Gateways guidance: 15.4 Induction of disabled doctors in postgraduate training

A report to the Royal College of Physicians, Doctors with Disabilities: Clearing the way, makes the following recommendations for the first meeting between the educational supervisor and the trainee:

• ‘Ask all trainees, not just those who seem to be disabled if they have any health problems.
• Be frank when asking about the disability rather than avoiding talking about it.
• Respect clinical confidentiality.
• Find out what the trainee finds challenging, and the ways in which he or she manages such situations. For instance, some trainees need time away from work within their working week, and others make a more effective contribution if they work intensively for three days.
• Ask them what adjustments, if any, they need to be made; for example, slowing their ward rounds, or help in carrying notes, recognition of hypoglycaemia by colleagues, etc
• Ask if they need pre-arranged sick leave where they can sort out their health-related issues, make any necessary adjustments to on-call rotas or night duties.
• Get them to outline realistically the practical procedures which they might be unable to perform.
• Talk to them about professional exams and their special requirements for those exams.
• Discuss their long-term goals and try to help them choose a specialty in which their disability will not interfere in their career progression.’
  

Of particular concern might be mental health. The BMA publication Doctors’ Health Matters points out that:

1. ‘Evidence shows that doctors are more likely to suffer from work-related mental ill health than other professions, with the prevalence of any common mental disorder in doctors as high as 28 per cent, compared with 15 per cent in the general population. Deep prejudices exist against people working in the NHS with mental illness. The myth that you cannot be a doctor if you are mentally ill is shown to be false and, although burnout and stress are important in medicine because of their frequency and disability caused, severe depression, near lethal suicide attempts and psychotic features are also all too frequent. Other studies have identified the major factors in mental illness as the long hours worked, the high workload, the pressure of work and their effect on the personal lives of doctors.’

It is important, however, to note that many disabled people have impairments that are not related to a health problem, since they are not ill.