study, published n the news JAMAthe researchers used data from the National Resident Matching Program, which matches applicants with residency programs in the United States. They analyzed match results for individuals applying to residency programs in 2022 and 2023.

Of the almost 70,000 people who applied for a residence permit during that period, 5.9% reported that they had a disability, answering “yes” to the application question “Are you a person with a disability (e.g. ADHD, learning, psychological , chronic health, mobility, hearing, vision,
etc.)?”

After evaluating the match rates for those who did and did not report a disability, researchers found a small but significant difference in the match rates: 83.2% of those who did not report a disability successfully applied to residency programs , compared to 81.8% of applicants reporting a disability.

When researchers then looked at the rates within the medical specialties, they found some where the match rates between the two groups were not significantly different. However, in other countries, including otolaryngology, neurology, physical medicine and rehabilitation, dermatology, pediatrics, internal medicine, and emergency medicine, match rates were higher for applicants with disabilities.

Driving the overall lower match rates for students with disabilities were the rates for general surgery – 65.5% versus 76.2% for students reporting no disabilities – and orthopedic surgery – 58.6% versus 73.3% .

During the matching process, students apply to specific programs, interview them, and then rank the programs in order of preference. Programs also rank their applicants, and the National Resident Matching Program uses an algorithm to determine matches based on the two sets of rankings.

According to researchers, the variation in match rates between specialties may reflect differences in the culture of specialties or the assessment practices of applicants, with biases – conscious or unconscious – influencing match rates.

“With this gap, I think it is important for every specialty, not just surgical specialties, to think about their processes and include disability as a benchmark to examine alongside race, ethnicity and gender when considering the diversity of their program,” said Nguyen.

The differences between specialties may also point to positive approaches that others can adopt or build from, said senior author Dowin Boatright, who is now vice chairman of research in the department of emergency medicine at New York University Grossman School of Medicine and this line of medication started. research at the Yale School of Medicine.

“Looking at specialties with higher match rates for applicants with disabilities may reveal successful strategies for fair evaluation,” he said.

Organizations such as the Accreditation Council for Graduate Medical Education, which evaluates medical residency and internship programs, also play a role, Nguyen said, pointing to the work the agency already does to promote awareness and support of students with disabilities.

“And of course, the number of applicants with disabilities in our study was very low, which points to disparities that may exist earlier in the training pathway and also need to be addressed,” she said.