Disclosureatallpoints:Umeandgme

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Disclosureatallpoints:UMEandGME

DanielGiang,MD

Vice-PresidentforGMEandDIOLomaLindaUniversityHealth

LisaMeeks,PhD

Director,MSDS,AssistantProfessorMedicineUCSFSchoolofMedicine

JaymeBograd,AAMCGSA

*Thepresenters’viewsandopinionsaretheirownanddonotnecessarilyreflectthepositionofthe AAMC.

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TheCoalitionandtheUCSFSchoolofMedicinewishestothanktheAAMCandfortheirgeneroussupportindevelopingthiswebinarseries.

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LearningObjectives

Throughthistrainingwehopeparticipantswillbetterunderstand:

AppropriatemechanismsfordisclosureattheUME,GMElevel;

ThelawsandbestpracticesfordisclosureintheUMEandGME;and

How professionalism shapesthe disclosureprocess.

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WhatisDisclosure

Disclosuremeansnotifyingyourinstitutionorresidencyprogramthatyouareanindividualwithadisability.Disclosuredoesnotmandatethatyoudiscloseyourspecificdisabilitytoanyoneotherthanthe ADAcoordinatorordisabilityprovider.

InordertobenefitfromprotectionandaccommodationundertheADA andtheRehabilitation Act,learnersmustdisclosetheir disabi

Slide 5:

WhyisDisclosureImportant

Benefitsofseekingsupport

Coverageunderthelaw

Accommodations

Reduce“sufferinginsilence”

Explaininganygapsintraining

Planningforclinicalaccommodations

Problemsolvingforunique accommodationneeds

Enhancingcommunicationandtrust

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PathwaystoDisclosure

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PathwaystoDisclosure:Students

ERAS

WebsiteInformation

Orientation

Mentors/Advisors

Faculty

LearningSpecialists

DirectlytoDisabilityServices

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PathwaystoDisclosure:Residents

Informationontheprogramswebsite(UCONNexample)

ProgramDirector

HumanResources

Employment orientation

PerformanceImprovementPlan

Hopefullyaddressedinadvanceofanyissues

Throughemployeecounseling

ERAS

TechStandardsorRequirementofProgramsposted

Slide 9: TheNeedtoKnow:Lawguidingdisclosurethroughtheprocess

Slide 10: UME:TheADAFERPA

TheADA

Civilrightslegislationthatprohibitsdiscrimination.TheADAisan"equalopportunity"lawforpeoplewithdisabilities.

FERPA

• Prohibitstheimproperdisclosureofpersonallyidentifiableinformationderivedfromeducationalrecords.

• Schoolsarerequiredtoprovidecertainprivacyprotectionsforeducationalrecordsandonlyshareinformationwhenthereisasubstantial“needtoknow.”

 SharingofInformation

• UMEprogramsshouldaimtoprotectanydisabilityspecificinformationandonlyshareaccommodationbasedinformationtothoseteammemberswhoimplementaccommodations(seesampleformsUCSF)

Slide 11: GME:Educators,Employers,CredentialingOrganizations

Aseducators,GMEprogramsrespondtomanyofthesamelegalstandardsasUME

Asemployers,GMEProgramsaregovernedbytheADAandinmanycasesstatelawsaddressingemployeeswithdisabilities

As credentialing organizations,GME Programsmust

• Selectphysicianswhoaresafe

• Monitorphysiciansforsafety

• Reportonphysiciancompetenceto:

‒ Statelicensingagencies

‒ Hospitalsandotherorganizations

Slide 12: GME

Forresidencyprograms,gettingtheresidentlicensedisessentialinmoststates.

Programswanttosupporttheirresidents'applicationsforlicensure.

Medicallicensureprocesswillhaveaccesstoinformationnotavailabletoemployersormedicalstafforganizations.

InGMEprogramswhohasa“needtoknow”andwhodoesnot?

Primarysourceverificationprocess:Delineatebetweensubstanceabuseissues,professionalism,anddisabilityrelatedissues(health,learning,psychological,orsensory).

Privilegedcommunicationfromonehospital(orstate)tothenext.

1.Assessmentofcompetenceineachofthesixgeneralcompetencies.

2.Anyhealthissuesthatmightimpairpractice

Slide 13: BestPracticesforDisclosure

Slide 14: BestPractice:

UME:

Buildaculturewheredisabilityispartofdiversity.

Setclearguidanceforstudentsinmultipleplaces.

Ensurefacultyknowhowtoreferastudentwhowishestodisclose.

Engageinaconversationduringorientationthatnormalizestheprocess.

GME:

UseUniv.ofConnecticutguidance

Considerexplaininganydiscontinuitiesintrainingontheapplication(ERAS)

Considerdiscussingaccommodationimmediatelyafterthematch

Slide 15: Disclosureasafunctionofprofessionalism

Professionalismincludesmaintainingoneownhealthtoprovidesafeandeffectivemedicalcare.

Howtheresidencyapplicanthandlesdisclosuremayenhanceordelaytheprocessofentrustment.

Programsmustmaintainprofessionalismarounddisability,aswell.Theyshould:

Provideclearpoliciesandproceduresfordisclosure

Ensurethatpeoplewhodisclosefeelrespectedandthatprivacyismaintained.

Engageinagood-faithinteractiveprocess.

Slide 16: ResultsofAppropriateDisclosure

Devotiontopatient

Devotiontodiversity

Improvedaccesstomedicalcare

Maintainlearners’rights

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Questions?

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