Disability left out of most U.S. pediatric medical training

By Louise Kinross

The topic of disability is lacking in six competencies used to assess medical residents and fellows training to care for children in the United States, according to a study published in JAMA Pediatrics last year.

Twenty four of 36 pediatric specialties, subspecialties and combined specialties had zero disability-related milestones to meet in patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills, professionalism, and systems-based practice.

The competencies are developed by the Accreditation Council for Graduate Medical Education.

Yes, disability was absent from the knowledge, skills and behaviours required to become a pediatrician, child neurologist, developmental-behavioural pediatrician, pediatric geneticist, neonatologist, pediatric critical care or emergency room doctor, and child and adolescent psychiatrist, to name a few. 

The subspecialties of neurodevelopmental disabilities and pediatric rehabilitation medicine and the combined pediatrics and physical medicine and rehabilitation "had numerous disability-related milestones, but child neurology and developmental-behavioural pediatrics” had none, the authors write, despite caring for children with disabilities “extensively.”

Not one of the 36 specialties reviewed had disability-related milestones in the areas of practice-based learning and improvement and systems-based practice. 

The lead author of the study was Dr. Amy Houtrow, chief of pediatric rehabilitation medicine services at the UPMC Children's Hospital of Pittsburgh. Her research with the DIVERSE Collective focuses on health equity for multiply marginalized children with disabilities, who are at risk of poor health.

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