Mapping the Landscape of Technical Standards: A Nationwide Review of Medical Schools

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Abstract
Purpose: As a requirement for accreditation, medical schools must have technical standards to outline essential abilities for admission, progression, and graduation. In the absence of national guidance, the AMA published recommendations in 2021 for schools to use “functional” technical standards language (focused on achieving outcomes), as opposed to “organic” (focused on body functions). This study benchmarks the extent to which U.S. MD- and DO-granting programs have adopted functional language and assesses public availability of technical standards. Method: In 2023, the authors conducted a national cross-sectional content analysis of technical standards from all fully accredited U.S. MD- and DO-granting medical schools (N = 192) using AMA-endorsed criteria. Three technical standard domains—observation, communication, and motor—were coded as “functional,” “organic,” or “mixed,” generating a composite score for each school. Descriptive analysis was used to identify patterns and associations. Results: Of 192 eligible schools, 99.4% of MD and 100.0% of DO programs provided their technical standards online; one school did not have technical standards. The mean composite score was 1.24 (95% confidence interval, 1.02–1.46; SD = 1.55) out of a possible 6 for fully functional standards. MD programs were more likely to use functional language than DO programs, reflected in the higher overall mean score of 1.43 (SD = 1.59) for MD programs compared to 0.37 (SD = 1.00; P < .001) for DO programs. Schools established in 2010 or after were less likely to have functional technical standards than older schools ( P = .01), and schools reporting updates to their technical standards in 2022 or later had slightly higher functional scores than schools with less recent updates. Conclusions: Adoption of functional technical standards is varied. Most medical schools maintain restrictive organic language despite AMA recommendations. Greater alignment with functional standards could enhance inclusion of people with disabilities in medicine.

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