Re-assessing physical disability among graduating U.S. medical students

Before the 1970s, many potential college and graduate students were denied admission or prevented from graduating on account of their disabilities. Since that time, legislation such as the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 has been enacted to end discrimination against individuals with disabilities. In two prior studies, the proportion of graduating medical students with physical disabilities (MSPD) was found to be 0.23% in 1980 and 0.19% in 1990. The current study sought to learn what effect passage of the ADA has had on the graduation of MSPD and the proportion of MSPD with pre-existing v. acquired physical disabilities. A questionnaire was sent to the deans of student affairs at all accredited medical schools in the United States (n=123) to determine the proportion of MSPD who graduated during the years 2002-2005 and onset of disabilities, either before or after admission to medical school. Current results indicate that the proportion of graduating MSPD was 0.15% in 2005, indicating a significant decline. Furthermore, a significantly lower proportion of graduating MSPD in our study had pre-existing physical disability before admission to medical school than in the Wu study. Speculation was made regarding the possible causes of the progressive decline. Ways to increase opportunities for MSPD through inclusion of disability-related questions in medical school application packets, removal of requirements by medical schools for the undifferentiated medical student, effort by the AMA and AAMC to include rather than exclude MSPD, and passage of laws by Congress to encourage students to enter medical careers are discussed

Experiences in recruiting volunteers through community based initiatives in Phase-1 vaccine trials in India

Success of HIV vaccine trials is dependent on infrastructural preparedness of the site, technical expertise of the trial team and strong Socio-political support of the local community. The processes followed and experiences gained while implementing various community based initiatives for recruitment of healthy volunteers during the three HIV vaccine trials in India are described. Major initiatives in community engagement implemented for the first time in India included establishment and involvement of Community Advisory Board and capacity building and engagement of lay community based volunteers called “peers” using “lay health promotion” model. Community education program designed for trial participants’ education, identification and enrollment was a three-tiered approach, moving from large community awareness meetings (first step) to facility-based small group meeting to provide trial specific information (second step); ending with one-to-one vaccine center based meeting with the volunteers to clear doubts, myths, and misconceptions about HIV/ AIDS, the experimental vaccine and HIV vaccine trials as well as to explain trial specific procedures (third step). It is important to focus on gender issues, locally relevant socio-cultural factors, informed consent, and post-trial care related matters during the conduct of sensitive clinical trials in socio-culturally diverse and resource limited setting like India