The Performance and Trajectory of Medical Students With Disabilities: Results From a Multisite, Multicohort Study

Lisa M. Meeks, Melissa Plegue, Bonnielin K. Swenor, Christopher J. Moreland, Sharad Jain, Christina J. Grabowski, Marjorie Westervelt, Ben Case, William H. Eidtson, Rahul Patwari, Nancy R. Angoff, Jack Leconche, Bliss M. Temple, Peter Poullos, Mijiza Sanchez-Guzman, Caitlyn Coates, Christine Low, Mark C. Henderson, Joel Purkiss, Michael H. Kim

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


PURPOSE: To conduct a post-Americans with Disabilities Act Amendments Act of 2008 multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWDs).

METHOD: From June to December 2020, the authors conducted a matched cohort study of SWDs and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S. MD-granting medical schools. Each SWD was matched with 2 controls, one from their institution and, whenever possible, one from their cohort for Medical College Admission Test score and self-reported gender. Outcome measures included final attempt Step 1 and Step 2 Clinical Knowledge scores, time to graduation, leave of absence, matching on first attempt, and matching to primary care.

RESULTS: A total of 171 SWDs and 341 controls were included; the majority of SWDs had cognitive/learning disabilities (118/171, 69.0%). Compared with controls, SWDs with physical/sensory disabilities had similar times to graduation (88.6%, 95% confidence interval [CI]: 77.0, 100.0 vs 95.1%, 95% CI: 90.3, 99.8; P = .20), Step 1 scores (229.6 vs 233.4; P = .118), and match on first attempt (93.9%, 95% CI: 86.9, 100.0 vs 94.6%, 95% CI: 91.8, 97.4; P = .842), while SWDs with cognitive/learning disabilities had lower Step 1 scores (219.4; P < .001) and were less likely to graduate on time (81.2%, 95% CI: 69.2, 93.2; P = .003) and match on first attempt (85.3%, 95% CI: 78.0, 92.7; P = .009). Accommodated SWDs had Step 1 scores that were 5.9 points higher than nonaccommodated SWDs (95% CI: -0.7, 12.5; P = .08).

CONCLUSIONS: Structural barriers remain for SWDs with cognitive/learning disabilities, which could be partially mitigated by accommodations on high-stakes exams.

Original languageEnglish (US)
Pages (from-to)389-397
Number of pages9
JournalAcademic Medicine
Issue number3
StatePublished - Mar 1 2022

Bibliographical note

Funding Information:
Funding/Support: This work was partially supported by grant UH1HP29965 from the Health Resources and Services Administration (HRSA; to L.M. Meeks and C.J. Moreland) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,791,026 with 0% financed with nongovernmental sources.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.


  • Cohort Studies
  • Disabled Persons
  • Humans
  • Learning Disabilities
  • Schools, Medical
  • Students, Medical
  • United States

PubMed: MeSH publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Journal Article


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