Different support systems, persistent stigma: disability inclusion experiences in US and Canadian medical education

Abstract

Legal obligations and social justice commitments demand equal access to medical education for disabled learners, yet significant barriers remain. Cross-national exploration of disability inclusion efforts in medical education could offer progressive insights but are nascent. We conducted a collective case study of disability inclusion experiences among US and Canadian medical students. Taking data from two extant studies (one US, one Canadian) as cases, we employed constructivist grounded theory techniques to analyze 20 interviews with disabled medical students. Our analysis revealed that learner experiences differed across the two cases according to disability service harmonization (formalization and embeddedness within the medical school), with associated ripple effects. Although greater harmonization of disability services was associated with improved experiences of accessing accommodation, disability stigmatization persisted nevertheless. We suggest that beyond meeting current legislated requirements for accommodations, anti-ableist culture change and a turn toward universal design are necessary foci to achieve inclusive medical education.