Internal medicine residents' self-described knowledge of general medical versus disability-focused concerns: An exploratory study.

Abstract

Background: The dearth of disability-focused education in United States residency programs fuels health care disparities faced by persons with disabilities (PWD). However, it has yet to be demonstrated that physicians-in-training feel less comfortable managing disability-specific health concerns than they do other medical conditions.

Objective or hypothesis: To assess Internal Medicine (IM) residents' level of comfort in managing disability-specific versus general internal medical (GIM) concerns. We hypothesized that: 1) IM residents are less comfortable managing disability-specific health conditions than other GIM conditions; 2) IM residents feel increasingly comfortable handling GIM conditions over the course of their training, but not in addressing disability-specific concerns, and; 3) prior exposure to PWD improves IM residents' comfort in managing disability-specific conditions.

Methods: An exploratory study utilizing a Likert Scale-based survey assessing IM residents' level of comfort in managing GIM and disability-focused conditions was developed then distributed through 3 IM programs. Main measures included residents' level of comfort in managing a variety of medical conditions, including those pertaining to the care of PWD. Data analysis included descriptive statistics, ANOVAs, and independent sample t-tests.

Results: The survey was distributed to 298 residents and 127 completed it (response rate of 42.6 %). Participants were less comfortable providing disability-focused care than GIM care. Upper-level residents were more comfortable than first-year residents in managing GIM conditions, but not in providing disability-focused care.

Conclusions: Internal medicine residents are inadequately trained to provide care for PWD. There is a need to incorporate disability-specific learning objectives into graduate medical program requirements and curricula.