Table 4.
Examples of the quotes that prompted framing of disability competencies expected from an Indian medical graduate in the role of a communicator
| Communicator With patients, families, colleagues, and community. (Can be equated with ACGME competency of Interpersonal and Communication Skills). | ||
|---|---|---|
| Exemplar quote | Disability Competency framed An IMG should be able to: |
|
| 3.1 | “Recently, I went to a diabetologist to get myself checked and, strangely, even though the doctor observed me being escorted into his cabin and being directed to sit on the stool next to him, he did not lift his face from the laptop while he spoke so I couldn’t even lip read. (DRA) | Demonstrate the use of verbal and non-verbal empathetic communication techniques while communicating with patients with disabilities and their caregivers in a manner acceptable to the specific disability culture |
| 3.2 | “Sometimes, the consent for intervention is requested from the attendants even for adult patients with noncognitive disability. It is taken for granted that because he has a disability, he is incompetent to give consent.” (DwD) | Assess the capacity of a patient with a disability to give informed consent and demonstrate the ability to take informed consent from a patient with disability |
| 3.3 | “For pressure sore management in spina bifida, it becomes the caregiver’s responsibility to go to one hospital after another since there is no management at the primary health center (PHC) level. The doctors say there’s no point keeping such children alive and surgery will cause even more nerve damage.” (DRA) | Explain the need for referral and the referral procedure to a patient with disability |
| 3.4 | “Whether it is a patient with special needs or a child with special needs, they have lots of questions and I have to give some special extra time to educate them beyond the treatment so that their general health does not deteriorate. For example, it may be a child with autism who is stammering and losing confidence.” (DwD) | Check to understand the medical advice related to treatment, prognosis, follow-up, and/or referral given to patients with disabilities |
| 3.5 | “For epilepsy, especially in rural areas when people go to the PHC where doctors come once in a week, they don’t talk about the management and just give the medicine, that’s all. How regular he should be or what he should do if he has fits - those things are missing. If they refer, they do not tell them how to reach that hospital and why they are referring.”(DRA) | Provide health education to patients with disabilities, their caregivers, their families, and at the community level in a culturally appropriate manner |