Disabilities at DMS - Policies, Procedures, and Services

Dartmouth Medical School admits some of this country's finest men and women, and among them are people with disabilities. We know from experience that having a disability does not necessarily preclude a person from becoming a wonderful physician; in fact, a disability can be a positive factor for some folks. Today there are quite a few practicing physicians who have been successful at Dartmouth Medical School with physical, learning, or psychological disabilities, and we are proud of that fact.

Of course not every applicant, with or without a disability, is considered qualified for the Dartmouth program. (To help you better understand our definition of "qualified", you are encouraged to read the DMS Essential Standards for Matriculation, Promotion, and Graduation on this website. If you have a disability, you will probably want to pay special attention to the Standards for Capacity). However, every qualified applicant, including those with disabilities, receives absolutely equal consideration in the admissions process*. Those applicants with disabilities who then matriculate, are welcomed warmly, and we do everything we reasonably can to accommodate their needs. Although we cannot guarantee any student success at DMS, there is NOTHING we want more than for all our students to succeed.

*Applicants are not required to notify DMS of a disability during the application process, but sometimes a disability may be obvious. Those applicants invited for an interview, who need accommodation for the interview itself, should contact us as early as possible.

Making Contact

Services for students with disabilities at DMS are coordinated by the Learning and Disability Services office (within the Office of Medical Education). Kalindi Trietley is the primary contact for all student disability issues at DMS. Please feel free to get in touch with her if you are 1) a person with a disability who is considering Dartmouth Medical School, 2) a current medical student with a disability or suspected disability, or 3) a concerned faculty/staff member. Ms. Trietley will be happy to talk with you about any issues that may be on your mind, and she is committed to maintaining your privacy.

Any DMS student who believes he or she has experienced discrimination on the basis of disability is urged to contact Ms. Trietley. Students may also wish to contact the Office for Institutional Diversity and Equity in McNutt Hall. The phone number is (603) 646-3197.

Basic Information for Students with Disabilities

The Americans with Disabilities Act (ADA), building on Section 504 of the Rehabilitation Act of 1973, mandates that: no qualified person with a disability shall, on the basis of disability, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives or benefits from federal financial assistance. According to federal regulations, otherwise qualified students with documented disabilities are entitled to equal treatment at institutions of higher education, and to reasonable accommodation if needed.

The Medical School curriculum, as established by the faculty, represents a core curriculum essential to all physicians. Therefore, Dartmouth Medical School expects that each student admitted will be capable of completing the full curriculum of required courses and electives under the established School policies. We believe that we have a responsibility both to our students and to society; and to help us adequately fulfill those responsibilities, we have created the Essential Standards for Matriculation, Promotion, and Graduation. All students and applicants must be capable of meeting the Standards for Capacity included in that document, with or without reasonable accommodation, and they are asked to sign a statement to that effect before matriculation. Learning and Disability Services can help applicants better understand those Standards.

Some accommodations can certainly be made for disabilities, but all students must be able to perform in a reasonably independent manner. No disability can be reasonably accommodated at DMS with an auxiliary aid or intermediary that provides a selective function, cognitive support, or medical knowledge. Aids and intermediaries also may not substitute for essential clinical skills or supplement clinical and ethical judgment. That is to say, accommodations cannot eliminate essential program elements.

Committee on Students with Disabilities

The Dartmouth Medical School Committee on Students with Disabilities (CSD) represents a broad faculty constituency and includes individuals with experience in some of the most common disability categories. The Committee membership may include the following: a representative from pre-clinical faculty, a representative from clinical faculty, a facilities administrator, DMS Director of Learning and Disability Services (Disabilities Director), a Dean's office representative, the 504/ADA Compliance Officer, the undergraduate Director of Disability Services, and legal counsel. Meetings of this committee are considered confidential.

The CSD reviews all requests for accommodation. They determine 1) whether or not a student is to be considered "disabled" at DMS under the Americans with Disabilities Act, 2) whether or not the student seems otherwise qualified for medical school, based on our standards for capacity, 3) whether or not the student is entitled to accommodation, based on documentation, and 4) what specific accommodations, if any, would be most reasonable. This committee also attempts to resolve disability issues that cannot be resolved through the DMS Disabilities Director alone, and it approves policy revisions related to disability issues as necessary. In order to maximize confidentiality, only the Disabilities Director and members of the CSD have access to students' full diagnostic information.

Accommodations for Students with Documented Disabilities

Section 504 and the Americans with Disabilities Act require the School to provide certain kinds of reasonable accommodation (to qualified students), when necessary to provide an equal learning opportunity. Under the law, "reasonable" must be individually determined after a student requests accommodation.

Qualifying
To qualify for accommodation, a student must identify him/ herself to the DMS Disabilities Director, declare the disability (or suspected disability) in writing, and request accommodation. It is also the student's responsibility to obtain a thorough written evaluation from an appropriate professional, documenting the presence, extent, and ramifications of the disability. In addition, the documentation should explain what specific types of accommodation the evaluator believes might be most helpful in offsetting the effects of the disability to an acceptable extent in a medical school environment. Our goal at DMS is to provide equal opportunity without undermining the integrity of any course, clerkship, or program.

The student must obtain this evaluation at his/her own expense and arrange to have the evaluation form and all supporting documentation forwarded to the DMS Disabilities Director. If an evaluation has already been conducted in the past, the Director will determine if it is recent enough. An evaluation performed more than three years earlier may not be acceptable, and there are instances in which an evaluation must have been completed within a few months or even weeks. The Disabilities Director can provide evaluation guidelines and forms before the student meets with an evaluator, or the student may refer to the documentation guidelines. All documentation must conform to these guidelines.

CSD Review
After receiving acceptable documentation, the Director will discuss the findings and recommendations with the student, and together they will come to agreement about a proposed plan. * The Director will then present all the information she's gathered to the Committee on Students with Disabilities. The CSD will review the documentation and consider the student's requests. If appropriate, they will approve a plan for accommodating the student.

If either the Director of Disability Services or the CSD finds that the documentation provided does not meet its established standards, additional information will be requested. If further evaluation is required, it remains the student's responsibility to arrange for that evaluation, at his or her expense. If the CSD disagrees with the findings of an evaluation that conforms with DMS guidelines, a second evaluation may still be requested, but at the School's expense.

Implementation
When a disability has been acknowledged, and a specific accommodation plan is approved by the CSD, the Disabilities Director will meet with the student again to help enact the plan. At that time, she will give the student a signed form outlining the approved accommodations. The student may then share a copy of this form with individual course and/or clerkship directors, or with other staff who have relevant responsibilities. Sharing this information is typically at the discretion of the student, and is his or her responsibility in order to arrange for accommodations. There may, however, be occasions on which the Director of Disability Services speaks directly with faculty or other administrators, on a need-to-know basis, about a student's functional limitations (see section on Confidentiality).

A student is not entitled to accommodation in any course, clerkship, or activity if the form is not presented before specific accommodations are needed. Course/clerkship directors provide approved accommodations to all students who have shown their forms, provided the forms are presented in a timely fashion. (Presenting the form as early as possible is recommended, and individual courses or clerkships may have deadlines.) If a student's accommodation plan includes assistive devices or extensive supplemental aid, additional time may be required to make arrangements, and the Disabilities Director will help to make those arrangements directly.

*The Director may approve temporary accommodations, at her discretion, until the CSD is able to meet and consider a student's requests.

Appeals

Any student wishing to appeal an accommodation decision made by the CSD should first appeal to the CSD itself. The student should explain in a letter why he or she believes the prior decision was unfair or unreasonable, and should include any available corroborating information with the letter. The Director of Disability Services will accept the letter and schedule a meeting of the CSD as soon as possible. The student should also be prepared to meet with the Committee and answer questions.

If a student disagrees with the CSD's decision after an appeal has been presented, that student may make a final appeal to the Dean of the Medical School. Once again, the student should submit a letter describing the situation and indicating why the CSD's decision does not appear to be fair or reasonable. The Dean may wish to meet with the student to discuss the issues. The Dean may also consult with other professionals for information and perspective. The Dean's decision is final and will be conveyed within three weeks of receiving the appeal letter.

If a faculty member disagrees with a decision made by the CSD, he or she should first talk with the Director of Learning and Disability Services for clarification of the issues. The next step would be writing a letter to the CSD, outlining any objections to the prior decision. If the faculty member is not satisfied with the subsequent decision by the CSD, he or she may make a final appeal to the Dean of the Medical School. He or she should write a letter to the Dean describing the situation and indicating why the committee's decision seems unreasonable.

Confidentiality

Disability information is considered private. Faculty, with the exception of those on the CSD, do not have the right to access students' diagnostic information. Ordinarily, faculty members and other relevant staff need only know the accommodations that are necessary to provide an equal opportunity for students.

There are times, however, when certain faculty members and/or administrators may have a legitimate educational need to know about a student's functional limitations, as well. In such cases, the Director of Disability Services may speak directly with those individuals to ensure appropriate planning. This kind of direct communication by the Director happens if the CSD has decided that members of the DMS community have an educational need to know about a student's limitations, or if an issue arises that may involve the safety and well being of patients, students, or staff. Students are also encouraged to speak with faculty as openly as possible to facilitate better understanding and support.

Faculty and/or staff to whom accommodation forms are presented may copy these forms for their records, but they should take care to keep the information private. The accommodation information conveyed on the forms should be communicated only to other faculty and/or staff who have an educational need to know (for instance, those who are involved in providing the accommodations, or those who are responsible for the educational environment). If a faculty member or a student has any questions about specific accommodations, he/she may contact the DMS Director of Learning and Disability Services. All documentation and correspondence concerning a student's disability are kept in a separate file in the Office for Learning and Disability Services.

Clinical faculty (e.g. clerkship directors) who have occasion to write student evaluations at the end of clerkships must be careful not to breach the confidentiality afforded students with disabilities. Written evaluations, which may be excerpted in the Dean's Letter or seen by others outside the DMS community, should not mention disabilities or accommodations for disabilities in any way. Once a student has been approved for specific accommodations by CSD, and has subsequently received those accommodations, that student should be held to the same essential performance standards as all other students. Therefore, clinical faculty should focus strictly on the student's performance in all these evaluations. With regard to letters of reference solicited by students, faculty members may mention a disability IF the student gives prior permission for them to do so.

Dartmouth Medical School does not notify potential residency programs or other employers about student disabilities without specific permission from the student. Since students with disabilities, once accommodated, are held to the same standards as other students, we do not make notation of any kind on the transcript or in the official Dean's letter.

Emergency Evacuation

Those students with concerns about evacuating in the case of an emergency should contact Learning and Disability Services to develop a personal plan for safety. This also pertains to students who have not needed to request accommodations for their impairment or disability, but who believe a fire or other emergency might necessitate special assistance. Dartmouth's comprehensive emergency plan is located here.

Summary

• Dartmouth Medical School does not discriminate against students with disabilities.
• In order to progress through DMS and graduate, all students must be able to meet the Essential Standards for Matriculation, Promotion, and Graduation including the Standards for Capacity, with or without reasonable accommodation.
• Specific accommodations for a disability are explored on an individual basis once a student makes that request and provides acceptable documentation.
• Requests for accommodation must be made through the DMS Office for Learning and Disability Services.
• The CSD makes all official determinations about disability status and accommodation.
• The particular needs of each student, as well as the essential components of each course and clerkship, are taken into careful consideration when determining accommodations.
• Whereas DMS may not always be able to meet every accommodation preference a student expresses, we do our very best to arrive at solutions that work well for students.
• Disability information is considered private, and is shared only with those who have an educational need to know within DMS.
• The Director of Learning and Disability Services is available throughout a student's course of study to answer questions, help with learning and performance strategies, resolve problems, and provide supportive counseling. She also acts as a liaison to faculty, providing information and helping them understand disability issues more thoroughly.

At Dartmouth Medical School, our sincere intention is to provide equal and excellent educational opportunities to all of our highly qualified students, including those with disabilities.

Faculty Consultation

Learning and disability issues can sometimes be hard to understand. The policies and procedures outlined in the previous section should answer most questions faculty may have. However, any DMS faculty member or administrator is welcome to talk directly with Ms. Trietley about questions or concerns.

Back to Office for Learning and Disability Services