ACP Position Papers Urge Disability Inclusion Across Medical Training, Patient Care

The American College of Physicians (ACP) has released a pair of companion position papers in Annals of Internal Medicine calling for structural reform to support physicians and trainees with disabilities while also addressing persistent health care disparities experienced by patients with disabilities.

Published simultaneously on March 09, 2026, the papers represent the organization's most comprehensive policy statement to date on disability as both a workforce equity issue and a patient care concern.¹˒²

“The underrepresentation of people with disabilities in medical education and health care has led to pervasive issues. Patients with disabilities face more barriers to health care than abled patients and have lower life expectancy, higher rates of chronic illness, and difficulty accessing preventive care,” said Jason M. Goldman, MD, president of ACP. “These barriers, including inaccessible health care facilities, exclusion from clinical research, and institutional discrimination, threaten the health of people with disabilities and actively contribute to increasing health disparities.”

Representation Gap Persists Despite Growing Disclosure Rates

Despite federal antidiscrimination protections under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, the proportion of practicing physicians with disabilities has stagnated near 3.1%, even as approximately 13% of graduating medical students and 7.5% of residents now report a disability.¹ ACP frames this drop-off not as a reflection of physician capability but as evidence of system-level barriers shape disclosure, limit access to accommodations, and ultimately affect retention.

According to the ACP, the most reported disability categories among practicing physicians include chronic health conditions, mobility impairment, psychological conditions, and hearing impairment. Among medical students, ADHD, learning disabilities, psychological conditions, and chronic health conditions are most commonly reported.¹

Data also show physicians with disabilities earn substantially less than nondisabled peers, with annual earned income approximately 20.8% lower in adjusted analyses, and report higher rates of mistreatment from both coworkers and patients.¹

Consistent with prior work, ACP identifies stigma as a primary driver of underreporting. Roughly half of first-year residents with disabilities who identified a need for accommodations did not request them, citing fear of stigma as the most frequent reason.¹ A review of graduate medical education handbooks from the 50 largest US programs found only 68% included any disability policy, and over half required disclosure to direct supervisors, which was a practice identified as a documented disincentive to disclosure.¹

ACP Recommendations Target Training Environments and Practice Settings

Across both papers, ACP offers 13 policy recommendations for physicians with disabilities and 11 for patients with disabilities, spanning medical education, graduate training, health systems, and professional organizations.

On the workforce side, ACP urges medical schools and graduate medical education programs to revise unnecessarily exclusionary technical standards, maintain transparent and legally compliant accommodation policies, and invest in disability resource professionals with specific expertise in medical education environments. ACP also calls on accreditation bodies — including the LCME and ACGME — to incorporate disability inclusion explicitly into diversity mandates and accreditation standards.¹

Of note, the ACP calls on the National Board of Medical Examiners and related certification bodies to align and streamline accommodation request processes. In the 2018–2019 academic year, 52% of students who disclosed disabilities and registered for USMLE Step 1 were denied requested accommodations, with more than a third subsequently failing the examination unaccommodated or withdrawing from their programs.¹

On the patient care side, ACP recognizes people with disabilities as a population experiencing health disparities, mirroring a 2023 designation by the National Institute on Minority Health and Health Disparities, and supports their designation as a Special Medically Underserved Population under the Public Health Service Act.² ACP also urges health care facilities to evaluate physical and communication accessibility, calls for disability education to be integrated into medical school curricula, and recommends increased data collection on disability-concordant physician-patient relationships and their effect on outcomes.²

From Policy to Practice

A companion editorial by Moreland and Meeks, also published in Annals, argues that position statements alone are insufficient to drive change in complex clinical training environments.³ The authors propose 3 interdependent implementation strategies: structured environmental transparency around disclosure and accommodation processes; community-building and institutional feedback loops grounded in quality improvement; and investment in trained disability resource professionals with expertise specific to medical education.

They caution each element is necessary, noting transparent policies without qualified expertise risk disclosure regret, while community spaces without feedback mechanisms surface concerns without creating pathways for resolution.³

Both ACP papers acknowledge important data gaps. Evidence to date has focused disproportionately on trainees, with far less known about accommodation practices, career trajectories, and burnout among practicing physicians with disabilities over time. ACP calls for increased longitudinal data collection to address these gaps, including study of how disability-concordant patient-physician relationships may influence care quality and patient satisfaction.¹˒²

References:

1. Cline K, Beachy MW, Carr PW, et al; for the American College of Physicians. Fostering support and inclusion for physicians, postgraduate trainees, and medical students with disabilities: a position paper from the American College of Physicians. Ann Intern Med. 2026. doi:10.7326/ANNALS-25-04518

2. Cline K, Beachy MW, Carr PW; for the American College of Physicians. Improving the health of and access to health care for people with disabilities: a position paper from the American College of Physicians. Ann Intern Med. 2026. doi:10.7326/ANNALS-25-04524

3. American College of Physicians. New ACP Papers Say Health Care Must Be More Accessible and Inclusive for Patients and Physicians with Disabilities | ACP Online. Acponline.org. Published March 9, 2026. Accessed March 9, 2026. https://www.acponline.org/acp-newsroom/new-acp-papers-say-health-care-must-be-more-accessible-and-inclusive-for-patients-and-physicians