Affects of ableism in medical education: happiness, resignation, and the disabled killjoy

Exclusion is not only an experience but a feeling. Yet, studies of disabled medical learners have paid little attention to their emotions. Affect theory provides a lens for studying how emotions are produced by socio-political ways of being and knowing. In this study, we investigated affects circulating through disabled student narratives to explore how these students perceived disability and agency within an ableist system. We conducted a reflexive thematic analysis of 674 open-text responses by disabled medical students from the 2019 and 2020 AAMC Year Two Questionnaire about their experiences with disability in medical school. We interpreted themes using affect theory and critical disability theory to map the interconnections between students’ emotions, the political actions they took, and where they responsibilized disability and change. Three primary affects circulated in these texts. Happiness underpinned students’ expressions of gratitude, awe, and institutional compliance with any accommodations they received, for disabilities they considered their own responsibility. Frustration accompanied descriptions of institutional silencing or failure to accommodate, where students emphasized environmental learning barriers, system failures, and embodied the “disabled killjoy” who resisted system constraints. Resignation circulated among students who gave up on institutional access, and resorted to managing disability alone in a system they assumed would not change. These students internalized principles of self-regulation to manage their disability, providing a novel perspective on disability non-disclosure in medical education. Affect theory provides an underexplored lens for studying the relations between emotions power, and highlights the need for nuance in interpreting disabled students’ emotions.