What are reasonable adjustments?
A reasonable adjustment is any change that your medical school, Deanery or hospital can make to assist your learning, or help that will enable you to overcome difficulties you may have, when compared with a non-disabled student or colleague.
How do reasonable adjustments translate in working life?
View the video of Dr Cate Wight talk about her experiences of adaptations made at her workplace.
View the video of Dai Samuels talking about disability at work.
What does the law say about reasonable adjustments?
The Equality Act 2010 describes a 'duty to make adjustments'. Reasonable adjustments are specific to each individual and should be discussed prior to attending university or commencing your postgraduate training.
Examples of reasonable adjustments include:
- mobility support
- adjusted work or on-call rotas
- extensions on deadlines.
For students, your medical school should have a disability support adviser to discuss with you the adjustments required to facilitate your learning. If reasonable, the adjustment is implemented and reviewed throughout your studies.
Prior to postgraduate training, contact your postgraduate dean or medical royal college to assess what you will need during your foundation year and beyond.
What does the GMC say?
The General Medical Council believes that the Equality Act 2010 imposes a duty to make reasonable adjustments under three requirements:
- Where a provision or practice puts a disabled person at a substantial disadvantage in comparison with persons who are not disabled. This requires changing policy or the way things are done by a particular organisation.
Example: Amending a 'no dogs allowed' policy for guide dog users.
- Where a physical feature puts a disabled person at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled.
Example: Making changes to the structure of a building to improve access.
- Where a disabled person would, but for the provision of an auxiliary aid, be put at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled.
Example: Providing information in an accessible format (Braille, large font), an induction loop for students with hearing aids, special computer software, or additional learning support.
Read more on the GMC website
What is reasonable?
What is reasonable will depend on a number of circumstances, including the cost of the adjustment. The Equality Act 2010 requires providers of medical education services to put measures in place before there is an effect on disabled people.
Factors which may be considered when assessing if an adjustment is reasonable:
- whether the adjustment will actually overcome the identified difficulty
- how practicable it is to make the adjustment
- the financial and other costs involved
- the amount of disruption caused
- the money already spent on adjustments
- the availability of financial or other assistance.
Many reasonable adjustments can be inexpensive and, in some cases, Disabled Students' Allowances can be granted to cover the partial or full cost of any adjustment. Disabled Students' Allowances are grants to help UK students meet the extra costs of studying that they face as a direct result of a disability or learning difficulty.
Find out more about Disabled Students' Allowances
Keeping you informed
Once your medical school has identified a reasonable adjustment, and has it put in place, the existence of the adjustment should be drawn to the attention of disabled people by, for example, putting a sign or notice at the entrance or highlighting it in publicity material.
Failure to make you aware of the adjustment could be considered as not making the adjustment at all.
If in any doubt, please discuss with an accredited specialist (physician) in occupational medicine.
What do existing disabled medical students think?
- 49% find one or more areas of the medical course to be challenging due to their disability, this is in contrast to two-thirds of disabled students who had not required, or sought any support from the university.
- For those that sought support from the medical school, the support provided was with regard to NHS placements arranged in accessible locations. 81% of disabled students had not sought support for help with placements outside of medical school.
- When support was sought, about 70% reported that the support that they had received was sufficient
- When asked about specific adjustments, 58% responded that disabled students should have adjustments made to assessments
- 57% agreed with the statement that 'disabled students could be allowed to graduate with limits on their registration' if they were unable to carry out certain areas of the course due to their disability.
Source: Sarah Miller et al (2009) Medical Teacher 31: e272-2
Find out which adjustments you are entitled to at each stage of your training
Read the experiences of disabled students and trainees