Kotla Aditya V, McCracken Ana, Gordon Darren, Davis Erik, Powers Mary T, Villa Aneli T, Shelton Julia, Aziz Hassan
University of Iowa Carver College of Medicine, Iowa City, Iowa.
Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa.
J Surg Res. 2024 Dec;304:280-286. doi: 10.1016/j.jss.2024.10.034. Epub 2024 Nov 21.
Disabilities affect a substantial portion of the US population, with mental health conditions being predominant. Despite the acknowledged challenges, there is a lack of data on disability prevalence among general surgery residents. This study aimed to compare the prevalence of disabilities in general surgery residents to the national benchmark, investigate the factors that prevent surgery residents from disclosing their disabilities, and assess the presence of a disability policy in a residency program.
A descriptive cross-sectional cohort study surveyed 198 general surgery residents from 323 programs using a 33-question conditional survey. The survey, distributed via mass email, covered demographics, disability status, disclosure practices, accommodation use, and awareness of disability policies and training.
Among respondents, 30.3% reported having a disability, higher than the national average. Although 83.9% of respondents reported that their disability has some impact on their ability to work, 62.9% of residents with a disability have not informed their program directors or administration. Moreover, many residents experienced negative outcomes due to their disabilities. Fear of discrimination and lack of transparency, among other factors, were major barriers to disclosure. Only 16.2% received disability training, and 75.3% were unaware of their program's disability policy or if one existed.
This study reveals significant gaps in disability policy and training within general surgery residency programs in the United States. Despite about 1 in 3 surgical residents reporting a disability, disability support seems lacking, impacting the health of residents and the care provided to patients. Furthermore, many residency programs do not comply with requirements and recommendations regarding disability policy from graduate education organizations. Enhancing transparency, providing robust support systems, and integrating disability awareness into training are crucial steps to improve resident experiences and promote inclusivity in surgical training programs.
残疾影响着美国相当一部分人口，其中心理健康状况最为突出。尽管存在公认的挑战，但普通外科住院医师中残疾患病率的数据却很缺乏。本研究旨在比较普通外科住院医师的残疾患病率与全国基准，调查阻碍外科住院医师披露其残疾情况的因素，并评估住院医师培训项目中残疾政策的存在情况。
一项描述性横断面队列研究使用一份包含33个问题的条件性调查问卷，对来自323个项目的198名普通外科住院医师进行了调查。该调查问卷通过群发电子邮件分发，涵盖人口统计学、残疾状况、披露做法、便利措施使用情况以及对残疾政策和培训的知晓情况。
在受访者中，30.3%报告有残疾，高于全国平均水平。尽管83.9%的受访者报告其残疾对工作能力有一定影响，但62.9%的残疾住院医师未告知其项目主任或管理人员。此外，许多住院医师因其残疾经历了负面结果。恐惧歧视和缺乏透明度等因素是披露的主要障碍。只有16.2%的人接受过残疾培训，75.3%的人不知道其项目的残疾政策或是否存在这样的政策。
本研究揭示了美国普通外科住院医师培训项目在残疾政策和培训方面存在重大差距。尽管约三分之一的外科住院医师报告有残疾，但残疾支持似乎不足，影响了住院医师的健康以及为患者提供的护理。此外，许多住院医师培训项目不符合研究生教育组织关于残疾政策的要求和建议。提高透明度、提供强大的支持系统以及将残疾意识纳入培训是改善住院医师体验并促进外科培训项目包容性的关键步骤。
