I believe that an emphasis on punctuality in medicine is likely to be discriminatory to #DisabledDocs

Let's discuss, #MedTwitter

Thread

Let's say you're a college student with well-controlled epilepsy. You've done well on the MCAT and in college, completed research, had helpful accommodations throughout college, and are currently writing your applications.

*I don't have epilepsy and apologize if I misportray*

You come across an article with tips for medical students, and it emphasizes how disrespectful tardiness is on the wards.

"Early is on time, and on time is late."

You think to yourself, well what am I going to do if I am delayed by a seizure? Especially if my condition is one I want to keep confidential between me and my school's disability office?

If I show up to the hospital late, how will I escape my resident's wrath?

Disabled doctors or those with health conditions or chronic illnesses are vastly underrepresented in medicine compared to the general population ( a sign of systemic ableism ).

Those who are in medicine report discrimination, lack of access, and significant barriers with most of the accommodations they ask for.

In order for a disabled college student to apply to medical school, or for a disabled medical student to apply to residency, they have to feel like they will be understood, will have the chance to succeed, and be valued along the way.

Our culture in medicine values certain aspects of professionalism that have never been shown to correlate with better patient care or to be needed aspects of medicine or training.

Many of these, such as mandatory attendance and punctuality, are actively discriminatory to disabled individuals - many of whom will not feel comfortable asking for an excuse, because the culture tells us not to tell people we’re disabled.

It's easy for abled individuals to feel like #DisabledDocs can just ask for an excused absence - but that is not the reality we face, given the culture of medicine.

Topics like the one I've demonstrated here are tricky. We all have a duty to ensure patient safety and provide the best care possible. But we also have to recognize what's actually important in ensuring this, and what are needless barriers.

I'm learning just as much, if not more, as I'm teaching. So as always, please reach out with thoughts, questions, corrections, comments, complaints....

Let's all strive for #DisabilityVisibility and an end to ableism.

Also, before someone yells at me, I’ll reiterate that I’m not saying punctuality isn’t important. And I’m not saying that being late cannot be harmful to a team.

But when we talk about it as this extreme virtue of medical students, we risk telling disabled traineees to stay away

Hopefully my final disclaimer.

I have not been late to med school once. I'm usually the first one in class or the zoom by 10 minutes. Pre-COVID, I was one of maybe 1/6 of my class who went regularly.

Doesn't mean this doesn't matter to me.