What approaches to supporting learners with disabilities have been implemented in postgraduate specialty training in the workplace?: A scoping review protocol.

Understanding experiences of disability and additional needs in postgraduate training: developing and implementing accessible work based training approaches in practice. Historically people with disabilities and additional needs have experienced discrimination across a breadth of sectors and workplaces, including in medical and clinical careers. While our society has made progress in addressing the direct and indirect discrimination experienced by people with disabilities, challenges remain that may impact every aspect of an individual’s daily life. Key legislation in the UK, the Equality Act (2010) protects individuals rights against discrimination and enshrines in law the right to reasonable adjustments to support individuals with disabilities (UK Government, 2010). This legislation therefore ensures that healthcare professionals, including those in postgraduate training, should have access to reasonable adjustments to support their participation in their workplace and careers. Along with other protected characteristics people with disabilities have historically been underrepresented in healthcare professions in the UK and across the world, including across the breadth of medical and clinical training (General Medical Council, 2019). Efforts to address representation and experiences in the healthcare workforce and training have become widespread in recent years, supported by the development and dissemination of national guidance and best practice, such as the General Medical Council (2019) ‘Welcomed and valued’ guidance in the UK. The work to date in developing increased representation of disability in medical and clinical professions demonstrates some progress towards ensuring fair, equitable and inclusive workplaces in healthcare. However, there is evidence that there is still significant progress to be made against these goals, with recent research indicating that UK Doctors widely believe there is not a disability inclusive culture in medicine (British Medical Association, 2020; (British Medical Association, 2025). Research into the experiences of medical and clinical learners with disabilities in the UK currently appears to have limitations and is largely survey based, such as the British Medical Association (2020) survey “Disability in the medical profession” and British Medical Association (2025) “Disability and Neurodivergence” survey. These studies are helpful in gathering responses from large numbers of professionals, but the survey methodology limits the depth to which their experiences, and the complexities of these experiences, can be explored and expressed in their own words. Little research currently exists about the experiences and views of UK supervisors of Postgraduate Specialty Trainees with disabilities. International research demonstrates these stakeholders arguably play an important role in the experiences and progress of trainees (Salinger et al.,2024), and supervisor approaches may not always support overall aspirations for equitable accessible postgraduate training. While the existing research provides helpful context of the scale of the challenge in supporting disability inclusive training and working environments in healthcare the findings may not be representative of the experiences of Postgraduate Specialty Trainees across a breadth of different workplace training settings. In addition, experiences and workplace training may now significantly differ from training pre COVID-19. Therefore, the workplace training environment, and experiences of learners, with and without disabilities, may differ across specialty training programmes, which may or may not support application of common approaches to address equity. With inclusion of training in non-clinical settings, or virtual delivery there may be similarities to experiences of people with disabilities working in more office based, non-clinical industries such as local Government. However, the combination of working across different settings with the specialty training programme structure of clinical supervision, place-based learning, frequent rotations and potentially working across multiple organisations makes specialty training distinct from corporate employment. Nationally a clear need to address inequity and unwarranted variations in access, outcomes and experiences in Specialty Training Programmes has been clearly identified (Iacobacci, 2020; Aggarwal et al., 2023). This is a clear priority for action recognised in the national review of postgraduate medical training (NHS England, no date; NHS England, 2025a; NHS England, 2025b) , and is also recognised as a wider challenge across the breadth of the health and care workforce (Care Quality Commission, 2025). This presents a policy window opportunity to use evidence and research into the lived experiences of Specialty Registrars with disabilities and additional needs to inform reviewed and updated policy and practice going forward, including the development of training and guidance for supporting fair and equitable workplace learning experiences. Study aims. A sociocultural lens, informed by critical theories of disability, will be used to explore the lived experiences of Postgraduate Specialty Trainees with disabilities and additional needs in workplace learning settings, and their supervisors. Overarching aim: To improve equity and disability representation in the NHS healthcare workforce through development of evidence based practical approaches to supporting workplace training and supervision, by addressing sociocultural factors negatively impacting learning and lived experience. This will be informed by understanding the lived experiences of Postgraduate Specialty Trainees with disabilities and additional needs in workplace learning settings, and their supervisors. This study is being performed as part of a PhD in Clinical and Medical Sciences Education.