Information for students with disabilities

By Rhona MacDonald senior editor, studentBMJ, London

Eleven UK medical schools still do not provide adequate disability related information on their websites despite being made aware of this a year ago, according to a new report the Sequel to Pushing the Boat Out.¹ The study, which also included dental and veterinary schools, is the follow up study to Pushing the Boat Out,² which was published a year ago. Both studies are part of the DIVERSE project (funded by the Higher Education Funding Council for England), which aims to improve the provision for disabled students in veterinary medicine, medicine, and dentistry.

Pushing the boat out

The focus of Pushing the Boat Out was how UK medical, dental, and veterinary schools differ in the information offered on their websites to potential applicants with disabilities. At that time, only 13 schools had information that could be considered anywhere near adequate for an applicant seeking disability related information. (Having information on a website can be considered a proxy for taking disability seriously.) This led the author, Anne Tynan, to undertake the follow up study, the Sequel.

Pushing the Boat Out was widely distributed. A copy was sent to every dean of all the UK medical, dental, and veterinary schools; professional bodies for medicine, dentistry, and veterinary medicine; disability organisations; and a wide range of other related organisations and individuals in the United Kingdom and abroad. It is therefore disappointing that although some improvements had been made, many schools still lack adequate information and differ widely in the information they offer. This led Anne Tynan to make yet more recommendations (see studentbmj.com).

Negative reactions

In her preface to the Sequel, Anne acknowledges that she received some negative comments from her first report:

• "The websites have no connection with what goes on in the real life of the schools. Everything is fine in the schools. There are no problems. We know what we are doing. We really don't need to take any notice of any of this."
• "This is quite alarming. All that this is going to do is raise people's hopes and land us in trouble. It's totally unrealistic--we really can't let in people who aren't up to it and will endanger the public. We need to keep this very low profile--it will only get worse if we respond."

Anne states: "Until it has become a well known fact that people with disabilities can work in health care, it is necessary to be repeated over and over again by each and every institution."

Admission policies

The information, including admission policy, on medical school sites differs from school to school. Recommendation 3 in the Sequel says, "There is an urgent need to ensure equality assessment and therefore opportunity for disabled applicants." It goes on to say that "serious consideration must be given to the respective roles of GPs [general practitioners], consultants, occupational health services, and disability services in the assessment of disabled applicants prior to entry."

Anne Tynan said: "I think that it is in the public's best interests for guidelines to be issued to schools. If the professional bodies determine the acceptable levels of competence, they should also accept responsibility for advising schools on the acceptability of what might be called 'alternative' methods of demonstrating or reaching the various aspects of competence. The alternative--that each school decides for itself--seems to me to be anarchic and certainly not in the best interests of students or patients."

The Royal College of Veterinary Surgeons (RCVS) has produced guidance on the admission of students with disabilities to the professional veterinary degree course, which includes advice about specific disabilities.³ For example, students with documented severe anorexia nervosa "could provide grounds for non-admission." Anne told Career Focus: "The RCVS guidelines are really just the start and will grow as the DIVERSE project proceeds. Even though limited, they have already proved their value for applicants, students, admissions staff, and even parents."

Responses to the Sequel

General Medical Council

Ben Griffiths, from the education section of the General Medical Council, says: "Our guidance on undergraduate medical education is already clear and firm--that students with a wide range of disabilities can achieve the necessary standards of knowledge, skills, attitudes, and behaviour. But we are keen to see how we can further demonstrate our support for students with disabilities."

He continues: "Currently, we are running a pilot to work out how we can best quality assure medical schools and we are specifically asking the volunteer schools to demonstrate their commitment to promoting equality and valuing diversity. We hope in this way to identify good practice that can be disseminated throughout the 28 medical schools in the UK."

Department of Health

On behalf of the Department of Health's equality and diversity in the medical workforce group, Paul Deemer says: "The Department of Health welcomes this report [the Sequel]." He continues: "We are currently considering the feedback from the consultation document on our overall equality and diversity strategy which is mentioned on page 85 of the report. We intend to issue a completed strategy document shortly--which will include a branch of work dedicated to addressing disability issues across the NHS."

BMA

George Rae, chairman of the BMA's equal opportunities committee says, "The BMA's equal opportunities committee has a remit to consider all areas of discrimination that can affect doctors in their work place and throughout their careers. This includes issues affecting students and doctors with disabilities. We welcome the publication of the Sequel, which highlights some of the key areas that still need to be addressed."

"The equal opportunities committee will be considering the recommendations in detail at its next meeting in April," George continues. "In the meantime, we believe that more should be done to encourage and support disabled medical students and doctors throughout their careers. In response, we are currently preparing a report on career barriers which will look at many of the issues that are of concern to under-represented groups of doctors, including disabled doctors who face barriers to their career progression."

The Council of heads of medical schools

Aideen Silke, policy officer at The Council of Heads of Medical Schools (CHMS), says, "CHMS firmly believes that disabilities should not be a bar to becoming a doctor and is working with the Occupational Health Physicians to consider medical (physical and mental) conditions in relation to core competencies for medical students. Following the conclusion of this work, CHMS will look to update its current principles for admission. In parallel the CHMS Education Committee has been considering experiences of Schools with students with disabilities both at admission and in progression through the course."

Visit studentbmj.com for the recommendations from Pushing the Boat Out and the Sequel

1. Tynan A. The sequel to pushing the boat out. Newcastle upon Tyne: LTSN-01 2004. www.ltsn-01.ac.uk/external_files/ pdfs/the_sequel.pdf
2. Tynan A. Pushing the boat out. LTSN-01: Newcastle upon Tyne, 2003. www.ltsn-01.ac.uk/ltsn_images/pdfs/ptbo_final. pdf
3. Royal College of Veterinary Surgeons. Guidance on the admission of students with disabilities to the professional veterinary degree course. RCVS: London, 2003. www.rcvs.org.uk/latestnews/pdf/dda_guidance.pdf