Disability in medical education: a gap that needs to be closed

I have been working in training skilled workers for years disability And yet it still surprises me that one of the most persistent barriers is neither technological nor architectural, but rather attitudinal.

If there is one idea that should guide all health training, it is that the disability lies not in the person himself, but in the interaction between that person and the barriers in the environment. These barriers also include – and we don’t always like to hear this – those of us who work in the healthcare sector. And that is a question of rights. Without talking about the convention that explicitly refers to it in the training of professionals, we can be facilitators or unintentionally obstacles. And this difference depends not only on the infrastructure or equipment, but also on our training and our attitude.

Today we’re talking about it accessibility physical, communicative, academic and, above all, attitudinal accessibility. The latter has to do with prejudices, stereotypes and social representations about the conditions of disability. And it is what determines whether a professional recognizes the other as a subject full of rights, with autonomy, desires and diverse ways of acting. Unfortunately, it is missing from most undergraduate curricula.

Disability and medical education

It is not necessary that every health professional student be proficient in sign language, braille or alternative communication systems; At this stage, it is essential that you understand the importance of accessibility. The details can be incorporated later, while also recognizing that each care service must have the necessary accessibility conditions to ensure fairness.

“The disability system is crashing, it is collapsing and we urgently need an answer.”

But we need them to understand something fundamental from day one: What is diverse is common. In everyday consultation, different committees, different paths and different types of communication coexist. If the professional does not start from this premise, he ends up forcing people to fit into a pattern.

It is not necessary that every health professional student be proficient in sign language, braille or alternative communication systems; “The most important thing is that you understand the importance of accessibility.”

If disability, accessibility and rights content is not addressed in undergraduate education, this could be interpreted as, perhaps unintentionally, privileging practice that is closer to a vision. biomedical This tends to reduce the person to a diagnosis.

And from there, paternalistic practices are inevitably made possible: talking to the partner, infantilizing, making decisions for the other, assuming that he cannot choose. However, people with disabilities have the opportunity to demonstrate their autonomy and if they need assistance in exercising this support, it is our duty to provide it and not to replace it. In my experience of training professionals from different disciplines, there is a moment that always repeats: when they understand that many “limitations” do not belong to the person, but to the system that accommodates them.

Paternalistic practices are made possible: talking to the partner, infantilizing, making decisions for the other, assuming that he cannot choose. However, people with disabilities have the opportunity to demonstrate their autonomy.”

The World Health Organization increasingly insists that health systems must be accessible, inclusive and person-centered. But in order for this recommendation to be put into practice, we need train capable specialists to do justice to diversity. Professionals responding to their own biases. Professionals who understand that accessibility is not a procedure but an ethics of the meeting. The good news is that this can be taught across disciplines. And when taught, it transforms, providing concrete ways to begin paying off an outstanding debt.

In short, it is not just about ramps, interpreters or protocols, but about professionals who look at the person in front of them and decide to accommodate them in all their uniqueness. The challenge is to build mutual inclusion, where professionals and patients feel part of the same community. And raising that awareness and interest starts in the classroom.