The Behavioral Health Consultant: Roles and Responsibilities.

With the scarcity of mental health services, integration of behavioral health into pediatric primary care increases the accessibility and availability to mental health services to a broad range of patients and their families while bridging the gap of physical and mental health. Encouraging whole-person care, the role of the behavioral health consultant serves as a proactive and preventative means fostering early intervention and detection, as 50% of all lifetime mental health disorders begin by the age of 14 years.

Prevalence, Plans, and Perceptions: Disability in Family Medicine Residencies.

BACKGROUND AND OBJECTIVES: Leading medical organizations including the Accreditation Council for Graduate Medical Education (ACGME) and American Association of Medical Colleges (AAMC) espouse the value of a diverse physician workforce, including disability, yet there is a dearth of research about this population in graduate medical education (GME). More information is needed on the prevalence of disability in the resident population, plans to recruit residents with disabilities, and program perceptions of barriers to inclusion. The goal of this study was to better understand the prevalence of disability in the resident population, plans to recruit residents with disabilities, and program perceptions of barriers to disability inclusion and frequency of disability-related complaints and litigation. METHODS: Surveys were emailed to 200 department chairs via SurveyMonkey as part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA). RESULTS: More than 30% of family medicine programs reported at least one faculty member with a disability, while 50% reported matriculating at least one resident with a disability in the previous 5 years. Programs with greater numbers of physicians with disabilities were more likely to have a plan to recruit residents with disabilities, and inadequate expertise was the largest perceived barrier to disability inclusion. CONCLUSIONS: Employing faculty with disabilities may be the driving force for having an active plan to recruit residents with disabilities. In order to meet the stated diversity goals of medicine, programs will need to increase professional development around disability inclusion.

Disability Policies and Practices in Family Medicine Residencies: A CERA Study.

BACKGROUND AND OBJECTIVES: Increasing the diversity of family medicine residency programs includes matriculating residents with disabilities. Accrediting agencies and associations provide mandates and recommendations to assist programs with building inclusive policies and practices. The purpose of this study was (1) to assess programs' compliance with Accreditation Council for Graduate Medical Education (ACGME) mandates and alignment with Association of American Medical Colleges (AAMC) best practices; (2) to understand perceptions of sources of accommodation funding; and (3) to document family medicine chairs' primary source of disability-related information. METHODS: Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance Chairs' Survey. Respondents answered questions about disability policy, disability disclosure structure, source of accommodation funding, and source of information regarding disability. RESULTS: Half (56%) of responding chairs reported maintaining a disability policy in alignment with ACGME mandates, while half (52%) maintain a disability disclosure structure in opposition to AAMC recommendations. Funding sources for accommodation were reported as unknown (32.9%), the hospital system (27.1%), or the departmental budget (24.3%). Chairs listed human resources (50.7%) or diversity, equity, and inclusion offices (23.9%) as the main sources of disability guidance. CONCLUSIONS: The number of students with disabilities in medical education is growing, increasing the likelihood that family medicine residency programs will select and train residents with disabilities. Results from this study suggest an urgent need to review disability policy and processes within departments to ensure alignment with current guidance on disability inclusion. Department chairs, as institutional leaders, are well positioned to lead this change.

The Unexamined Diversity: Disability Policies and Practices in US Graduate Medical Education Programs.

BACKGROUND: Graduate medical education (GME) institutions must ensure equal access for trainees with disabilities through appropriate and reasonable accommodations and policies. To date, no comprehensive review of the availability and inclusiveness of GME policies for residents with disabilities exists. OBJECTIVE: We examined institutions' compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements and alignment with Association of American Medical Colleges (AAMC) policy considerations. METHODS: Between June and August 2019, we conducted a directed content analysis of GME institutional policies using the AAMC report on disability considerations and the ACGME institutional requirements as a framework. RESULTS: Of the 47 GME handbooks available for review, 32 (68%) included a disability policy. Forty-one of the 47 (87%) handbooks maintained a nondiscrimination statement that included disability. Twelve of the 32 (38%) handbooks included a specific disability policy and language that encouraged disclosure, and 17 (53%) included a statement about the confidential documentation used to determine reasonable accommodations. Nineteen of the 32 (59%) maintained a clear procedure for disclosing disabilities and requesting accommodations. CONCLUSIONS: While disability policies are present in many of the largest GME institutions, it is not yet a standardized practice. For institutions maintaining a disability policy, many lack key elements identified as best practices in the AAMC considerations.