Conversations: Medical Education​

We had the chance to catch up with Dr. Alvin Loh, Developmental Pediatrician at Surrey Place Centre and Dr. Kerry Boyd, Psychiatrist working at Bethesda, McMaster Children's Hospital, and McMaster University and lead in the Curriculum of Caring. We spoke to them about their experiences teaching and training medical students to care for patients with developmental disabilities.

Dr. Kerry Boyd is a psychiatrist currently working at Bethesda, McMaster Children's Hospital, and McMaster University.  (Include link to Curriculum of Caring)

What led to your interest in training clinicians caring for patients with developmental disabilities?

I had very limited experience in medical training to equip me to provide care to patients who had communication and cognitive impairments. Shortly after I graduated from my psychiatry specialty training, I was fortunate to work with the wonderful team providing consultation and care to people who had a dual diagnosis (developmental and intellectual disability and mental health or behaviour challenges). It didn't take me long to realize how engaging these people are and how rewarding the work can be. I want to make sure that students receive good experiences and professionals are increasingly engaged in providing the kind of person centred care that people with IDD need and deserve.

Why is it important to address clinician training for patients with developmental disabilities early in health care education?

Meeting people with IDD early on in training, coupled with suitable introduction to resources, increases comfort.

What lessons would you lend to others planning to take on a similar initiative?

Invite people with developmental disabilities to participate in the training as hosts and people who will share something of their lives, interests, and struggles. We have a team of "Champion educators" who live with disabilities and are eager to meet annually (or more frequently). Whenever there is a parent talking about their story of a child with special needs, everyone is moved and we have many students wanting to "give back," "learn more," and welcome people into their future practices.

Dr. Alvin Loh is a Developmental Paediatrician currently working at Surrey Place Centre, and University of Toronto.

Why do you think it is important to include people with developmental disabilities in health care education?

The motto from England for self-advocates with developmental disabilities is clear: "Nothing about us, without us."  We need people with disabilities to tell their stories and to help us communicate better with them.  We need their feedback about what is helpful to them and what is not.

What led to your interest in training clinicians caring for patients with developmental disabilities?

As I began to teach 3rd year medical students about communicating with patients with developmental disabilities, I read a sobering report from England titled "Death by Indifference". In it, I learned about the tragic deaths of many men and women with developmental disabilities, in hospitals, as a result of clinicians not listening to patients and their families, and not responding to pleas to take notice of their pain and suffering. At that moment, I realized that our challenge is not just to teach some "helpful" communication skills, but to sound the warning that if specific skills and attitudes are not adopted and practiced with this population, it could result in a doctor's greatest fear, the preventable death of a patient.

Why is it important to address clinician training for patients with developmental disabilities early in health care education?

Early exposure in health care education to patients with developmental disabilities helps students learn the most important principle in health care, when they are most receptive. The principle that every patient is unique and of great value regardless of their socioeconomic status, occupation, diagnosis, or intellectual ability.  It also empowers clinicians with an approach to communicating with patients with developmental disabilities, which without, often leads to frustration and avoidance of the population.

What lessons would you lend to others planning to take on a similar initiative?

Work with a team of like-minded educators, from different specialties, and even different cities. Learn from one another's successes and failures.  Speak to the leaders of undergraduate education about the need and possible opportunities.  Be ready with some learning activities that develop key competencies in communication, interaction, assessment and management.