Monday, April 19, 2010

MiM Mailbag: Medical school, with a disability

Hi, MiM!

I'd like to start by saying that your blog inspires me each and every time there is a new post or I just can have a moment to pop in and read the archives! Way to go, ladies! Now, I'm Erin, a pre-medical student from Georgia. My case is a little special.

I'm a music therapy major with a pre-medicine advising track. For many reasons, but the main one is the fact that math and science are just not my thing. Having mild spastic cerebral palsy, I didn't know what was possible or if that was even something I should consider due to physical issues.

Then I realized. It's not about me; yes, I'm the one that has to complete the coursework and get the MD behind my name, but the patients that I serve are so much more important than whether or not I think I'm academically capable. I'm not saying that your GPA isn't important because I know that it's one of the biggest things that med schools consider during the admissions process, but it's more important to me to treat my patients with the highest quality of care possible, keeping in mind that though the human body is fascinating, the fact that I'm making sutures in an abdomen isn't "cool"; though unintentionally, i am inflicting pain upon this patient, and why would I think it was "cool" to see the reason for someone's suffering to unfold? I guess that just comes with having twenty years of clinical experience "from the other side of the table" and unfortunately, for nine of those times in the last twenty years, the surgical patient was me.

Currently, my medical school interest in terms of specialty is physical medicine and rehabilitation, so Fizzy's articles are some of my favorites. I'm toying with the idea of taking a fellowship in peds and then adding on a fellowship in developmental peds so that I have the opportunity to be the doctor I wish I had when I was younger, and besides that, they're just cute.

So, while this may be going out on a bit of a limb, my questions are these:

How do you think is the best way to approach a disability in front of the medical school staff?

Which parts of the process, based on what you all know, will be difficult for me?

How should I "keep my head high" despite obstacles I face?

Oh, and I'm a blogger as well. Feel free to check it out at the link below. Look forward to more of your tweets and blogs!

Thanks, ladies!


  1. Erin,

    PM&R is definitely a good choice for med students with disabilities. In my residency, there were two attending physicians who were wheelchair-users: a paraplegic and a quadriplegic. Physicians are desperately needed right now in pediatric rehab.

    It's hard for me to predict exactly what issues you will face. I think most med schools are pretty good about accommodating disability, but I think the bigger issue is the occasional asshole who just can't deal with anyone they perceive to be "getting away with something." Every woman who's had a child as a physician has dealt with a person like that at some point. There was a student at my school who had MS and was told outright by an attending that she should "seriously reconsider" being a doctor. If you go into the process knowing you're going to face idiots like this at some point, it might be easier to deal with.

    In any case, you can take comfort in knowing you're not a trailblazer. There are lots of med students with disabilities who you can use as resources when the time comes. You might also want to check this out:

    Good luck!

  2. There's a pretty famous PM&R faculty member I've met who uses a wheelchair. Not sure what her disability is, however. Her research is interesting too.

  3. I know a great child psychiatrist who is in a wheelchair since his early twenties after an extended post-viral/flu vaccine (?) Guillain-Barre syndrome.

    Not to belittle what you have in front of you, but I think we all face obstacles in med school based on past experiences - whether physical or emotional. I think your own story will bring a lot to the table to offer your patients in terms of empathy and ethics that many students lack, so you will definitely have an advantage there.

    Good luck!

  4. Erin -
    You should not let a physical disability drive you away from medicine and I agree that you would have much to offer patients from your personal experiences.
    My worry is your non-diability related comment that "math and science are just not my thing".
    If these subjects have been difficult for you in the past, then take the entry level courses and get any needed tutoring, and as your abilities and confidence advance you will progress to the courses you need. If, however, you truly do not enjoy these subjects, I think medical school would be a burdensome task. You don't have to major in math or science (I didn't), but the core courses you need should not be an intolerable burden for you.

  5. Thank you all for your input, and thank you for your encouragement. A special shoutout to KC for posting the letter!

    Now, here's my attempt to address all of your concerns in one comment!

    The truth is that there are many, many physicians out there with disabilities. One major influence in the field of physiatry, Dr. Joel DeLisa, wrote an article that can be found at the address below. The article states the apparent need for medicine entrants with disabilities and the benefits and accommodations made in such cases.

    Additionally, at the AAMC conference earlier this week, John Hostermann presented on the topic, and there will be a book released to the deans of medical schools later this year.

    In regards to the academics that are required for becoming a doctor, though math and science aren't my strong point, there is no doubt that I can work to make it happen. Why is it fair for me to pursue something that may as well be a "cakewalk" when my patient base will come from individuals who would do anything to have the ability to problem solve and to think critically. I have struggled a bit with math this semester, but I will make up for it.

    Ultimately, I'm not becoming a doctor for me. I'm becoming a doctor for my patients. To help them thrive, to help them learn, and to help them grow so that they may reach the highest degree of health possible along with the highest quality of life possible.

    Thank you ladies!

  6. Erin,

    I'm here to comment on your post at the behest of a longtime reader of this blog who is a friend of mine. She thought I'd have some advice--I'm an intern with mild spastic diplegic CP.

    I'm a D.O. now. I made it through medical school and now I'm navigating residency. I am here to tell you that it is totally possible to do this with CP.

    Challenges you will face are, as Fizzy said, mostly of the asshole-who-thinks-you-are-getting-special treatment variety. The chip on my shoulder (yes, I have one), makes it so that I fear "special treatment" almost to the point of never asking for help. This is not exactly healthy, and I'm getting better at it.

    In medical school and residency, sometimes you have to ask for help. This does not reflect a failing. I struggled with that somewhat until a non-disabled friend pointed out "Honey, we ALL ask for help in this process." And you will. And people will help you.

    On our medschool campus, we had this big concrete stair on the hill down to the class buildings which had no railing. It was steep, scary, and looked deadly to me. I refused to take them, walking around the 15 minute long way instead. I went to the admin, and I said "Look someone is going to fall down those stairs and die. Forget the part how ADA was ten years ago, and focus on the idea that a fast person will be behind a slow person and the slow person will fall. It ain't gonna be me." They initially did nothing, and I let it go--but the student association didn't. And that body of people got a railing put up.

    The second most important thing, I think, is if you forsee potential problems on a particular clinical rotation, you need to voice those concerns upfront. This goes for the dean of medical schools question also--be honest and upfront about it. I was deathly afraid I was going to fall in the surgical theatre and impale myself on a scalpel. I went to the preceptors and the student coordinator, and they helped me figure out how to do the get-gowned-spin-around dance without falling. They suggested bracin my hip on the surgical table, which is really all the balance help I needed. And the scrub nurses were kind enough to point out the easy way through cords etc.

    This can be done. It's a worthy goal and a career I love. I say go for it!


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