• Accommodation eligibility review.
• Reasonability determinations and implementation with faculty.
• Ongoing faculty and staff education.
• Advice on accommodation efficacy and disability management.
• Supporting students through applying for accommodations on licensure exams.
• Referrals to community and support such as advocacy organizations, disability inclusion initiatives, and assistive technology tools.

MD and MSPA students in need of academic accommodations should initiate a request with the office of Disability Resources. Start by filling out a confidential Student Information Form or emailing disabilityresources-omsa@stanford.edu.

Documenting a Disability

Disclosure of disability is a deeply personal decision. Stanford University School of Medicine is committed to disability inclusion and compliance with the Americans with Disabilities and its Amendments Acts and Section 504 of the Rehabilitation Act. Documentation submitted to Disability Resources stays confidential within secure storage.

Disability Resources and the Office of Accessible Education share the same documentation requirements and privacy standards.

Generally, all documentation must be:

1. Translated into English, typed on letterhead, include the title and credentials (including relevant licensing information), dated, and signed.
2. Prepared by appropriate qualifying professionals with comprehensive training and direct experience providing health services and/or treatment to the student.
3. Documentation from a family member or someone with a personal relationship with the student (although they may be qualified by training and licensure) will not be accepted.

Documentation Should Include:

1. Summary of the professional relationship to the student, including duration of time providing care, identification of assessment instruments, testing procedures, or other methods of evaluation. Original referral information can also be helpful.
2. Current disability, including diagnosis and diagnostic code(s).
3. Relevant medical, developmental, cognitive, and/or psychosocial history.
4. Severity of the condition and, if applicable, prognosis or expected duration of disability.
5. Information regarding treatment plan, necessary elements of daily living, disability management, medication and possible side-effects.
6. Description of the current functional limitations experienced as a result of the condition. This should address the student’s disability experience in such a way that adequately illustrates substantial limitations on one or more life activities in an academic setting.
7. Recommended accommodations and rationale that directly ties the accommodation(s) need to the functional limitations of the disability.

Accommodation determinations are made by the Director of Disability Resources. Sometimes, a requested accommodation may be considered appropriate in some educational contexts but not be as reasonable in others (for example, didactic accommodations will be different than clerkship accommodations and each clerkship and clerkship site will have its own structure and outcomes).   

The right to the interactive process includes thorough consideration of each accommodation, in each educational environment, as needed and in close collaboration with faculty. All accommodation denials will be made in writing and accompanied with reasoning in addition to an invitation to meet to identify alternative reasonable accommodations.   

Disagreements with accommodation determinations will be referred to the University ADA/Section 504 Grievance procedure.  

Stanford-Specific Organizations & Resources

Clerkship Resources for MD Students outlines general information about clerkship sites, schedules, call schedules, and teaching sessions. This is very helpful for students who need to ensure they have adequate time for personal medical appointments,  

Stanford’s Medical Students with Disability and Chronic Illness (MSDCI) group is a chapter of the national MSDCI organization. Stanford MSDCI provides education, support, and advocacy with and for MD and PA students at Stanford Medicine. This includes educational events about accessibility in medicine and the challenges and benefits of becoming a clinician while living with disability/chronic illness, community-building opportunities, and advocacy efforts to increase resources and access for trainees with disability and chronic illness. To sign up for the Stanford MSDCI Listserv, please click here. For questions about Stanford MSDCI, please email stanfordmsdci-owner@lists.stanford.edu.

Stanford Medicine Alliance for Disability Inclusion and Equity is an advocacy organization, employee resource group, and network of healthcare professionals with disabilities and allies throughout the Stanford Medicine enterprise. SMADIE hosts annual conferences and promotes community, health equity, advocacy, research, mentorship and education in medicine.  

Stanford’s American Academy of Developmental Medicine and Dentistry (AADMD) Chapter aims to advocate for inclusive health and equitable inclusion of people with intellectual and/or developmental disabilities (I/DDs) in the healthcare system through events centered on awareness, amplifying the voices of people with I/DDs, and partnerships with Special Olympics Northern California.

National Organizations & Resources

MSDCI (Medical Students with Disability and Chronic Illness) National is a student-run nonprofit organization comprised of MSDCI Chapters from over 50 medical schools across the US and aims to develop community, engage in national advocacy efforts, create educational content, and increase accessibility. This organization offers virtual journal clubs, opportunities to be featured on their blog and social media, a 1:1 mentorship program, and more.

Disability in Medicine Mentorship Program is a grassroots movement that supports disabled healthcare professionals and trainees as they navigate the field of medicine. Through monthly virtual gatherings, members build self-advocacy skills and exchange disability-specific career advice among a supportive community of healthcare workers with disabilities.  

The Docs With Disabilities Initiative (DWDI) uses research, education, collective leadership and sharing of stories to drive change in perceptions, policy, and procedures in health professions, biomedical and science education. Through publications, podcasts, and professional development activities, DWDI’s aim is to build more inclusive educational environments for trainees with disabilities and increase representation of disabled clinicians and scientists.

Resources from the AAMC: The Association of American Medical Colleges (AAMC) maintains a list of resources specific to disability and accessibility in academic medicine. This includes webinars (as part of the “IDEAS: Inclusion, Diversity, Equity, and Anti-racism” Learning Series) and resource toolkits such as the Accessibility Resource Bundle.

Licensing exams are high stakes milestones in professional clinical education. The below is a distillation of the steps of USMLE and PANCE testing accommodation processes. Requesting accommodations can take a significant amount of time. Reach out for help as you are navigating the process.

Important tips:

1. Get started early. A 6-9 month lead-time is highly recommended
2. Work on medical documentation first. Your health providers will need time to evaluate or re-evaluate your condition, write letters of support, and document clinical evidence of impairment
3. Work with the OMSA Learning Specialist, MSPA Learning Specialist, or Director of Disability Resources, on your personal statement and application materials
4. Watch this Access in Medicine webinar on crafting a powerful personal statement
5. Don’t give up. Download and peruse AIM’s written guide to requesting accommodations on USMLE Step Exams includes extremely helpful resources for destigmatizing this process, navigating obstacles, and support letter templates

USMLE Step Exam Accommodations: Overview and Instructions

• Register for USMLE test(s)
  • During registration, indicate that you will be requesting disability accommodations; your scheduling permit will be released to you once you complete the disability accommodations application process
• Request a Certification of Identification and Authorization from the Registrar
• Download and complete a New Request for Test Accommodations form here
  • Specify which accommodations are being requested (extended time, additional breaks/shorter question sections, or exam splitting over multiple days)
• Write your personal statement
  
• Gather supporting documentation
  • Medical records, letters from treatment providers must meet NBME’s documentation guidelines and disability-specific requirements
  • Educational records that are relevant to your case might include MCAT score reports and historical accommodation information
• Request a Certificate of Prior Accommodation from Disability Resources
  
• Send all materials to NBME Disability Services via fax or email
  • Note: decisions can take up to 60 business days

   

NCCPA PANCE Testing Accommodations: Overview and Instructions

• Review NCCPA’s Policies and Procedures for Testing Accommodations
  • The policies document contains documentation requirements, accommodation implementation logistics, and tips for navigating the process
• Determine which accommodations you need
  • Options include extended time, more frequent/additional breaks, separate testing room, reader, specific medical devices, color contrast, font enlargement, or an adjustable workstation
• Complete the online Exam Accommodations Request form
• Submit medical documentation that meets the NCCPA’s guidelines via email
  • Updated medical documentation, completed within 12 months of the date of your application, is required
• Request a certificate of prior accommodation from Disability Resources
• Once your application is complete and reviewed, you will receive a decision from NCCPE’s exam accommodations office
  • You will be instructed to return an Accommodations Agreement form and then will receive instructions for scheduling at a testing center.

updated December 5, 2024