| December 24,
Does the Ivory Tower Need Ramps?
Penn Initiative Leads to Survey of Faculty Members
with Disabilities at Seven Medical Schools
PA) -- Doctors are among the first to recognize that
physical disabilities can occur at any point in an individual's
life, but even medical school faculty members facing
the onset of such a disability often keep it secret
for as long as possible, fearing discrimination from
their colleagues and academic officials when it becomes
That concern underscores the experience and expectations
of disabled medical faculty as they persevere in their
careers with "a silent and lonely tenacity,"
according to findings of a paper to be published in
the December 25 issue of the Journal of the American
Medical Association (JAMA).
"Anecdotal reports suggest that many medical faculty
members with disabilities decide against making their
condition known because they fear reprisals, particularly
the loss of professional opportunities such as tenured
positions," said Annie G. Steinberg, MD,
of the Department of Psychiatry at the University of
Pennsylvania School of Medicine. Steinberg co-authored
the study with Lisa I. Iezzoni, MD, MSc, of the Department
of Medicine at Beth Israel Deaconess Medical Center
and Harvard Medical School in Boston, Mass.
"Faculty members with disabilities bring a wealth
of personal insight and experience to medical teaching,
but they must be made to feel as welcome, comfortable
and secure as their able-bodied colleagues. They are
neither super-heroes nor more vulnerable than their
peers, but only require legally-mandated accommodations
to succeed, " Steinberg added. "Through the
daily example of their lives, they may remind students,
residents and attending colleagues that medicine is
about more than diagnosis, treatment and cure -- it
requires an understanding of chronic illnesses that
affect 100 million Americans."
The research paper, which is being published as a "special
communication" in JAMA, is an outgrowth of the
Penn Initiative 2000 project to examine quality of life
issues for the university's faculty. Steinberg, Iezzoni,
and their colleagues broadened their original work to
encompass seven medical schools throughout the country.
The findings raise questions of access and convenience
for academic medical professionals with
disabilities as they function within a political and
social context that the authors describe as increasingly
challenging. The 1990 Americans with Disabilities Act,
for example, offers no specific accommodation standards
but instead mandates "reasonable" efforts
by employers that will cause them no "undue hardship,"
thus leaving room for various legal interpretations.
For the nation's medical schools, the resulting legal
ambiguity is translated into a wide range of responses
-- from supportive teaching environments to professional
isolation. Often, disabled faculty face huge challenges
that escape the notice even of sympathetic colleagues.
One faculty member who uses a wheelchair told researchers
she had to refrain from eating or drinking at a reception
where she was the honoree because the auditorium where
the function was held had no wheelchair-accessible restroom.
Another said the head of her department will not offer
her a tenure-track position out of concern that it would
be too stressful, leaving her faced with a year-to-year
According to the survey, disabled medical faculty want
their institutions to move past those sorts of oversights
and misplaced, sterotype-based concerns. They believe
they could compete for promotions more successfully
with limited changes in academic criteria, such as extended
timelines for professional promotions and promotion
criteria that de-emphasize extensive travel. They also
believe they could benefit in their work from improvements
in physical access to teaching, research and clinical
sites, and the opportunity to modify their clinical
and teaching schedules.
"Now that we recognize these needs, academic medicine's
response to them will be a true indication of the values
and empathy we offer as members of the healing profession,"
Steinberg said. "It will also be part of the legacy
of example we will leave for those who come after us,
and one real measure of how we, ourselves, can expect
to be treated by medical professionals in the future."
Penn faculty also participating as researchers for the
survey were Alicia Conill, MD, of the Department
of Medicine, and Margaret Stineman, MD, FACRM,
of the Department of Rehabilitation Medicine. The study
was conducted through volunteer time and efforts.
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