General Medical Council 'Gateway to the professions' guide issued March 2008

http://www.gmc-uk.org/education/undergraduate/undergraduate_policy/gateways_guidance/index.asp

Executive summary:

http://www.gmc-uk.org/education/undergraduate/undergraduate_policy/gateways_guidance/gateway_exec_summary.asp

The Appendix on examples of reasonable adjustments includes items and support that are relevant to DSA:

Physical environment

Examples of reasonable adjustments to the physical environment: 

• ramps to all necessary locations
• accessible lifts and lift buttons
• automatic doors
• accessible external paths and landscaping
• accessibility within buildings, including their interior layout
• vibrating and light fire alarms for deaf people
• adapted fire alarms and door bells in university accommodation
• vibrating pagers
• fire refuges or alternative escape routes for people with mobility impairments
• quiet refuges and first aid facilities where people with epilepsy, for example, might go after an attack
• rooms without fluorescent lighting
• enhanced signage and colour or tone contrasts to aid orientation
• enhanced lighting to facilitate lip reading
• effective sound system with T loops
• desks, laboratory benches, work surfaces and reception desks at varying or flexible heights
• appropriate seating
• reserved areas in all teaching and learning locations, including the library
• accessible technology, including screen readers, and libraries
• accessible toilets
• accessible services, such as catering facilities, or payphones in a corridor
• convenient and reserved parking spaces
• lowered kerbs.

Application process

Examples of reasonable adjustments to the application process:

• text phones for the enquiry stage
• information, such as university policies and course leaflets, in potentially accessible formats: such as email, braille, easy read, large print, audiotape, and computer disc
• electronic information that can be accessed by a range of screen readers and assistive software
• staff trained in communicating with a wide range of disabled people.

Where possible, all information should be:

• offered in both visual and audible formats
• available in different font sizes
• available with different background and foreground colours
• available without enhancements such as boxes
• easily navigable, if electronic, using either a mouse or keys.

Teaching and learning

Examples of reasonable adjustments to the teaching and learning environment:

• audience-facing lecturers under good lighting
• elimination of background noise
• adjustments to the physical environment as above
• availability of laptops or hand-held devices for taking notes
• availability of a note-taker for lectures
• full lecture handouts
• lecture notes available in different text formats
• written materials available in audio format
• availability of notes in electronic format to enable use of assistive software (such as text to speech; speech to text; mindmapping software)
• intranet material that meets established guidelines for compatibility with specialist software
• availability of searchable reference texts
• availability of spell checkers
• small groups for practicals keeping the same group throughout
• stethoscope linked to a display screen
• compatibility of online teaching resources / websites, patient records, X rays and test results with the student's software magnification programmes
• availability of screen readers
• microscopes linked to CCTV screens
• additional learning support and coaching
• support in researching booklists for those unable to ‘browse’ in the library
• provision of study skills support covering essay writing or dissertation skills
• additional time and flexible deadlines for assignments for those with variable conditions
• adjustments to assignments, such as allowing a student to submit a piece of work on video rather than in writing
• comments on course work in alternative formats
• additional training for teachers in making teaching and learning more accessible to disabled students.

Assessments

Examples of reasonable adjustments to assessments and examinations:

• flexible seating arrangements in examination halls
• written exams being done in a small room as opposed to a large sports hall
• appropriate timing during the day
• examination papers and assessment instructions available in different formats
• individuals given more time to complete examinations
• assistants, such as a scribe to transfer answers onto computer paper
• flexibility in ways of enabling students to answer, such as: an oral rather than written assessment; a written exam, extended essay, or PowerPoint presentation rather than a verbal presentation
• flexible deadlines for those with variable conditions
• partial retakes and deferred exams for those with illness
• extension of the registration and completion period for Royal College examinations.

For practical assessments such as OSCEs:

• students given additional time to read instructions
• timing of OSCE exams to earlier rather than later in the day
• individual circuit for OSCE assessments
• OSCE stations made more accessible, for example a resuscitation manikin placed on a couch
• trainee allowed to use own modified stethoscope
• examiners briefed about individual trainee requirements
• a signer entering the assessment cubicle with the student to place a microphone on the manikin while the student reads the instructions.

Clinical placements

Examples of reasonable adjustments on clinical placements:

• additional support for students in finding placements that meet their requirements
• clinical placements being suitably located if possible to minimise travel
• transport to locations or checking availability of public transport
• buildings made accessible for wheelchair users and others with mobility impairments
• checking of lighting and obstacles
• alternative learning opportunities where placements cannot be made accessible
• an electric scooter for getting around a hospital
• replacement sets of wheels for entry to the operating theatre
• training of work placement providers in disability equality and how to work with disabled students
• increased supervisory support
• slowing of ward rounds, help in carrying notes
• arrangements made to ensure that disabled people can take personal assistants or assistive technology with them where necessary
• amplified stethoscopes
• compatibility of patient records, X rays and test results with the individual’s software magnification programmes
• flexible working hours
• adjustments to working hours, for example reduced hours, reduced daytime on-call duties, fewer or no night time duties or weekend calls
• adjustment made to duties, for example no crash calls for wheelchair users
• part-time placements
• extra time and time out
• time off to fit treatment schedules, therapy and out-patient appointments
• placements modified to allow attendance at signing and lip reading classes in the evening.

Other support:

• time out from studies for those with illness
• appropriate treatment assured
• links with specialist organisations if help is needed, for example by dyslexic students
• a mentor or additional mentoring
• local ‘buddy system’ between disabled and non-disabled students
• disability-awareness training for staff to increase awareness of common disability related issues
• staff in accommodation blocks made aware of the disabled student’s needs
• staff trained in communication with a hearing impaired person
• colleagues made aware of individual’s circumstances.