Moving beyond the hidden curriculum: Am I ableist?

The e-book Am I Ableist? Disability Awareness in Healthcare[1] was written by medical students from Dalhousie University, in collaboration with disability advocates, researchers, and people with disabilities. Prompted by the lack of resources addressing ableism within medical education, it was created with the goal of challenging medical students to be more intentional in how they view and address disability throughout their training.

The e-book begins with a historical overview of how physicians have used disability to institutionalize and further disadvantage ethnic minorities and people of lower socioeconomic status. This highlights physicians’ power to influence societal views, which can translate to ableist policies. Even today, society often looks to physicians to understand and label disabilities; physicians are gatekeepers to resources. All medical students will have opportunities to either advocate for their disabled patients or continue to propel the ableist voice in health care and society. Thus, it is essential that future physicians are exposed to and understand patients’ disability experience, in the same way they receive cultural competency training. As it stands, medical students rely heavily on the hidden curriculum and observation of preceptors for disability-related training.[2] Am I Ableist provides a well-researched, unbiased view into the disability perspective. It offers concrete examples of ableist language commonly used in clinical settings and provides alternative phrases that are both thoughtful and approved by those with disabilities.

It wasn’t until I [author J.S.] read this book as a fourth-year medical student that I reflected on physicians’ role in perpetuating ableism. I believe that learning more about the disability perspective would have allowed me to use language more intentionally and with confidence.

Author C.V.: “My daughter has cerebral palsy, and I encourage both physicians-in-training and practising physicians to read this book. It makes a huge difference to parents when physicians recognize the weight people with disabilities and their loved ones carry. We wear so many hats and are expected to keep everything together. Having a physician take the time to learn what is important to our family conveys that they also want the best for our child—this is what makes the journey manageable.”

In the same way physicians have patient interactions they remember for the rest of their careers, patients and caregivers hold on to their experiences with physicians for the rest of their lives. It is essential for medical students and health professionals to provide trauma-informed care to all patients and to recognize within themselves the language that can perpetuate ableism.

Here are three reasons you should read this book:

• It provides clear examples of ableist language commonly used by physicians, with alternative suggestions.
• It provokes self-reflection about unconscious biases we may have and explains the impact this could have on our patients with disabilities.
• It offers opposing views on the disability perspective to provide an unbiased perspective on the subject.

Download a free copy at https://bit.ly/amiableist.
—Judy So, MD
Resident Physician, Department of Pediatrics, University of British Columbia
—Cynthia Vallance, BA
Patient & Family Engagement Advisor, Sunny Hill Health Centre
—Esther Lee, MD, FRCPC
Pediatrician, Complex Care Program, BC Children’s Hospital
Palliative Medicine Specialist, Canuck Place Children’s Hospice
Clinical Assistant Professor, Department of Pediatrics, UBC

Note: When this letter was first drafted, Dr So was a fourth-year medical student; it was written as part of a UBC FLEX project.

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References

1.    Farid M, MacLellan A, Ford RZ. Am I ableist? Disability awareness in healthcare. 2024. https://bit.ly/amiableist.

2.    Kaundinya T, Schroth S. Dismantle ableism, accept disability: Making the case for anti-ableism in medical education. J Med Educ Curric Dev 2022;9:23821205221076660.