The topic of disability is taught, albeit in a limited way, in our medical schools. We are taught to recognize disparities, to challenge ableism, to approach people with compassion and to practice inclusivity. Yet, one essential element remains glaringly underrepresented: accessibility.
Although closely related, disability and accessibility are not the same. Disability education focuses on helping future physicians understand the experiences and medical care of individuals with disabilities. In contrast, accessibility education teaches how to identify and eliminate barriers – such as physical obstacles, sensory overload or systemic inequities – that prevent people from accessing health care in the first place.
About one in five people in Canada has a disability. Almost everyone will experience some form of disability during their lifetime. Accessibility is not about serving a minority, it is about creating environments that work for everyone. When health-care settings are inaccessible, individuals experience decreased access to care, lower quality of care and, ultimately, poorer health outcomes.
Topics such as inclusive clinic design, accessible communication strategies and sensory-friendly environments are rarely covered in most medical schools. Equally absent is foundational knowledge of physical accessibility standards – such as door-width requirements, ramp gradients, desk height, accessible washroom features, parking space design, Braille signage, colour contrast for text, visual-auditory alerts like horn strobes and more. These are basic elements outlined in accessibility guidelines such as the Americans With Disabilities Act, yet they remain unfamiliar to most physicians.
While accessibility is a collaborative effort involving people with lived experience, designers, construction teams, engineers and policymakers, physicians also have a critical role to play. Although they do not need to memorize building codes, medical education should equip physicians with a basic understanding of accessibility – enough to recognize their own biases, identify when a space is inaccessible and prioritize accessibility in clinical settings. Without this awareness, physicians risk perpetuating the very health disparities they aim to address. The ability to recognize and advocate for accessible environments is a fundamental component of ethical, person-centered care.
Accessibility education aligns closely with the CanMEDS Framework, the foundation of Canadian medical education that outlines the core competencies physicians are expected to develop. It supports the Health Advocate role by training physicians to recognize and address barriers to care. It reinforces the Leader role by encouraging physicians to promote inclusive clinical environments and advocate for systemic improvements. It strengthens the Collaborator role by emphasizing teamwork in addressing accessibility features. It enhances the Communicator role by promoting accessible language and communication tools. Teaching accessibility is a practical extension of the CanMEDS competencies.
Despite the value of accessibility education, several barriers limit its integration into medical training. Curriculum time is already constrained, making it difficult to introduce new content without displacing existing material. In the absence of accreditation standards or national learning objectives that explicitly include accessibility, institutions often lack the mandate or incentive to prioritize it. Accessibility also is frequently viewed as the responsibility of administrators, engineers, or policymakers – rather than physicians – reinforcing a siloed approach in which clinicians are expected to work within, rather than challenge, existing systems. Additionally, systemic ableism in healthcare can result in the de-prioritization of accessible care environments, further marginalizing the rights of individuals with disabilities.
The mindset needs to change. Accessibility is not a convenience – it is a human right. If we aim to train physicians to deliver equitable, person-centered care, we must also equip them to help design the systems that make such care possible. Embedding accessibility into medical education is not simply about expanding the curriculum, it is about fulfilling our ethical obligation to create a health-care system that is inclusive by design, not by exception.
