Pereira-Lima Karina, Meeks Lisa M, Nguyen Mytien, Sheets Zoie C, Jain Neera R, Stergiopoulos Erene, Addams Amy N, Moreland Christopher J, Boatright Dowin B
Acad Med. 2025 Jun 23. doi: 10.1097/ACM.0000000000006128.
Studies suggest that medical trainees often experience uncertainty regarding their alignment with institutional and legal definitions of disability, which is exacerbated by barriers to documentation, stigma-related concerns, and ableist societal perceptions. This study examines demographic characteristics and burnout outcomes among medical students uncertain about their disability status compared to those identifying as a person with a disability.
The authors analyzed data from second-year medical students identifying as having a disability (N = 2438) or reporting not knowing if they had a disability (N = 496) among the 27,009 participants in the 2019 and 2020 Association of American Medical Colleges Year-Two Questionnaire cohorts (AAMC-Y2Q). Burnout was measured using the Oldenburg Burnout Inventory for Medical Students. Demographic associations with disability status uncertainty and its relationship with burnout were examined through multivariable logistic regression.
Compared to White students, those identifying as Asian (OR: 3.36; 95% CI, 2.56-4.39), Black/African American (OR: 2.49; 95% CI, 1.71-3.59), Hispanic/Latino/Spanish origin (OR: 1.65; 95% CI, 1.14-2.36), and Multiracial (OR: 1.66; 95% CI, 1.22-2.24) had significantly higher odds of reporting disability status uncertainty. Asian students also had significantly higher odds than Hispanic/Latino/Spanish origin (OR: 2.03; 95% CI, 1.37-3.05), Multiracial (OR: 2.02; 95% CI, 1.44-2.86), or Other (OR: 2.64; 95% CI, 1.31-5.92) students. Male students had significantly higher uncertainty odds than females (OR: 1.31, 95% CI, 1.06-1.61). Disability status uncertainty associated with significantly greater odds of high burnout (OR: 1.28; 95% CI, 1.03-1.59).
Medical students uncertain about their disability status showed increased risk of burnout with differences by race, ethnicity, and gender underscoring the need for institutions to address structural and cultural barriers to seeking disability resources. Further research should investigate strategies for mitigating differences for medical students navigating disability and promoting well-being for all learners.
研究表明，医学实习生常常对自身是否符合机构和法律对残疾的定义感到不确定，而文件记录方面的障碍、与耻辱感相关的担忧以及社会对残障人士的歧视观念加剧了这种不确定性。本研究调查了与明确认定自己为残障人士的医学生相比，那些不确定自己是否有残疾的医学生的人口统计学特征和职业倦怠情况。
作者分析了2019年和2020年美国医学院协会二年级问卷队列（AAMC-Y2Q）的27009名参与者中，明确表示有残疾（N = 2438）或表示不知道自己是否有残疾（N = 496）的二年级医学生的数据。使用医学生奥尔登堡倦怠量表来测量职业倦怠。通过多变量逻辑回归分析了与残疾状况不确定性相关的人口统计学因素及其与职业倦怠的关系。
与白人学生相比，那些认定自己为亚裔（比值比：3.36；95%置信区间，2.56 - 4.39）、黑人/非裔美国人（比值比：2.49；95%置信区间，1.71 - 3.59）、西班牙裔/拉丁裔/西班牙裔血统（比值比：1.65；95%置信区间，1.14 - 2.36）和多种族（比值比：1.66；95%置信区间，1.22 - 2.24）的学生报告残疾状况不确定性的几率显著更高。亚裔学生报告残疾状况不确定性的几率也显著高于西班牙裔/拉丁裔/西班牙裔血统（比值比：2.03；95%置信区间，1.37 - 3.05）、多种族（比值比：2.02；95%置信区间，1.44 - 2.86）或其他（比值比：2.64；95%置信区间，1.31 - 5.92）的学生。男学生报告残疾状况不确定性的几率显著高于女学生（比值比：1.31，95%置信区间，1.06 - 1.61）。残疾状况不确定性与职业倦怠程度高的几率显著增加相关（比值比：1.28；95%置信区间，1.03 - 1.59）。
不确定自己残疾状况的医学生职业倦怠风险增加，且在种族、民族和性别方面存在差异，这突出表明各机构需要消除寻求残疾资源的结构性和文化障碍。进一步的研究应调查如何减少医学生在应对残疾问题上的差异，并促进所有学习者的幸福感。
