Contributor: Dr. Nadine Abu-Ghazaleh
Why this matters
Disability is a common human experience. A 2021 Canadian Medical Association survey found that 22% of physicians report a disability or chronic health condition, most of which are non-apparent. Yet medical education continues to be shaped by a “selfless superhuman” ideal that assumes unlimited stamina, constant availability, and no need for accommodation. This narrative fuels internalized, cultural, and systemic ableism—and creates barriers for learners and faculty alike.
What is the “selfless superhuman”?
Medical culture continues to reflect an outdated “selfless superhuman” ideal that prioritizes endurance over wellbeing. We must challenge the stereotype that a “good doctor” is endlessly resilient, requires no rest, never gets sick, and consistently places personal needs last. By questioning how we define, model, and reward excellence, we can begin to recognize not only the systemic roots of this problem, but also the ways internalized ableism is perpetuated through our own clinical practices, teaching behaviours, and evaluative feedback.Creating space for this reflection is essential to fostering psychologically safe environments for learners, faculty, and all health-care allies.
What can you do?
Medical educators hold real power: in evaluation, scheduling, curriculum design, and culture-setting. Moving from reactive accommodationto proactive accessibility is a necessary step toward equity, wellness, and sustainable medical practice.
Practical Take-aways for Educators:
- Reflect on your own assumptions about competence, efficiency, productivity, and “fit”
- Use inclusive language and respect identity-first or person-first preferences when speaking about patients or colleagues
- Model self-care (e.g., taking sick days, attending medical appointments, setting boundaries)
- Learn the language and pathways: understand key terms (disability, ableism, accommodation, accessibility) and know where to direct learners for support, rather than expecting them to navigate systems alone (see below).
- Know your accommodation policies—and advocate for clearer, more transparent ones where gaps exist
- Design proactively: clear expectations, flexible teaching methods, and transparent scheduling
- Approach learners with curiosity and compassion, not suspicion, when challenges arise
Key Take-away:
Accessibility is not about lowering standards—it’s about removing unnecessary barriers so people can meet them.
Key Definitions:
- Disability: A broad and diverse experience that may be physical, mental, cognitive, neurodevelopmental, sensory, episodic, temporary, or permanent—and intersects with other aspects of identity.
- Ableism: A belief system that values certain bodies and minds as the “gold standard,” consciously or unconsciously positioning disabled people as less capable or less worthy.
- Accommodation: An individualized adjustment that enables equitable participation. It is not a favour, preference, or guarantee of success—but a [human] right grounded in a functional need.
- Accessibility: A proactive process of identifying, removing, and preventing barriers so environments work for everyone—not just those who request accommodations.
- Internalized ableism: The process by which individuals—including health professionals—absorb cultural norms that equate worth, competence, or professionalism with productivity, endurance, and independence, often leading to shame, self-silencing, or unrealistic expectations of oneself and others.
Resources:
- The Office of Resident Affairs – McMaster University: https://pgme.mcmaster.ca/resident-affairs/
-Offers confidential support, at arm’s length from programs and PGME, including support to navigate personal, academic or workplace issues that emerge during training, and offers wellness counselling. To view availability and book a virtual appointment visit: https://macmdstudentresidentaffairs.janeapp.com/ or reach out to their confidential email at pgaffair@mcmaster.ca - Supports for Trainees with Chronic Illness or Disabilities:
Academic Accommodations for Disability:
see under resources section of Resident Affairs website or on medportal https://pgme.mcmaster.ca/resident-affairs/wellness-resources/. The confidential contact for trainees can be reached at pgaccomm@mcmaster.ca with any questions about accommodations, whether trainees have determined they require them or not.
References:
Canadian Medical Association. (2021). National physician health survey.
https://www.cma.ca/our-focus/physician-health-and-wellness/national-physician-health-survey Ontario Human Rights Commission. (n.d.). Policy on ableism and discrimination based on disability.
https://www.ohrc.on.ca/en/policy-ableism-and-discrimination-based-disability
Jain, N. R. (2022). The capability imperative: Theorizing ableism in medical education. Social Science & Medicine, 315, 115549.
https://doi.org/10.1016/j.socscimed.2022.115549
Centers for Disease Control and Prevention. (2023). Disability and health overview.
https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html
