Accommodations in residency: approved is not the same as provided

If you have a disability, your sponsoring institution must have an accommodation policy, and as your employer it generally must work through an interactive process with you once you ask. Many residents do the hard part. They ask, they provide documentation, and they receive an approval letter. Then nothing on the schedule changes.

This page covers the process: how to ask, what the institution should do, and how to check that an approval was put into practice. Whether you have a disability or a claim is a question for a lawyer who has reviewed your file.

Guides

Questions to ask about your own accommodations

  • Did you make the request in writing, and do you have the date?
  • Was there an interactive meeting, and did you receive a written determination?
  • Does the determination list each accommodation, who is responsible for it, and when it starts?
  • Was the determination sent to your program, and did anything in your schedule, evaluations, or remediation plan change because of it?
  • Were you given a chance to use the accommodations before you were evaluated, suspended, or dismissed?
  • If a request was denied, does the denial describe what you actually asked for? If not, did you correct it in writing?
  • Did anything adverse happen soon after you asked?

If any answer is no

Write it down the same day. Send a short, factual email to HR and your program contact asking when each approved accommodation will be in place. Keep copies outside your institutional account. Your accommodation file should be kept separate from your training file, so ask who has seen it.

Keep a dated timeline: the request, the meeting, the determination, the first day each accommodation was actually in place, and any adverse action. The gap between approval and use is often the key fact.

One honest limit

Accommodations usually work going forward. They rarely erase concerns raised before you asked, which is why asking early matters.

Deadlines

There is no fixed deadline to ask for an accommodation, but accommodations generally apply only going forward, so the request date matters. Charges for disability discrimination or failure to accommodate carry the same 180- or 300-day federal limit as other discrimination charges. See deadlines you cannot miss.

Approved but not provided?

Send us your determination letter and tell us what has changed on your schedule since. We will review it confidentially and tell you the next step: start a confidential intake.

Resident Help is not a law firm, and submitting an intake does not create an attorney-client relationship. If your situation needs a lawyer, we will tell you and help you find one.

Common questions

Does my residency program have to accommodate a disability?
Your sponsoring institution must have an accommodation policy, and as your employer it generally must work through an interactive process with you once you ask. Whether a specific accommodation is required is a question for counsel who has reviewed your file.
Do accommodations erase performance concerns raised before I asked?
Rarely. Accommodations usually work going forward, which is the strongest reason to ask early and in writing.
Is there a deadline for disability discrimination or failure-to-accommodate charges?
Charges generally must be filed with the EEOC within 180 days, or 300 days where a state or local agency enforces a similar law. The deadline cannot be extended once missed, and an internal process does not pause it.