Abstract

To conduct a post-Americans with Disabilities Act Amendments Act multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWD).From June to December 2020, the authors conducted a matched cohort study of SWD and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S. MD-granting medical schools. Each SWD was matched with 2 controls, one from their institution and, whenever possible, one from their cohort for Medical College Admission Test score and self-reported gender. Outcome measures included final attempt Step 1 and Step 2 Clinical Knowledge scores, time to graduation, leave of absence, matching on first attempt, and matching to primary care.A total of 171 SWD and 341 controls were included, the majority of SWD had cognitive/learning disabilities (118/171, 69.0%). Compared to controls, SWD with physical/sensory disabilities had similar time to graduation (88.6%, 95% confidence interval [CI]: 77.0, 100.0 vs 95.1%, 95% CI: 90.3, 99.8; P = .20), Step 1 scores (229.6 vs 233.4; P = .118), and matched on first attempt (93.9%, 95% CI: 86.9, 100.0 vs 94.6%, 95% CI: 91.8, 97.4; P = .842), while SWD with cognitive/learning disabilities had lower Step 1 scores (219.4; P < .001) and were less likely to graduate on time (81.2%, 95% CI: 69.2, 93.2; P = .003) and match on first attempt (85.3%, 95% CI: 78.0, 92.7; P = .009). Accommodated SWD had Step 1 scores that were 5.9 points higher than nonaccommodated SWD (95% CI: -0.7, 12.5; P = .08).Structural barriers remain for SWD with cognitive/learning disabilities, which could be partially mitigated by accommodations on high-stakes exams.

View details for DOI 10.1097/ACM.0000000000004510

View details for PubMedID 34817411