Medical students with specific learning disabilities: mixed-methods systematic review of the prevalence, academic performance, challenges, and perceived impact of support interventions.

backgroundSpecific learning disabilities (SpLDs)-including dyslexia, dysgraphia, dyscalculia, and dyspraxia-affect approximately 5-8% of medical students. The demands of medical education may exacerbate these challenges, while stigma and inconsistent institutional support contribute to ongoing barriers. This mixed-methods systematic review synthesised evidence on prevalence, academic performance, challenges, and support needs to inform more inclusive medical education practices.

methodsA mixed-methods systematic review was conducted following Joanna Briggs Institute (JBI) methodology and PRISMA 2020 guidelines. PubMed and EBSCOhost were searched in October 2024. Primary studies on undergraduate medical students with formally diagnosed SpLDs were included. Fifteen studies met the inclusion criteria (eight quantitative, seven qualitative). Quantitative data were synthesised using meta-analysis and narrative approaches, qualitative data using meta-aggregation, and findings were integrated using a convergent segregated approach.

resultsThe prevalence of SpLDs among medical students ranged from 2% to 11.5% (mean 5.5%). Meta-analysis of three studies showed no statistically significant difference in multiple-choice assessment performance between students with and without SpLDs when accommodations, most commonly additional examination time, were provided (standardised mean difference d = 0.045; 95% CI: -0.094 to 0.183), although evidence was limited and context-dependent. Evidence for other assessment formats was inconsistent, with some indication of lower performance. Qualitative findings identified persistent academic challenges and psychosocial impacts, alongside unmet support needs, including early identification, flexible assessment design, structured mentoring, and increased staff awareness.

conclusionsLimited quantitative evidence suggests that medical students with SpLDs may achieve comparable performance in some accommodated MCQ-based assessments, but findings remain context-dependent. Qualitative findings consistently indicate substantial additional effort, emotional burden, and systemic barriers, suggesting that comparable outcomes may not necessarily reflect equitable learning conditions. More inclusive, flexible, and proactive educational approaches are needed to support equity, inclusion, and wellbeing in medical education.