Does being disabled make you underrepresented in medicine (URM)?

[Zdawg1303]

Hi! I'm a sophomore at Hopkins studying public health with a physical disability. My main EC's are various disability advocacy projects in disability policy and digital accessibility at the state and national level for which I've received recognition for internationally. Even my public health research is disability-focused. I plan to apply to medical school in the 2024-2025 cycle (I graduate in Spring 2024) to become an advocate for others with disabilities within the healthcare system.

I am starting to think ahead about applying and I'm getting conflicting opinions on whether disclosing a physical disability and talking about your work in disability advocacy/growth as a person with a disability makes you underrepresented in medicine. All the stats say that doctors with disabilities are very rare (only about 3%), but I'm not sure if owning my disability identity would make me a URM (I'm second-generation Asian-American: Chinese and Vietnamese) or would it be a compelling narrative/potential X-factor for me. I'm also a little concerned that it could be a liability for med schools and maybe I should just not mention it (but it's going to be very hard to avoid since most of my EC's stem from my journey of living with a disability). I won't need too many accommodations, just clear masks and closed captioning on Zoom calls. Would love your guys' thoughts!

Some of my current stats (Two solid semesters of A's and A-'s, and then this past semester was a little rough with a C+ in orgo as I dealt with some family emergencies. I still have a while to go, so I'm hopeful I can raise it), I do not have an MCAT score yet.
cGPA: 3.70 sGPA: 3.64

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[Moko]

Hi! I'm a sophomore... with a physical disability. My main EC's are various disability advocacy projects in disability policy and digital accessibility at the state and national level for which I've received recognition for internationally. Even my public health research is disability-focused. I plan to apply to medical school in the 2024-2025 cycle (I graduate in Spring 2024) to become an advocate for others with disabilities within the healthcare system.

I am starting to think ahead about applying and I'm getting conflicting opinions on whether disclosing a physical disability and talking about your work in disability advocacy/growth as a person with a disability makes you underrepresented in medicine. All the stats say that doctors with disabilities are very rare (only about 3%), but I'm not sure if owning my disability identity would make me a URM or would it be a compelling narrative/potential X-factor for me. I'm also a little concerned that it could be a liability for med schools and maybe I should just not mention it (but it's going to be very hard to avoid since most of my EC's stem from my journey of living with a disability). I won't need too many accommodations, just clear masks and closed captioning on Zoom calls. Would love your guys' thoughts!

I'm guessing your disability is hearing impairment based on your requested accommodations.

AAMC defines underrepresented minorities (URMs) by racial and ethnic backgrounds and not by the presence of a disability. Instead of focusing on the URM designation, it is better to focus on the unique viewpoints that you bring to the table as someone who is thriving with a disability and has interacted extensively with the deaf and hard of hearing community. Your experience being hearing-impaired will contribute tremendously to the diversity and learning of the class. I certainly have learned a lot from a couple physician colleagues who have cochlear implants.

While subconscious biases will no doubt exist, the overall benefits of disclosing your disability will likely outweigh the negatives, especially when it's an important and obvious part of your narrative. Your academic performance and LORs will speak to your academic capabilities and interpersonal communication. And as you surmised, it will also be difficult to hide your disability based on your extracurricular activities and possibly your interview performance and contents of your LORs.

However, you need to ensure that you meet the technical standards put forth by medical schools. How severe is your hearing impairment (again, my assumption) and to what degree has it been corrected (if at all)? There will be many instances during your training in which you cannot rely on lip reading and/or closed captioning, e.g. when the conversation takes place by phone; when it's simply impractical for those around you to exchange into a clear mask for brief interactions during a hectic shift; when the other party can only wear an opaque respirator due to the standard N95 masks not fitting, etc. This would be my main concern. Just my thoughts and best of luck.

 

[Zdawg1303]

I'm guessing your disability is hearing impairment based on your requested accommodations.

AAMC defines underrepresented minorities (URMs) by racial and ethnic backgrounds and not by the presence of a disability. Instead of focusing on the URM designation, it is better to focus on the unique viewpoints that you bring to the table as someone who is thriving with a disability and has interacted extensively with the deaf and hard of hearing community. Your experience being hearing-impaired will contribute tremendously to the diversity and learning of the class. I certainly have learned a lot from a couple physician colleagues who have cochlear implants.

While subconscious biases will no doubt exist, the overall benefits of disclosing your disability will likely outweigh the negatives, especially when it's an important and obvious part of your narrative. Your academic performance and LORs will speak to your academic capabilities and interpersonal communication. And as you surmised, it will also be difficult to hide your disability based on your extracurricular activities and possibly your interview performance and contents of your LORs.

However, you need to ensure that you meet the technical standards put forth by medical schools. How severe is your hearing impairment (again, my assumption) and to what degree has it been corrected (if at all)? There will be many instances during your training in which you cannot rely on lip reading and/or closed captioning, e.g. when the conversation takes place by phone; when it's simply impractical for those around you to exchange into a clear mask for brief interactions during a hectic shift; when the other party can only wear an opaque respirator due to the standard N95 masks not fitting, etc. This would be my main concern. Just my thoughts and best of luck.

Hi! Thank you for your feedback. That all makes sense. I was born with severe conductive hearing loss in my left ear (essentially single-sided deafness) and I wear a Baha implant (similar to a Cochlear implant) that helps me participate fully except in really noisy situations. I rely on lipreading and asking people to repeat themselves a lot.

 

[Matthew9Thirtyfive]

I rely on lipreading and asking people to repeat themselves a lot.

This is going to be really difficult particularly in your clinical years for the foreseeable future as everyone is wearing masks. Every site I rotated at required medical grade masks and would not allow alternatives like clear masks. It will get really annoying for your preceptors and patients to have to constantly repeat themselves.

 

[Mr.Smile12]

Network (find a mentor?): AMPHL

Also: Access And Opportunity For People With Disabilities | HSM Coalition

NPR story (2018): Doctors With Disabilities Push For Culture Change In Medicine

 

[allseasons]

This is going to be really difficult particularly in your clinical years for the foreseeable future as everyone is wearing masks. Every site I rotated at required medical grade masks and would not allow alternatives like clear masks. It will get really annoying for your preceptors and patients to have to constantly repeat themselves.

yea, while I think OP would meet the technical standards on paper, becoming a doctor may be quite difficult.

 

[Moko]

Hi! Thank you for your feedback. That all makes sense. I was born with severe conductive hearing loss in my left ear (essentially single-sided deafness) and I wear a Baha implant (similar to a Cochlear implant) that helps me participate fully except in really noisy situations. I rely on lipreading and asking people to repeat themselves a lot.

If your implant and adaptations to your hearing loss allows you to "participate fully except in really noisy situations", then I think you will be fine. However, when you state "I rely on lipreading and asking people to repeat themselves a lot", that does give me (and others) some pause as it suggests that you remain fairly impaired despite your implant.

Once you turn to face someone (possibly with your right ear slightly 'forward') and they repeat themselves once, can you carry on a conversation without lipreading and more repetition? As @Matthew9Thirtyfive said, having to constantly repeat oneself during the same conversation is disruptive, and some patients may simply stop talking with you altogether out of frustration.

If you are not truly reliant on lipreading and do not require others to repeat themselves multiple times during a conversation, then much more care needs be taken when describing your current level of impairment as to avoid unnecessarily raising concerns, i.e. don't downplay but also don't exaggerate the degree of your impairment.

As a medical student, you won't be put in any essential role in which you must operate under "really noisy situations". But as a resident and attending, you will be called to respond to emergencies where you are expected to lead the team despite the surrounding chaos. If you are unable to do this reliably, that will likely limit the specialties that you can pursue without being a liability to the hospital (e.g. emergency medicine will be on the 'noisy' end of this spectrum). Just my thoughts.

 

[Zdawg1303]

Network (find a mentor?): AMPHL

Also: Access And Opportunity For People With Disabilities | HSM Coalition

NPR story (2018): Doctors With Disabilities Push For Culture Change In Medicine

Thank you for sharing all of that info! I actually know a few of the people in the NPR article. I will reach out to those organizations.

 

[WildWing]

One of the video AMAs we did this year on the SDN Youtube channel was with a pediatric PM&R physician, Dr. Christopher Lunsford, who also has hearing loss. He spoke specifically about recommendations for disabled premeds (link goes directly to the question):



He's active on Twitter if you want to reach out: https://twitter.com/CLunsfordMD

We also interviewed the Coalition for Disability Access in Health Science and Medical Education back in 2016. They might also be able to provide insight and suggestions:

 

[Zdawg1303]

If your implant and adaptations to your hearing loss allows you to "participate fully except in really noisy situations", then I think you will be fine. However, when you state "I rely on lipreading and asking people to repeat themselves a lot", that does give me (and others) some pause as it suggests that you remain fairly impaired despite your implant.

Once you turn to face someone (possibly with your right ear slightly 'forward') and they repeat themselves once, can you carry on a conversation without lipreading and more repetition? As @Matthew9Thirtyfive said, having to constantly repeat oneself during the same conversation is disruptive, and some patients may simply stop talking with you altogether out of frustration.

If you are not truly reliant on lipreading and do not require others to repeat themselves multiple times during a conversation, then much more care needs be taken when describing your current level of impairment as to avoid unnecessarily raising concerns, i.e. don't downplay but also don't exaggerate the degree of your impairment.

As a medical student, you won't be put in any essential role in which you must operate under "really noisy situations". But as a resident and attending, you will be called to respond to emergencies where you are expected to lead the team despite the surrounding chaos. If you are unable to do this reliably, that will likely limit the specialties that you can pursue without being a liability to the hospital (e.g. emergency medicine will be on the 'noisy' end of this spectrum). Just my thoughts.

How I best hear and communicate with others changes depending on the situation (aka I do both things you described above) so that's why I didn't explain it well in my previous posting. I will be sure to clear that up throughout the application process and whenever I get to medical school. I'll also ask for advice from my mentors here at Hopkins.

 

[Goro]

yea, while I think OP would meet the technical standards on paper, becoming a doctor may be quite difficult.

I had a student with a similar disability. He's a doctor now.

Don't speak unless you know.

 

[Proudfather94]

Hi! I'm a sophomore at Hopkins studying public health with a physical disability. My main EC's are various disability advocacy projects in disability policy and digital accessibility at the state and national level for which I've received recognition for internationally. Even my public health research is disability-focused. I plan to apply to medical school in the 2024-2025 cycle (I graduate in Spring 2024) to become an advocate for others with disabilities within the healthcare system.

I am starting to think ahead about applying and I'm getting conflicting opinions on whether disclosing a physical disability and talking about your work in disability advocacy/growth as a person with a disability makes you underrepresented in medicine. All the stats say that doctors with disabilities are very rare (only about 3%), but I'm not sure if owning my disability identity would make me a URM (I'm second-generation Asian-American: Chinese and Vietnamese) or would it be a compelling narrative/potential X-factor for me. I'm also a little concerned that it could be a liability for med schools and maybe I should just not mention it (but it's going to be very hard to avoid since most of my EC's stem from my journey of living with a disability). I won't need too many accommodations, just clear masks and closed captioning on Zoom calls. Would love your guys' thoughts!

Some of my current stats (Two solid semesters of A's and A-'s, and then this past semester was a little rough with a C+ in orgo as I dealt with some family emergencies. I still have a while to go, so I'm hopeful I can raise it), I do not have an MCAT score yet.
cGPA: 3.70 sGPA: 3.64

I would put disadvantaged and explain in the essay that's what I did

 

[crimsonly]

Medicine in theory is a progressive field but its practice environment can be incredibly ableist. If you spin your disability in a way that shows your mindfulness for other people with disabilities (or as an advocate for those with disabilities who are unable to advocate for themselves) that can be seen as a huge asset.

 

[Matthew9Thirtyfive]

I had a student with a similar disability. He's a doctor now.

Don't speak unless you know.

No need to be rude. He said it may be difficult, which it very well may be in the age of everyone wearing masks and having a significant hearing loss that relies on lip reading and repetition.

 

[Browns99]

I had a student with a similar disability. He's a doctor now.

Don't speak unless you know.

All he/she said was that, it would be quite difficult, and I assume it likely will, so your comment was a little harsh to be honest.

 

[Med Ed]

Hi! Thank you for your feedback. That all makes sense. I was born with severe conductive hearing loss in my left ear (essentially single-sided deafness) and I wear a Baha implant (similar to a Cochlear implant) that helps me participate fully except in really noisy situations. I rely on lipreading and asking people to repeat themselves a lot.

Do you ever use sign language?

 

[deleted1100659]

I had a student with a similar disability. He's a doctor now.

Don't speak unless you know.

I would second this. There are many doctors out there with hearing impairments. If physicians couldn't practice with hearing impairments, then most of the psychiatrists would be retired right now, since the vast majority are >55 years old.

Most schools will make accommodations, pre clinical and clinical years. The vast majority of attendings wouldnt sit there and watch someone with an impairment suffer through their clinicals.

 

[Zdawg1303]

Do you ever use sign language?

Hi! I do not use sign language. I use listening/spoken language. I am currently learning ASL in classes right now, but just a beginner right now.

 

[allseasons]

I would second this. There are many doctors out there with hearing impairments. If physicians couldn't practice with hearing impairments, then most of the psychiatrists would be retired right now, since the vast majority are >55 years old.

Most schools will make accommodations, pre clinical and clinical years. The vast majority of attendings wouldnt sit there and watch someone with an impairment suffer through their clinicals.

I was going by the OP's comment that he does a lot of lip reading. I didn't realize that was "only in noisy situations", thought he/she meant more generally.

But yea, best of luck to OP! As others have said, maybe consider staying away from "noisy" specalties, but your choice and I wish you best of luck!

 

[hmockingbird]

I had a student with a similar disability. He's a doctor now.

Don't speak unless you know.

Same. I know multiple physicians with hearing loss, hearing aids, etc.

 

[Mr.Smile12]

I am a medical student with significant hearing loss. Here’s what the pandemic has been like for me and others with my disability

Masking, social distancing, and Zoom have made us all safer during the pandemic, but those measures have complicated communication for those with hearing loss.

www.aamc.org

 

[Zdawg1303]

I am a medical student with significant hearing loss. Here’s what the pandemic has been like for me and others with my disability

Masking, social distancing, and Zoom have made us all safer during the pandemic, but those measures have complicated communication for those with hearing loss.

www.aamc.org

Thank you! I got in touch with her after one of my mentors sent the article to me.

 

[M_C]

Hi OP, thank you for your vulnerability in your post, as someone living with a neurological disability (movement disorder) and applying to medical school this year, I resonate with everything you are feeling. While the experiences of people within the disability community definitely vary, I can share my experience in hopes that it is helpful and encouraging for you!

To preface, I am currently applying this cycle and I have had 5 interviews, with 3 acceptances (1 T5, and 1 T20). I share this as someone who fully disclosed my disability, made disability advocacy and awareness a central theme of my essays, PS, activities and spoke about this heavily in my interviews. When I was applying, I also got a lot of conflicting advice on whether or not to disclose. Many people (in the medical field, and outside of it),, warned that disclosing I had a movement related disorder would immediately eliminate me from medicine because it would be "dangerous". People told me to maybe consider a different field, because it would be too difficult. And they said that if I disclosed this, it would only be putting me at a disadvantage.

However, disability advocacy has been a huge part of my life for many years! I'm involved with national organizations to spread awareness about my disability, and I have given so many presentations to schools and programs across the nation to help supports students with my disorder. I also faced a lot of challenges when receiving medical treatment, including being misdiagnosed for several years. So, to me, how could I NOT write about this in my application?

The advice I have is to just trust yourself, and to block out the noise of what other people are saying. I've found that many people who try to comment on what it's like to apply with a disability, often do not have any personal experience with living with a disability. In my opinion, while it has been very difficult, I've still been successful in research, clinical and professional settings despite needing extra accommodations or working through things a little differently, and that's okay! Diversity in the medical profession also means making the field more accessible to people with disabilities. We can bring a lot to the table, we've had to persevere and stay resilient through many obstacles, navigate a lot of social stigma, and we've developed a lot of self-reflection to accept ourselves and our differences.

To summarize, all I have to say is, disclose everything, be yourself, and pursue your passions! I spoke about my story 100% authentically, with passion and it most definitely paid off with acceptances to some great schools. Is it possible I was rejected from some programs because I disclosed my disability? Maybe, I'll never know. But honestly, if a school rejected me because of my disability, I wouldn't want to attend that institution anyways. I resonate with you completely, it's a tough position to be in because there are not many success stories out there for us to use as a model, but there are some! I have full faith in you, keep on working hard, and proud of the resilience you've shown. I think you should not be afraid to be 100% authentic in applications, if you ever need anything, feel free to reach out!

 

[Zdawg1303]

Hi OP, thank you for your vulnerability in your post, as someone living with a neurological disability (movement disorder) and applying to medical school this year, I resonate with everything you are feeling. While the experiences of people within the disability community definitely vary, I can share my experience in hopes that it is helpful and encouraging for you!

To preface, I am currently applying this cycle and I have had 5 interviews, with 3 acceptances (1 T5, and 1 T20). I share this as someone who fully disclosed my disability, made disability advocacy and awareness a central theme of my essays, PS, activities and spoke about this heavily in my interviews. When I was applying, I also got a lot of conflicting advice on whether or not to disclose. Many people (in the medical field, and outside of it),, warned that disclosing I had a movement related disorder would immediately eliminate me from medicine because it would be "dangerous". People told me to maybe consider a different field, because it would be too difficult. And they said that if I disclosed this, it would only be putting me at a disadvantage.

However, disability advocacy has been a huge part of my life for many years! I'm involved with national organizations to spread awareness about my disability, and I have given so many presentations to schools and programs across the nation to help supports students with my disorder. I also faced a lot of challenges when receiving medical treatment, including being misdiagnosed for several years. So, to me, how could I NOT write about this in my application?

The advice I have is to just trust yourself, and to block out the noise of what other people are saying. I've found that many people who try to comment on what it's like to apply with a disability, often do not have any personal experience with living with a disability. In my opinion, while it has been very difficult, I've still been successful in research, clinical and professional settings despite needing extra accommodations or working through things a little differently, and that's okay! Diversity in the medical profession also means making the field more accessible to people with disabilities. We can bring a lot to the table, we've had to persevere and stay resilient through many obstacles, navigate a lot of social stigma, and we've developed a lot of self-reflection to accept ourselves and our differences.

To summarize, all I have to say is, disclose everything, be yourself, and pursue your passions! I spoke about my story 100% authentically, with passion and it most definitely paid off with acceptances to some great schools. Is it possible I was rejected from some programs because I disclosed my disability? Maybe, I'll never know. But honestly, if a school rejected me because of my disability, I wouldn't want to attend that institution anyways. I resonate with you completely, it's a tough position to be in because there are not many success stories out there for us to use as a model, but there are some! I have full faith in you, keep on working hard, and proud of the resilience you've shown. I think you should not be afraid to be 100% authentic in applications, if you ever need anything, feel free to reach out!

I really appreciate you sharing your story. It's taken me a lot of time to "own" my disability and be proud of it, so I'm glad I don't have to hide such a large part of my identity during the most important application process (so far) of my career. That makes me feel a lot better and I will be sure to reach out if I have any questions.