I'm going to try to comment on both of your threads here.
Thoughts:
First, on accomodations during residency. Residency programs like all employers are required to make "reasonable" accomodations. There is a large body of discussion about what is "reasonable". The following two facts are clear:
A. Costs -- whether an accomodation is reasonable or not based upon costs is evaluated by looking at the entire employer. Hence, if you were to need some sort of specialized equipment costing $10,000, the standard would be whether the Hospital / System that has hired you could afford that, not whether the residency program could afford it.
B. Schedules / Work -- an accomodation cannot change the overall "key aspects of the job". What exactly the core aspects of the job are is unclear. I would say that taking overnight call would be a core aspect of the job. Some would argue that when you graduate you won't take overnight call, and hence it's not really a core aspect of being a physician -- but I think that's unreasonable, as taking overnight call is a core aspect of being a resident, even if that doesn't translate into your long term job (this raises the bigger question of whether residents should be responsible for overnight call at all, which is beyond this discussion).
So:
1. As others have mentioned, you have been vague so it is difficult to make assessments about what accomodations you need. I'll assume you have a chronic medical condition that could affect your ability to work, such as IBD. In that case:
A. If you became ill enough such that you could not work, I would put you on medical leave. I would expect each leave would be at least 1-2 weeks until your illness stabilized.
B. Continuity of patient care is a core aspect of the job. Hence, if you kept being ill requring coverage on a regular basis, this would not be acceptable. So, if you illness creates a situation where you are too ill to work on Monday, then OK Tues and Wed, then too ill on Thursday, etc, this would not be acceptable.
C. I would not be able to decrease the intensity of rotations -- i.e. I would not decrease your patient census, or your call schedule, etc.
D. I might consider spacing out your call blocks. I would consider a schedule that alternated call blocks with non call blocks. Of note, I would require that your complete the exact same number of call blocks as everyone else, so such a schedule would require extended training. I would only do this if it was clear that it would help your illness -- if with this schedule you still required medical absences, then I would put you on full leave until your medical condition was treated well enough that you could work this schedule.
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The title of your thread is "shared residecy spots" -- this would also be a reasonable option. It would assume that someone else who wants to share a spot is found, and we would need to deal with a continuity clinic in some way. This is not easy -- you'd only get 1/2 a salary, but I would be forced to pay full benefits for two people, which could be quite expensive. ADA law does not require that I create a shared spot -- if you cannot perform the core aspects of the position, I do not have to consider splitting the position across two people.
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Your other thread asks about being off cycle. If you took a leave of absence, you will likely be off cycle. This depends somewhat on the Board involved. In the ABIM situation, if you take a leave (if you miss more than 1 month of training including vacations in any year) you are off cycle and cannot get caught up -- you cannot forfeit vacations, etc. That being said, being off cycle isn't the kiss of death. Plenty of people end up off cycle (pregnancies, death in family, etc) and do just fine. You can still get a fellowship or job when off cycle.
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Some of your threads suggest that you may be terminated, and that you might be looking at legal action. This relates to what is stated above. The ADA does not exempt you from the core aspects of a position, and certainly cannot be used as an explanation for unsatsifactory work. Pursuing legal action against a program is often a losing battle -- they have deeper pockets than you, and you may only force them to take you back (and then they can find a way to fire you later).
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So really, it depends on what type of schedule changes you are looking for. Not taking call would seem unreasonable to me. Having a schedule with a decreased number of call blocks would be reasonable, but you should be prepared / offer to complete the same number of call blocks as everyone else. Hence, you would get more electives, but your training would be extended. Would this affect your chances of getting a fellowship? It depends -- perhaps not an outpatient one but certainly an inpatient focused one. Would it affect your ability to get a job? Probably not -- as you would be looking for a job that you could do full time and would play to your strenths.
