Disability, Program Access, Empathy and Burnout in US Medical Students: A National Study.

OBJECTIVE
To investigate whether self-disclosed disability and self-reported program access are associated with measures of empathy and burnout in a national sample of US medical students.


METHODS
The authors obtained data from students who responded to the Association of Medical Colleges (AAMC) Year 2 Questionnaire (Y2Q) in 2019 and 2020. Data included demographic characteristics, personal variables, learning environment indicators, measures of burnout (Oldenburg Burnout Inventory for Medical Students) and empathy (Interpersonal Reactivity Index), and disability-related questions, including self-reported disability, disability category, and program access. Associations between disability status, program access, empathy, and burnout were assessed using multivariable logistic regression models accounting for YQ2 demographic, personal-related, and learning environment measures.


RESULTS
Overall, 23,898 (54.2%) provided disability data and were included. Of those, 2,438 (10.2%) self-reported a disability. Most medical students with disabilities (SWD) self-reported having program access through accommodations (1,215 [49.8%] or that accommodations were not required for access (824 [33.8%]). Multivariable models identified that compared to students without disabilities, SWD with and without program access presented higher odds of high exhaustion (1.50 [95%CI, 1.34 - 1.69] and 2.59 [95%CI, 1.93 - 3.49], respectively) and lower odds of low empathy (.75 [95%CI, .67 - .85] and .68 [95%CI, .52 - .90], respectively). In contrast, multivariable models for disengagement identified that SWD reporting lack of program access presented higher odds of high disengagement compared to students without disabilities (1.43 [95%CI, 1.09 - 1.87], while SWD with program access did not (1.09 [95%CI, .97 - 1.22]).


CONCLUSIONS
Despite higher odds of high exhaustion, SWD were less likely to present low empathy regardless of program access, and SWD with program access did not differ from students without disabilities in terms of disengagement. These findings add to our understanding of the characteristics and experiences of SWD including their contributions as empathic future physicians.