Guest c4rd14c Posted January 30, 2003 Report Share Posted January 30, 2003 Do med schools have a policy regarding disabilties? (Not a learning disability). For example, is there any requirement for schools to have a certain number of accepted students whom have a disability or does this policy really only apply to minorities? Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted January 30, 2003 Report Share Posted January 30, 2003 Hi there, From what I've read, schools in Canada (and many in the U.S.) are very specific regarding their policies on students with disabilities. However, as far as I've seen, these policies do not extend to setting quotae for students with disabilities (only a few Canadian schools employ quota structures at all, e.g., for Aboriginal or international applicants). Many schools list criteria for applicants with disabilities which specify that the disability must not impede the doctor-to-be from being able to practice medicine, the specifics of which are better described on the individual medical school websites. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest aneliz Posted January 30, 2003 Report Share Posted January 30, 2003 I am not aware of any Ontario schools offering 'reserved' places to people with learning or other disabilities. As far as I am aware, these people are subject to the same admission standards and procedures as everybody else. There used to a paragraph in the official admissions materials (the OMSAS booklet) that stated something like "applications from individuals with disabilities are welcomed, however, the nature of a career in medicine makes great physical and mental demands. The ability of the applicant to meet and cope with the demands of practicing medicine will be evaluated on an individual basis and may affect the chances of being admitted. Admission may be restricted to individuals that will be able to realistically meet the expectations of a career in medicine as judged by the admissions committee." My PCL group actually discussed this topic last week in the context of adolescent spinal cord injury...There was a pretty even split within our group of eight over whether a quadriplegic should be able to go to medical school...and if it would be different if a practicing physician was injured later in life and became a quad... Many of our class felt that these people should not go into medicine because they are unable to fully participate in the curriculum (ie clinical methods) and would not 'pull their weight' during clerkship...they would also be fairly limited in practice due to their physical limitations (ie a quadriplegic can't realistically perform surgery) Of course a quadriplegic is a bit of an extreme example of disability...we also discussed the implications of blind or deaf students attending medical school. The schools have never really thought about the issue of disablied students as they don't face them often. Whether this is because nobody with a disability is applying or if they are just not getting in is another story. Our faculty facilitator told us that there was one partially deaf medical student at Western a couple of years ago. She graduated and went into family medicine and is apparently quite active in treating members of the deaf community. She has a great insight into the needs of this community and is able to communicate fluently in ASL directly with her patients (no translator) which is an obvious benefit. But, she was the only even slightly disabled student that he could remember at Western in the recent past and he remembers her having some problems during clerkship, especially in more 'busy' (in terms of background noise and activity pace) rotations. One of my classmates that applied and got in to a couple schools in the states was asked to sign a form stating that he was free of any known disability and had no physical or mental impairments that would prevent him from participating in any way in the medical school curriculum or the practice of medicine.... Obviously the views on disabled medical students are quite clear cut in the 'land of opportunity'.... Link to comment Share on other sites More sharing options...
Guest Sil Posted January 31, 2003 Report Share Posted January 31, 2003 Just food for though. During orientation week we had a family doctor talk to us about her experiences in medicine. I believe that she graduated from U of O (early 80's but not sure). One of her good friend's became blind during the fourth year of med school (from complications with diabetes). Her mother read all the texbooks and made them into tapes (Harrison's internal medicine comes to mind) and she graduated. She went on to practice medicine (I don't know which field) but she wrote a book about her life, can't remember the exact title but I think is either the doctor can't see you anymore or the doctor won't see you anymore. Saddly she passed away recently, I would be interested in reading the book. Link to comment Share on other sites More sharing options...
Guest K2Optimist Posted January 31, 2003 Report Share Posted January 31, 2003 I think the book you are referring to is The Doctor Will Not See You Now by Jane Poulson I haven't read it, but it looks interesting ... Link to comment Share on other sites More sharing options...
Guest Sil Posted January 31, 2003 Report Share Posted January 31, 2003 Thanks K2Optimist! I looked it up she graduated from McGill in the late 70s. Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted January 31, 2003 Report Share Posted January 31, 2003 Certainly there are some specialties that are inaccessible to some forms of disability. The quadripalegic and/or blind can't do cardiac surgery (yet! wait for robotic sugery advances. . . who knows what the future may hold?) but what about the blind doing psychiatry, or even Medical Genetics? These are mostly cerebral and interview based (a bit of physical exam skills are needed for medical genetics) specialties and a quadripalegic or a blind medical student could go into either. And what about someone who was hemipalegic? That person could do almost a complete physical exam, opening up a realm of other fields. And what do you consider a disability? Is mental illness a disability? What about Bipolar disorder (ie manic depression)? It definitely can be disabling. Yet the author of THE textbook on the disease, Dr. Jamison, is herself manic depressive. There are significant number of physicians who practice yet have this illness. How about depression and anxiety disorders? These too can be disabling - and yet my understanding is that either the incidence or prevalence for both of these disease is higher in physicians than in the general community. Plus, I think it would be completely bogus for anyone to complain if such a person were unable to fulfill 100% of their duties in clerkship. As it stands, if someone is either Hep B positive or HIV positive, they modify the clerkship activities for that person. Why wouldn't they be able to do that for someone who was differently-abled? Link to comment Share on other sites More sharing options...
Guest macdaddyeh Posted January 31, 2003 Report Share Posted January 31, 2003 Man, I was waiting for someone to hit this one on the head! You responded to this post very articulately UWOMED2005. You offered some very good insight. I think we in society, especially those who are pursuing a medical career, must surrender our cherished conceits of how we define illness and disease (the TWO being VERY different by the way!) Disease is the biomedical explanation for a phenomena whereas illness refers to the socio-cultural explanation. You will likely recall, as an embarassing part of recent Canadian history that at one point women were not even considered "persons" under the law, inferior to men and therefore unacceptale for admission to many medical schools. Dare we categorize and preclude the "disabled" in a similar fashion? BTW, for those who are ignorant of "deaf" culture, many deaf would tell you that they are not disabled at all nor are they "impaired" as they are ignorantly labelled. In fact many would chastize the hearing for failing to learn their language (ASL). I speak from experience. The only thing that I want you to keep in mind is that "disability" is RELATIVE Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted January 31, 2003 Report Share Posted January 31, 2003 By "experience," Macdaddyeh, to what are you referring? I'm actually quite familiar with the Deaf Community as I worked for a summer at the Canadian Association of the Deaf, a Deaf rights advocacy group run entirely by the Deaf. As you pointed out, Macdaddyeh, they absolutely do not see themselves as impaired, but rather they see themselves as a culture with a distinct language (ASL or LSQ if you're from Quebec. ) In fact, the CAD sees cochlear implants (something I'm sure Ian is familiar with!) as a form cultural genocide. I also worked at a summer camp at the CNIB for a couple summers (the deaf and the blind offer a FASCINATING comparison, btw.) I've worked with a number of people who were hemipalegic or parapalegic while volunteering at the Nova Scotia Rehabilitation centre. With all the groups, I've found they were not in fact "disabled" so much as they were "differently abled." This was particularly true working with the kids at the CNIB - there really weren't many games or sports we couldn't play, it was just a matter of adapting things to suit the kids. We even played softball, albeit with a beeping ball! Actually, to be honest, it sometimes shocks me to see some of perceptions, biases, and reactions about impairments and/or disabilities on the part of med students. Most seem a bit uncomfortable around the subject. And it unfortunately doesn't surprise me to hear that there were med students arguing against permitting people with disabilities into medical school. I'm not sure of the reason for it, but I have a few theories. I think the main is that a lot of med students and physicians see their role as being to "cure" people. And I think often we see impairment as something that needs to be "cured." But as Macdaddyeh pointed out, the impaired don't always see it that way. And even for those that do want to have impairment taken away, we can't always do anything for them. Many med students associate not being able to do much as depressing. I think this is the reason surgical specialties are so popular, because there's often a quick and easy "cure" in surgery, whereas less popular are often the specialties where the treatments aren't so effective (ie PM&R, Developmental Pediatrics, Family Medicine, Psychiatry) and you have to help people deal with their current situation. But I also think part of the reason is that med students tend to be perfectionistic people in all facets of their, and see disabilities as imperfection, and the fact that some med students don't have any experience working with these groups Link to comment Share on other sites More sharing options...
Guest macdaddyeh Posted January 31, 2003 Report Share Posted January 31, 2003 Hey UWOMED2005. Again, your response was very appropriate. Personally, my wife is just short a few courses from finishing an ASL accredited program as an interpreter. She is responsible for my insight. I sign only a bit, but have some deaf friends. Your insight on cochlear implants is brilliant for a hearing person. For those who do not know about cochlear implants I challenge/invite you to do some further research. I always thought the topic might make a good discussion theme for the (in)famous Mac interview tutorial! Without sounding like some type of disability "expert" I must be fair in saying that a few years ago I too would have thought that, as you stated, "disabilities" (loosely defined) needed to be "cured." In fact I also have one dear blind friend with whom I was speaking a few weeks ago. I must admit I've always wondered if she really wanted to see if she had the chance, and without asking she recently told me that the only thing she fears is SIGHT! That's right, she would rather be dead than have full vision (as per her claim). Similarly, MANY deaf people are very militant about their "disability" and simply see themselves as "speaking" another language, not having some type of "impairment" as was astutely mentioned in the above post. Please please please aspiring doctors, while nothing may be wrong necessarily with the term "disabled," one just must be able to justify why they used that term. PS. UWOMED2005, You'll make a great doctor! Link to comment Share on other sites More sharing options...
Guest aneliz Posted February 1, 2003 Report Share Posted February 1, 2003 Macdaddyeh....good to see you have the distinction between disease and illness down....but illness is the person's perception of their disease...a subjective, individual experience.....you should look into the person and context aspects of the patient centred model to round it all out....it may come in handy for interviews.... Link to comment Share on other sites More sharing options...
Guest strider2004 Posted February 1, 2003 Report Share Posted February 1, 2003 I wouldn't be so quick to define 'disease'. One of our profs was mentioning a talk that she went to. I believe this was a researcher looking at the prevalence of osteoporosis in our population. He pulled out a chart and shower that after menopause, the rates of osteoporosis climb exponentially until at 90 years of age, almost 100% of women have the disease. Her thought was...well...if everyone's got it....how is it a disease? I could also easily argue that most hip fractures in the elderly occur because muscle weakness impairs coordination and ability to walk and not because of osteoporosis. Her point was that sometimes society (especially the drug companies) invents diseases just so it can cure them. For instance, what the heck is erectile dysfunction? It was something invented by Pfizer to promote a vasodilator that they tried to use for coronary artery disease. I'm trying to make the point that even medical 'disease' isn't all that objective. Link to comment Share on other sites More sharing options...
Guest medicator007 Posted February 1, 2003 Report Share Posted February 1, 2003 Strider raises some great points! How can we simply define disease/illness/syndrome? But more importantly i think.... do we really have to? The example of osteoperosis is not unique! BPH has a near 100% incidence in men over the age of 80, is that a disease? LPDD is an adverse reaction experienced by some women to an apparantly normal cycling of hormones. How do our definitions deal with this? As we have seen in the past, distinctions and classifications of disease may indeed prove to be futile... for example the old schema of disease classification between organic and functional has largely been abandoned because of its role in marginalizing situations like Chronic Fatigue Syndrome or Visceral Hypersentivity. The way I see it.. the definition is irrelevant, if people are suffering (difficulty urinating, mild depression, fractured hips...etc) then physicians must use all resources at their disposal to improve the patients overall state. As to the topic of erectile dysfunction, I don't think we should be dismissing it so readily. The ability to achieve or maintain an erection irrespective of age is something that certain people consider important and can have an impact on their lifestyle and overall well being. Not too long ago it was assumed by the medical community to be largely psychogenic and yet recent evidence (viagra included) has led to the belief that there may very well be significant physiological involvement. If we can help these people, why shouldnt we? Forget the diseases name, perhaps it was named by PFizer, reality is that this "condition" does have an effect on real people and the treatment is welcome by those in need of it. I'm not saying that drug companies are angels, for they are certainly far from it... but if there is a way to improve a patients quality of life then it is the role of the physician to do so. As I said before, great point with respect to defining diseases, which i agree cannot easily be done in an objective manner but I just wanted to nuance ur assessment of ED. Cheers, Medicator Link to comment Share on other sites More sharing options...
Guest Ceds Posted February 1, 2003 Report Share Posted February 1, 2003 Great discussion folks! I took a Biomedical Ethics course during the summer (excellent course!) and one of the first things that they talked about was the definition of Health and Disease. As is evident from this thread, neither are easy to define and sometimes it is best not to. The problem is that when health care systems try to set their policies and plans they feel a need to define it so that they can set borders as to what is covered and what is not so there is much debate as to what appropriate definitions are. It would be great if things like this aren't so grey... Link to comment Share on other sites More sharing options...
Guest Tal Posted February 2, 2003 Report Share Posted February 2, 2003 Hi! I don't have time to write down all my thoughts on this great discussion (supposed to be studying) but I just really wanted to share a great example I've seen. i work for the Center for Students with Disabilities at my university and i have seen some students with disabilities do amazing things. I know a person who is blind and took a neuroanatomy course, and in the lab, would identify ALL the parts of the brain through touch! (I'm pretty sure they did the bell-ringers too!) Also, i find that most of the people i encounter with a disability gravitate more towards psycology. But it more seems to me they are simply interested in psycology because that is the way in which they would like to help people, not because they think they can't do medicine. Anyway, I've just met some pretty amazing people with different disabilities, and i totally agree with what has been said, most of them don't consider that they have a disability at all. Link to comment Share on other sites More sharing options...
Guest macdaddyeh Posted February 2, 2003 Report Share Posted February 2, 2003 I just realized that the original poster of this discussion may not even be talking of disability in the way that we have been (ie. blind/deaf/paraplegic). Perhaps that individual was talking about a learning "disability" ie. dyslexia. Being differently-abled cognitively may be a tough situation as well but definitely not impossible to manage. Reading and mental-processing "disabilities" might indeed make it difficult to be a doctor, and I'm sure ample examples abound that would testify to this end (ie. detailed prescription drug names or confusing long names of diseases that are difficult to pronounce and read for even the "average" individual who claims to have no disability). Nonetheless, I would invite those suffering from any self-proclaimed disability (or one that you have been categorized into by society) to apply any day. Ample opportunity is given to explain oneself at the beginning of the OMSAS application and that info will be taken into consideration. Any further thoughts?:eek Link to comment Share on other sites More sharing options...
Guest tirisa Posted February 2, 2003 Report Share Posted February 2, 2003 What an amazing discussion this has been. And I must agree on most accounts. Disability is such a pejorative term, and many people with disabilities can do incredible things. Too bad everyone focuses on what they can't do, rather than what they can. I work with land mine survivors and other people with disabilities in Central America, and one of the participants of our program is training to be a psychologist and is a triple amputee. Triple. And you would almost never know it, thanks to amazing prosthetics. There are certainly several other specialties as well that he could work in if he was a physician, using his one good arm. I was also recently in London at the BodyWorlds exhibit (an incredibly fascinating anatomy exhibit of actual human bodies that have been plastinated... check out their website at bodyworlds.com) and I saw a woman who was blind, and she was allowed to feel the plastinates and could tell her friend exactly what anatomical feature she was feeling. She clearly is/was a health professional and knew her anatomy. I can't imagine having to learn by feel though in a traditional anatomy room. Plastinates would be much more effective. Anyway, "disability" is such a broad term, and we can't generalize about the 'abilities' of people with disabilities. If you think about it, the OMSAS policy below applies not only to dis-abled people, but to abled people as well. "the nature of a career in medicine makes great physical and mental demands. The ability of the applicant to meet and cope with the demands of practicing medicine will be evaluated on an individual basis and may affect the chances of being admitted. Admission may be restricted to individuals that will be able to realistically meet the expectations of a career in medicine as judged by the admissions committee" Med school is not for everyone, no matter how "abled" we are. That said, I do hope (selfishly and for many of you) that the admissions committee thinks that it's for us. We'll see. :b Cheers, Tirisa Link to comment Share on other sites More sharing options...
Guest mying Posted February 2, 2003 Report Share Posted February 2, 2003 I don't think the original poster was asking about learning disabilities, since they specifically said "Not a learning disability." Which doesn't preclude there being discussion about cognitive and learning differences... just that they didn't ask about them. Link to comment Share on other sites More sharing options...
Guest mumfirst Posted February 2, 2003 Report Share Posted February 2, 2003 What a great thread this is! It's great to see that so many doctors-to-be are so open minded about the disAbilities of others and can focus on an individual's strengths. My daughter has mild cerebral palsy and says that she wants to be a doctor when she grows up - maybe it is because she knows that mummy is trying to get into "doctor school", but I will be the first one to encourage her to pursue ANY career that she chooses. I certainly hope that an awkward and laboured gait will not be considered a "handicap" by any potential employers (or med adcoms)! One of the most respected and well known doctors in childhood C.P. is Dr. Brunstrom. She practices in Washington and her expertise is in pediatric neurology. BTW, she has cerebral palsy! Link to comment Share on other sites More sharing options...
Guest macdaddyeh Posted February 2, 2003 Report Share Posted February 2, 2003 What a great opportunity to procrastinate. Hey mumfirst, you go girl! (And your daughter too!). It will be enough of a challenge in itself to be a parent in med school, but that is a discussion for another thread... BTW, did any of you see the recently released movie (now available for rental) entitled "Door to Door" about a salesman named Bill Porter who has cerebral palsy? Great movie; though not very heavy about medical issues, it is a must see in terms of how we categorize one's disability... Link to comment Share on other sites More sharing options...
Guest mying Posted February 2, 2003 Report Share Posted February 2, 2003 The doctor who was a major part of my decision to go into medicine has mild CP. She wrote me a reference letter for my second round of applications. She's a fireball. Absolutely incredible. I always think of her as ten feet tall and with the speed of a locomotive... in fact, she's quite short but the speed part is true. I envy all the Toronto students who may get a chance to work with her. Link to comment Share on other sites More sharing options...
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