Barriers Before Entry: Opportunities for Improving Pre-Admission Guidance for Disabled Medical School Applicants in Australia and New Zealand

Despite widespread calls for greater inclusion of disabled people in the healthcare workforce, significant barriers remain. These barriers exist even before admission to training, when applicants are considering study options and future careers. In Australia and Aotearoa/New Zealand (NZ), the Medical Deans of Australia and New Zealand (MDANZ) have developed guidelines for inclusive pre-admission practices, but the extent to which these are enacted is unclear. This study aimed to explore the extent to which Australian and NZ schools have adopted these guidelines and whether their websites communicate to prospective applicants in a way that explicitly recognises disability as a valued dimension of diversity. We used these data to develop a set of reflective questions intended to help medical schools improve their pre-admission communication to applicants. In January–September 2024, we conducted an audit and content analysis of all Australian and NZ public-facing medical school websites. Domains examined included the use of Inherent Requirements and/or MDANZ Guidelines for Inclusive Medical Education and how these documents framed program requirements from organic or functional perspectives. We also explored the accessibility of relevant information, the transparency of pre-admission discussions, and identified where schools framed disability as a deficit versus using positive and strengths-based language. While we found examples of inclusive practices, many schools could improve the clarity and framing of the information provided to applicants. Many schools framed disability as a deficit or avoided explicit reference to disability. Clear information regarding procedures for confidential discussion of applicant circumstances and access to accommodations prior to admission was often absent, potentially leaving applicants uncertain about the impact of disability disclosure. Only half of the schools referenced the MDANZ Guidelines. Those that used Inherent Requirements often employed organic framing which did not acknowledge the role of accommodations. Establishing the state of current practice illuminates opportunities to make medical programs more inclusive from the early stages of the student lifecycle. These findings illustrate the potential gap between policy and practice. Here, we identify the practical importance of reviewing pre-admissions communication through a disability-inclusive lens, and provide a series of recommendations and reflective prompts to support medical schools as they work towards more inclusive practice.