Anticipating Accommodations in A Clinical Rotation

While it's not possible to predict all the specific ADA accommodations a future medical student may be eligible for in a clinical rotation, here are possible accommodations that may be needed, and ways to meet them.

Possible Accommodations for Clinical Rotations

While it’s not possible to predict all the specific ADA accommodations a student may be eligible for in a clinical rotation, accommodations may be needed.

It is critical to be aware that:

not all disabling conditions are visible and
effective planning discussions must occur without needing to disclose protected information about diagnosis or disability.

Focus on addressing the barrier, not the diagnosis.

The table below lists disability categories, examples of functional limitations stemming from these disabilities, possible barriers that could exist within a clinical rotation, and examples of what to consider when determining accommodations.

The list is by no means exhaustive; students may have multiple functional limitations with multiple diagnoses.

Anticipating Accommodations in a Clinical Rotation
Disability Category	Functional Limitation	Examples of Barriers in a Clinical Rotation	Examples of Accommodations
Physical / Mobility	Difficulty walking Difficulty standing for long periods of time Decreased or no dexterity (fingers, hands, arms, legs) Need extra time for transitions Limited fine and/or gross motor movements Limitations with motor coordination Decreased stamina / increased fatigue	Need to maintain pace Need to spend time standing Need to move in certain ways Need to move from place to place (at specific speeds) Patients located in locations with stairs	Additional time for walking Access to a stool Assignments that minimize distance walked to patient location Having an intermediary Modified break schedule Use of assistive devices such as a wheelchair, cane, or scooter Modifications with medical equipment or its use Ergonomic considerations
ADHD (Attention-Deficit Hyperactivity Disorder)	Processing difficulties Attention difficulties Concentration or focus difficulties Difficulty remembering tasks Difficulty multi-tasking	Difficulty hearing or processing information during rounds Difficulty with cold calling Environmental triggers (sounds, lights, smells) Prolonged use of screens Transition time	Ability to get missed information in-the-moment or later Team wearing clear masks Support with inputting or reading notes Use of assistive technology Modified break schedule Record patient encounter Breaks Rest time Additional mid-rotation feedback (verbal or written)
Psychological / Mental Health	Decreased concentration, attentiveness, or organization Decreased physical or verbal engagement Decreased stamina Increased fatigue Needing additional time to process information	Length of shift time Inconsistent schedule Pace of rotation (to/from patients) Pre-rounding or rounding	Flexible schedule Modified breaks Rest time Service animal Access to food or medication Additional mid-rotation feedback (verbal or written) Additional time to process information
Chronic Illness	Increase in symptoms Need for unexpected management of condition Increased fatigue Difficulties or increased pain with long periods of standing/sitting/walking Medication or food requirements Difficulty with noise Difficulty with transitions Sensitivities or allergens Headaches Nausea Cannot view screens for long periods	Long, inconsistent shifts Long periods of standing / sitting / walking Need to maintain pace Distance between patients Location of patients Environmental triggers (noise, lights, allergens, screens) Limited breaks / lunch	Modified or flexible schedule Modified break schedules Rest time Adaptive technology Assistive technology Access to food or medication Ergonomic considerations
Learning / Neurodivergent	Difficulty processing information (written and spoken) Difficulty organizing thoughts or verbalizing information Difficulties with organization, planning, processing high volume of information Reduced concentration or attention Light sensitivity Noise or sound sensitivities Smell / touch sensitivities Difficulty reading social cues or body language	Needing time to process or integrate information Transitions Lack of or limited visual aids Pace or speed of information being provided	Flexible breaks Assistive technology (such as text-to-speech software) Additional time to integrate information or provide a response Additional mid-term rotation feedback (written or verbal) Extended time for door notes or patient encounter Modified break schedule
Hearing	Difficulty with hearing or an inability to hear Unable to read lips Decreased communication speed (without proper accommodations in place)	Decrease of verbal input or communication Noise sensitivity	ASL interpreters Clear masks More time to process verbal or written information CART (real-time captioning) Additional mid-term rotation feedback (verbal or written) Noteboard or whiteboard Paging services Assistive technology
Vision	Difficulty with interpreting charts, graphs Difficulty accessing visually presented information	Font size too small, too large, difficult to read Lighting too bright, too dim, wrong color spectrum	Large print text or images Assistive devices

Important Considerations

Some clinical sites are located outside of Burlington, and determining reasonable accommodations may take additional time.
Students should contact the Health Sciences Disability Coordinator as early as possible to discuss potential accommodations. The Coordinator will work with the program director to assess the feasibility and timeline for implementing accommodations.
If an ADA accommodation need arises just before or during a clinical/practicum experience, the process involving SAS, the student, the program, and the clinic site may need to delay implementing the accommodations.
Accommodations are not retroactive.
Early engagement with SAS ensures a smoother accommodation process and minimizes potential disruptions to clinical training.
The process to determine eligibility and implement accommodations may take 4–6 weeks.

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