As I began my applications for residency, I wasn’t sure whether I should disclose my disabilities. I was fully aware of the biases in the medical field: beyond just stigma attached to disabilities, many adhere to the belief that physicians should be superhuman, immune to any health conditions or illnesses.
Would the medical community think my endometriosis and generalized anxiety disorder made me unfit to be a doctor? I was afraid that if I disclosed these conditions, my application would be tossed out and I would not match into residency.
But in the end, I chose to disclose my disabilities. And to my surprise, my experience has been positive, as I have found plenty of programs and residency leaders that value the unique perspectives I bring to the community as a future MD and resident. Here I will delve into the complexities of self-disclosure, explore the impact of intersectionality of marginalized identities, and discuss the importance of normalizing disabilities in the medical community.
A 2021 survey of 6,000 physicians in the U.S. found that 3% of respondents self-reported having a disability, with chronic health conditions and mobility issues being the most common. Furthermore, 9.2% of physicians with disabilities identified as members of underrepresented racial or ethnic groups in medicine. The Association of American Medical Colleges All Schools Summary Report indicated that an increasing number of graduating medical students are self-disclosing that they experience a disability, rising from 7.6% in 2020 to 9.3% in 2022. The most common conditions were ADHD, psychological disabilities, and chronic health disabilities.
The growing prevalence of incoming medical doctors who have a disability necessitates that the medical community become more cognizant of our colleagues living with a disability.
However, part of the issue is that medicine perpetuates a double standard: physicians are expected to be “super-heroes” who do not suffer from health conditions, yet they must be completely dedicated to the healthcare of others. The fear of being perceived as weak or “lazy” can contribute to imposter syndrome, particularly for individuals with already marginalized identities. These biases prevent physicians from publicly acknowledging their own health conditions, leading to a culture of secrecy and shame. Instead, we need to normalize the fact that physicians are human too.
My journey through medical school was marked by challenges, including failing Step 1, taking a leave of absence, and managing multiple health conditions diagnosed during my second year of medical school. My intersectionality of identities — being a Latina disabled woman — added another layer of stigma to overcome.
Feeling isolated in my struggles, I first opened up to a small group of classmates after discussing similar health conditions in class. One of my challenges throughout medical school was balancing my health and academics. For example, when we would have 3-hour exams without scheduled breaks, I would push my bladder and forgo bathroom breaks because I was worried about missing time for the questions. I’d sit for hours in excruciating pelvic pain, riddled with anxiety, which impacted my focus on the written material. In clinicals, my legs and low back would ache during long rounds, rendering me unable to focus on the presentation of patient information. However, once I worked with the Disability and Accessibility office, I was able to get accommodations such as set break times on exams and stools to sit on while doing walking rounds in the hospital.
To my surprise, I was met with an abundance of support and gratitude for my disclosure. This gave me courage to open up to the rest of my class through a written post on our group chat platform. I was able to connect with peers who were similarly struggling and who introduced me to the disabilities and accommodations world.
As I became more accepting of my challenges, I decided to disclose to an even wider audience through social media, my website, and most recently on a podcast. My vulnerability in sharing my experiences has allowed me to break down walls, find a supportive community (including physician mentors), and offer support to those who might be silently suffering.
My discussions with program directors, residents, attendings, and the disability community provided me with insights into the varying levels of acceptance across medical specialties and individual programs. My decision to disclose my health conditions in the initial application was fraught with challenges, as biases can affect the evaluation process.
On my application, I was terrified that my initial failure of Step 1 and taking a year off to care for my health conditions would lead a program to deny me an interview. Despite these potential “red flags,” I chose to include my health conditions in my application as I believed they contributed to my personal narrative as a future doctor. My experiences have provided me a unique perspective that allows me to foster empathy and connection with my patients. However, disability is just one aspect of my identity. Therefore, I didn’t focus on it in my residency application and instead expanded upon the various identities and values I hold that can help me better connect with my patients.
A Two-Way Street
Interviews and employment pose additional hurdles for physicians with disabilities. So, I knew it was important to make sure I found a supportive program. Any interview runs two ways.
While undergoing the residency interview process I focused on asking questions about available resources, the culture around taking sick leave, and how they have worked with previous residents who might share similar experiences. I want to choose a program that will train me to be the best doctor I can be.
Positive Results and Normalizing Disabilities
It’s essential that institutions understand the importance of hiring health providers with disabilities. We contribute to diversity, equity, and inclusion efforts at an institution, and may be able to better connect with some patients. Normalizing disabilities in the medical community is crucial to breaking down stereotypes and encourages a more empathetic and understanding healthcare environment.
In sharing my journey, I aimed to dispel the isolation that many medical students and doctors grappling with disabilities feel. Disabilities should not be viewed as something to be cured or fixed, but as facets of diverse identities. The medical community must recognize the humanity in everyone, promoting equity and providing fair opportunities for all to thrive. By embracing vulnerability and normalizing disabilities, we can foster a more compassionate and inclusive medical profession.
Stephanie Moss is a trauma-informed advocate and health disparities activist who will graduate with her MD in April 2024 from Rush Medical College in Chicago. She shares her experiences through narrative writing, public speaking, and on her podcast “Life as a Patient-Doctor.”