Holmes Cheryl L, Bulk Laura Yvonne, Lear Naomi, Ashdown Lynn, Clarke Quinten K, Farrell Laura, Giddings Rachel, Graves Lisa, Hanes Julia Ersilia, Kim George, Quon Michael, Razack Saleem, Rizzuti Francesco A, Ruddy Ginger, Scott Alex, Stergiopoulos Erene, Toner Lee, Nimmon Laura
Acad Med. 2025 Jun 24. doi: 10.1097/ACM.0000000000006132.
A socially accountable physician workforce must include disabled learners and providers. However, current Canadian Technical Standards (TS) for medical school admissions create barriers to their inclusion. These standards overlook advances in assistive technology, universal design, evolving inclusion practices, and legal protections. Replacing the TS required consensus, but traditional methods of achieving consensus on disability inclusion risk reinforcing ableism in medical education. To address challenges with existing TS, the Association of Faculties of Medicine of Canada (AFMC) formed the "Re-envisioning TS Working Group," using a novel consensus approach grounded in disability inclusion and critical disability discourse. Guided by transparency, accessibility, and respect for disability as diversity, the group prioritized engagement with disabled physicians, educators, scholars, and learners. The WG followed five stages: (1) identifying key concepts and reviewing literature on TS reform and ableism; (2) examining relevant legislation and case law; (3) drafting functional Core Competencies; (4) consulting partners across the medical education continuum; and (5) presenting outcomes to the AFMC Board, highlighting a commitment to disability inclusion in undergraduate medical education. The AFMC Board unanimously endorsed the "Report on Re-Envisioning Technical Standards," including the "Desired Outcomes" and the "Core Competencies for Entering Medical Students." The AFMC's adoption of functional Core Competencies is a significant step toward inclusion and support for learners with disabilities in Canadian medical education. Medical schools should adopt these competencies, combat ableism, and invest in universal design to promote access. Accommodation support should extend from admission through postgraduate training to independent practice. Finally, efforts to foster an inclusive culture and contribute to a healthy, diverse physician workforce must be evaluated as part of medical schools' social accountability mandate.
一支具有社会责任感的医生队伍必须包括残疾学习者和从业者。然而，加拿大目前的医学院入学技术标准（TS）为他们的融入设置了障碍。这些标准忽视了辅助技术、通用设计、不断发展的融合实践和法律保护方面的进步。取代技术标准需要达成共识，但在残疾包容方面达成共识的传统方法有可能强化医学教育中的能力主义。为应对现有技术标准带来的挑战，加拿大医学院协会（AFMC）成立了“重新构想技术标准工作组”，采用一种基于残疾包容和批判性残疾话语的全新共识方法。在透明度、可及性以及将残疾视为多样性并予以尊重的指导下，该小组将与残疾医生、教育工作者、学者和学习者的参与置于优先地位。工作组遵循了五个阶段：（1）确定关键概念并审查有关技术标准改革和能力主义的文献；（2）研究相关立法和判例法；（3）起草功能性核心能力；（4）咨询医学教育连续统一体中的各方合作伙伴；（5）向AFMC董事会汇报成果，强调在本科医学教育中对残疾包容的承诺。AFMC董事会一致批准了“重新构想技术标准报告”，包括“预期成果”和“医学新生核心能力”。AFMC采用功能性核心能力是加拿大医学教育朝着包容和支持残疾学习者迈出的重要一步。医学院校应采用这些能力，对抗能力主义，并投资于通用设计以促进可及性。住宿支持应从入学延伸至研究生培训，直至独立执业。最后，培养包容文化并为打造一支健康、多样的医生队伍做出贡献的努力，必须作为医学院校社会问责使命的一部分进行评估。
