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People with intellectual and developmental disabilities have benefited significantly from the medical advances of the last century. While the life expectancy of the general population has increased by around 30 percent over the past 80 years, the life expectancy of people with intellectual disabilities has increased by 200 percent. Once relegated only to discussions of pediatric medicine, intellectual and developmental disabilities are becoming increasingly more prevalent in the adult patient population. In fact, for the first time in the course of human history, there are now more adults living with intellectual and developmental disabilities than children.
Unfortunately, despite their longer life expectancies, people with ID/DD experience significant disparities in the quality of healthcare that they receive. As a result they are kept in poorer health and can be expected to die at a younger age than their non-disabled cohort. Though there are many factors contributing to this, lack of a physician training is frequently cited as one of the most pervasive. The fact that most medical students and medical residents will never receive adequate training to treat this patient population is a direct result of the lack of focus that medical schools and residency programs have in their curricula regarding patients with ID/DD.
In 2010, the National Curriculum Initiative in Developmental Medicine (NCIDM) was created to address this issue. The NCIDM was formed through a partnership between the American Academy of Developmental Medicine and Dentistry (AADMD), the Family Medicine Education Consortium (FMEC) and the North Carolina Mountain Area Health Education Center (MAHEC). The purpose of the NCIDM was to develop a socio-biologically balanced, well-organized curriculum that could be implemented in primary care residency training programs around the United States.
The curriculum was developed through the interaction of over 30 experts in the field, dispersed geographically across the United States, via regular meetings over the course of nearly two years, to reflect the six core competency areas of the ACGME. The curriculum was vetted through multiple organizations, stakeholders, self-advocates and through international experts with similar curriculum development experience.
The curriculum itself has been divided into three tiers. The first tier is considered core information that every resident must know about treating patients with ID/DD. The next tier is a recommended level of learning that most residents should achieve prior to the end of their training program. The final tier is considered an exemplary level of training that would be appropriate for a physician who is considering dedicating his or her career to the field of Developmental Medicine. In order to view all three tiers of the NCIDM curriculum visit the interactive report here: http://aadmd.org/page/interactive-report
As with all curricula, this document reflects a snapshot of the current thinking of its time. If the history of people with ID/DD has taught us anything, it is that our attitudes and knowledge base can change very rapidly. With this in mind, it should be noted that this curriculum is meant to be a living document. It is the hope of the authors of this document that the goals, objectives, materials, resources and evaluations associated with this curriculum be revised, updated and adapted periodically to reflect the environment in which they are being applied.