A dearth of disability-related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0.
Amy J Houtrow, Max B Hurwitz
PMID 39177053WHAT IT FOUND
Disability was absent from training milestones in 37.5% of the 32 medical and surgical specialties.
In 19 of the 32 specialties, disability appeared as a potential barrier to communication, and no specialty had disability-related milestones for systems or practice improvement.
Key findings
0137.5% of the 32 specialties had no disability-related milestones in any subcompetency.
02Nineteen specialties included disability as a potential barrier to communication in the Interpersonal and Communication Skills domain, or in neurology's barrier and bias mitigation subcompetency.
03No specialties had disability-related milestones in Systems-Based Practice or Practice-Based Learning and Improvement domains.
STILL TO COME
How it was doneWhat they found
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What it does not show
The review looked at written milestone requirements, not at what trainees learned or did. It could not know the Milestone Committees' intentions about ensuring a disability-competent workforce. The presence of a disability-related milestone does not ensure that trainees become competent in that area. The timing of Milestones 2.0 and the Core Competencies on Disability meant the two could not be integrated in this review. It did not address undergraduate medical education, which could also include disability training.
Declared interests
Funding came from LEND Pittsburgh and the FISA Foundation. The authors declared no conflicts.
The easy way to misread this
Do not apply this to physical, occupational, or speech therapy training. The study reviewed physician residency milestones, not therapist education or patient care.