Eidtson William H, Nguyen Mytien, Hodgens Tiffany M, Pereira-Lima Karina, Fancher Tonya L, Sheets Zoie C, Smeltz Lydia, Rastogi Suchita, Curry Raymond H, Jain Sharad, Green Charlene, Grabowski Christina J, Patwari Rahul, LaRochelle Jeffrey S, Francis John, Moreland Christopher J, Tarlanov Shami, Stauffer Catherine, Hardin Blake, Tolby Leah, Abrams Gabriel, Low Christine, Betchkal Rylee, Arnold Joanna, Coates Caitlyn, Park Yoon Soo, Meeks Lisa M, Kim Michael H
Acad Med. 2025 Oct 1;100(10S Suppl 1):S105-S112. doi: 10.1097/ACM.0000000000006125. Epub 2025 Jun 11.
Medical students with disabilities (MSWD) from racial and ethnic populations that are underrepresented in medicine (URiM) may experience disparate educational paths compared to their peers, including disruption during training. This study examined whether MSWD who are also URiM experienced disproportionate rates of unintended leaves of absence (LOA) or extended time to graduation (TTG) compared to those who are only URiM, only MSWD, or neither.
The authors analyzed data from 372 MSWD and 689 matched nondisabled controls across 9 U.S. MD-granting programs. Students were matched by gender, graduation cohort, and Medical College Admission Test scores. MSWD were categorized into cognitive, physical/sensory, and chronic health disabilities, while race/ethnicity was classified as underrepresented in medicine (e.g., American Indian/Alaska Native, Black/African American, Hispanic/Latino, or Native Hawaiian/Pacific Islander), Asian, or White. Likelihood of LOA and extended TTG outcomes were assessed using mixed-effect logistic regression models.
MSWD were 2.6 times more likely to take an LOA (25.0% vs 12.6%, P < .001) and 2.6 times more likely to have extended TTG than nondisabled peers (38.6% vs 21.9%, P < .001). URiM students were 1.7 times more likely to take an LOA (22.9% vs 15.3%, P = .01) and 2.1 times more likely to experience extended TTG than White students (36.2% vs 22.5%, P < .001). Adjusted analysis showed URiM MSWD were 5.9 times more likely to take an LOA (40.6% vs 13.4%, P < .001) and 4.9 times more likely to experience extended TTG than nondisabled White peers (56.4% vs 28.7%, P < .001).
URiM MSWD faced disproportionately heightened risks for academic disruptions in the form of LOA and extended TTG, underscoring the need for interventions that are more supportive of students with overlapping identities.
在医学领域代表性不足的种族和族裔群体中的残疾医学生（MSWD）可能与同龄人经历不同的教育路径，包括培训期间的中断。本研究调查了与仅为代表性不足群体、仅为残疾医学生或两者都不是的学生相比，同时属于代表性不足群体的残疾医学生是否经历了不成比例的意外请假率（LOA）或延长毕业时间（TTG）。
作者分析了来自美国9个授予医学博士学位项目的372名残疾医学生和689名匹配的非残疾对照的数据。学生按性别、毕业队列和医学院入学考试成绩进行匹配。残疾医学生被分为认知、身体/感官和慢性健康残疾，而种族/族裔被分类为医学领域代表性不足（例如，美国印第安人/阿拉斯加原住民、黑人/非裔美国人、西班牙裔/拉丁裔或夏威夷原住民/太平洋岛民）、亚洲人或白人。使用混合效应逻辑回归模型评估请假和延长毕业时间结果的可能性。
与非残疾同龄人相比，残疾医学生请假的可能性高2.6倍（25.0%对12.6%，P <.001），延长毕业时间的可能性高2.6倍（38.6%对21.9%，P <.001）。与白人学生相比，代表性不足群体的学生请假的可能性高1.7倍（22.9%对15.3%，P =.01），经历延长毕业时间的可能性高2.1倍（36.2%对22.5%，P <.001）。调整分析显示，与非残疾白人同龄人相比，代表性不足群体的残疾医学生请假的可能性高5.9倍（40.6%对13.4%，P <.001），经历延长毕业时间的可能性高4.9倍（56.4%对28.7%，P <.001）。
代表性不足群体的残疾医学生面临以请假和延长毕业时间形式出现的学业中断风险不成比例地增加，这凸显了需要采取更多支持具有重叠身份学生的干预措施。
