Jerusha’s plea – help make med school accessible for people with disability
A Melbourne PhD student living with cerebral palsy has made an impassioned plea to universities and ACER to help make medical school more accessible for people living with disabilities.
- Jerusha Mather has spent her life working towards her dream of becoming a medical doctor
- Despite having completed her Biomedical Sciences honours year and undertaking a PhD into brain stimulation, difficulty handwriting has made med school entry requirements like GAMSAT near impossible, “…there is an unrealistic expectation for me to be able to complete the GAMSAT in my head.”
- Ms Mather has urged universities and ACER to take immediate action against what she feels is discrimination against people with disability.
My name is Jerusha Mather. I am a prospective medical student with disability working hard on ways to enter medical school.
I was born in Sri-Lanka on 15th December 1994. At birth, the doctors gave my parents a diagnosis that I had mild-moderate severity cerebral palsy (CP) – chorea-athetoid. This meant that my chances of surviving and living a decent life would be a bare possibility.
With the hope of greater opportunities (especially for me) my parents immigrated to Australia when I was two years old.
The Australian medical system, being more advanced, enabled me to access rehabilitation therapy which helped to improve my speech and motor functions, as cerebral palsy affects my movement and speech to a moderate degree. I went on to successfully complete mainstream primary and high school.
During high school, apart from my growing love for neuroscience and biology, I was part of the T-ball team, raised funds for 40-hour famine and attained a place in the Kwong Lee Dow Scholar Young Achievers Program.
I initiated and facilitated a seminar and morning tea for young women in conjunction with the local Member of Parliament.
This seminar raised awareness and discussion on common feminine issues. I also carried out an initiative to send uniforms to an orphanage in India.
One of the highlights of my years was when I was able to procure sporting equipment for my school following a proposal to Fairtrade Australia. During my free time, I could be found reading and expanding my fervour for piano and singing. Presently I still enjoy playing the piano, singing, listening to music, occasional writing and have a good time travelling around the world with my family.
After high school, I completed my Bachelor of Science (Biomedical Sciences) at Victoria University and afterwards, completed my Biomedical Sciences honours year at RMIT University, whereby I conducted a systematic review on maternal biomarkers for fetal brain damage and designed a clinical trial based on the outcome of this review. I am currently undertaking a PhD at Victoria University where I am investigating how, and if, strength training and transcranial direct stimulation can improve motor outcomes for adults with spastic cerebral palsy.
My study will utilize a non-invasive brain stimulation methodology, called transcranial direct current stimulation (tDCS) to deliver low and constant electrical current over the scalp, to increase the strength of signals sent from the brain to muscles prior to training sessions.
It is expected that this will lead to faster and larger strength gains following training. This, in turn, will enable us to better examine the impact of strength gains on function, which we expect will improve.
My study will also use functional near-infrared spectroscopy (fNIRS) to understand the impact of both tDCS and strength training on brain activity in individuals with spastic hemiplegia CP.
This research is expected to influence interventions for young adults with spastic hemiplegia CP, who are currently underrepresented in CP research.
Despite the perceived challenges, I have lived a relatively normal life, applying myself to my studies and excelling at both my undergraduate and postgraduate degrees.
I believe it is because of, and not in spite, of my disability that I will make an excellent candidate to become a doctor.
I have a sense of empathy unmatched by my colleagues, understanding of life with a chronic health condition and remarkable patience. As a patient I have experienced the spectrum of health care professionals, good and bad, and feel motivated to be part of a generation of doctors where communication and compassion are paramount skills.
I have experienced significant barriers on my journey to becoming a doctor. And today, I am going to openly share them with you. I am are also going to share some insight on overcoming them.
Firstly, we must acknowledge the laws; the Disability Discrimination Act and the Equal Opportunity Act that were created to protect the civil rights of individuals with disabilities in the education and employment sector. However, we still have a long way to go to manifest these laws into our education systems.
Particularly in medical education, we see a lot of indirect discrimination occurring. Even so, it is time we showed zero tolerance to discrimination and seed the value students with disabilities can bring to the medical education.
Some of the barriers upon entry are the inflexible admission requirements and a lack of special consideration. Moreover, the barriers during medical school are inadequate support in preparation for clinical exams, inflexibility during clinical exams, and insufficient support during clinical placements.
Most students with a disability fear if they disclose their disability in their application, they will get discriminated against. In fact, students have openly shared stories of experiencing discrimination when expressing interest in studying medicine to medical schools. Medicine is a highly competitive degree. This high level of competition makes it harder for students with disabilities to compete with their able-bodied peers.
However, we must understand that disability does not equal inability. A person with a disability can still complete the task but in a different way.
An inclusion strategy that could be used by medical schools is an alternative entry pathway for aspiring medical students with disabilities.
A similar initiative must be made available for prospective medical students with disability.
Currently, we have few medical students with a disability in Australia. A study completed by Western Sydney Medical School showed that less than 1 percent of medical students had a disability in their yearly cohort. We are among the lowest represented in the medical profession. This is not okay.
Also, if an alternative entry scheme or pathway was implemented, disadvantage could be considered.
Whilst external bodies such as ACER do provide adjustments, these are not enough for students with handwriting and reading disabilities.
For someone like myself, sitting the GAMSAT is brutally challenging.
There is an unrealistic expectation for me to be able to complete the GAMSAT in my head, which is extremely unfair.
The GAMSAT is not like typical university exams, they are not testing prior knowledge. It's testing problem solving ability and the nature of the test being written and timed causes great challenges for someone like myself to successfully complete it.
Furthermore, possible discrimination could occur in the admissions interview whereby one could easily judge me based on my disability and underestimate my ability.
The establishment of an alternative entry scheme or pathway would make it somewhat easier for the student to disclose their disability in a comfortable manner. This would also mean the medical school can prepare for the student’s journey ahead of time.
The incorporation of a structured interview method in the alternative entry scheme or pathway as opposed to the multiple mini interviews would greatly reduce the risk of bias and discrimination and ensure that reasonable adjustments such as additional time are made during the interview processes.
Some reasonable adjustments that medical schools could use to accommodate for medical students with a disability include:
- Additional time during exams (with rest breaks)
- Multiple-day testing
- Additional doctor - patient sessions to troubleshoot strategies for clinical skills
- Clinical assistant to help students with clinical tasks
- One on one time with academic staff
- Working with an occupational or speech therapist on developing clinical/communication strategies / skills
Some technologies and adaptable medical equipment that have been used in the past for medical students with a disability are:
- Dragon Medical – Speech to Text Software
- Vein Viewer – enables you to visualise someone’s veins in an enlarged form
- Electronic Medical Forms
- Amplified Stethoscopes
- Automatic Pressure Machines
Everyone is different and therefore, reasonable adjustments should be implemented on a case by case basis. More adjustments that a medical school could use can be found in The Guide to Assisting Students with Disabilities: Equal Access in Health Science and Professional Education by Lisa Meeks.
Medical schools also need to develop inclusion policies. Hence when a medical student with a disability gains admission, the school demonstrates the best tendency to provide an inclusive environment for the student.
There are quite a few doctors with a disability registered with the Australian medical board. They are working within major hospitals and clinics. However, most of them acquired their disability after entry into medical school. There are also plenty of training specialty colleges such as pathology, oncology, radiology, medical administration; general practice and rehab medicine that are willing to open their doors for doctors with disabilities. Thus, why then cannot medical schools open their doors?
Dr Thomas Strax who lives in New York has cerebral palsy. He had severe speech and mobility concerns. However, he became a rehabilitation psychiatrist and contributed greatly to medicine. He served six deans in three medical schools as a department chair, training hundreds of residents. Fourteen went on to become professors. He was a chief medical officer. For years, he was the consultant for our National Board of Medical Examiners. He was at the White House for the Americans with Disabilities Act signing. Nonetheless, he may not have been able to study medicine in Australia in 2019 due to the inflexible and biased admission requirements.
Lastly, let us open doors, think laterally about tasks, and see the possibilities inside a person. When we give someone with a disability a chance to become a doctor and support them, we all win because we are producing caring and compassionate doctors that I bet will make a great mark in medical history.
I hope you can join us in our journey to making medicine more inclusive for students with disabilities, please sign the petition for alternative pathways for prospective medical students with disability.
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