Letter to ACGME on disability clinical care and competency training

October 13, 2026

George E. Thibault, MD
Chair, Board of Directors
Accreditation Council for Graduate Medical Education
401 North Michigan Avenue, Suite 2000
Chicago, Illinois 60611

Dear Dr. Thibault:

I am writing to you in my capacity as the Chairman of the National Council on Disability (NCD). We are an independent federal agency charged with advising the President, his Administration, Congress, and federal agencies on matters of disability law and policy. The purpose of this letter is to continue the now years-long positive engagement NCD has had with the Accreditation Council for Graduate Medical Education (ACGME) concerning disability clinical care and competency training of residents in programs that fall under the authority of your organization. Building on NCD’s July 2021 letter to the ACGME, the ACGME’s subsequent participation in NCD’s 2023 Council meeting discussion, and the 2025 ACGME Disability Summit encouraged by NCD, which resulted in the ACGME acknowledging that “physicians need to be better trained in how to care for patients with disabilities,” ¹ NCD welcomes continued dialogue. Specifically, would welcome a discussion about how disability clinical-care and competency training should be reflected in the ACGME’s current major revision of the Common Program Requirements and, as appropriate, in the Neurology and Child Neurology revision processes.

As NCD has previously shared with the ACGME, a substantial body of literature ² confirms significant disparities in the quality and adequacy of healthcare received by people with disabilities. Although these disparities are influenced by multiple factors — including access to care, stigma, reimbursement practices, transportation, socioeconomic conditions, and environmental barriers — one consistently identified contributing factor is insufficient physician training in the assessment, management, and treatment of patients with disabilities. This training gap has been recognized across both graduate medical education and postgraduate clinical training, including residency and fellowship programs.

Many ACGME accredited medical training programs leave providers with little or no skills, knowledge, comfort, confidence, or awareness in the proper treatment of patients with disabilities, which is reflected in adverse clinical outcomes. In addition to primary care, the obvious negative consequences are observed daily in every specialty and sub-specialty. It is NCD’s position that this is a problem that must be remedied to comply with Section 504 of the Rehabilitation Act of 1973 ³ and the Americans with Disabilities Act.⁴ It is crucial that disability clinical care and competency training be required of medical residency programs rather than simply encouraged. In the absence of a clearly stated requirement, disability clinical care and competency training has not become the norm across the majority of ACGME accredited training programs across the nation.

The ACGME’s current revision of its Common Program Requirements, and Neurology and Child Neurology revision processes, is an optimal opportunity for the ACGME to now require its accredited residency and fellowship programs to adopt and implement clinical care and competency training. NCD recommends that, at a minimum, such training integrate NCD’s Model Disability Clinical Care Competency Curricula Framework. ⁵ Health care providers that people with disabilities see for examination and treatment must be trained to provide the care and proper treatment that people with disabilities require.

We would like to meet with you and discuss this recommendation. Addressing this longstanding gap in residency training directly advances the ACGME’s mission to “improve health care and population health by assessing and enhancing the quality of resident and fellow physicians’ education through advancements in accreditation and education.” ⁶

As a courtesy, Amged M. Soliman, NCD Senior Attorney Advisor, will call your office on October 21, 2026, to coordinate a date and time for an initial discussion. If you have any questions or desire to reach me in advance of that call, you can reach me via email at nromano@ncd.gov. Mr. Soliman can be reached at asoliman@ncd.gov or 202-381-7753.

Respectfully,

Neil Romano
Acting Chairman

cc: Debra F. Weinstein, MD
President and Chief Executive Officer

\ Kathy Malloy
Senior Vice President, Accreditation Standards and Policy

Disabilities* (2025), https://www.ncd.gov/report/framework-to-end-health-disparities-of-people-with-disabilities.