Episode 114: ACGME/DWDI Disability Resource Hub Case Study: Psychological Disability in a Nephrology Fellowship

Interviewees: Justin Bullock, MD, MPH; Cary Payne, MD

Interviewer: Lisa Meeks, PhD, MA

Description:

In Episode 114, Dr. Lisa Meeks talks with Dr. Justin Bullock (nephrology fellow, University of Washington; living with bipolar disorder) and Dr. Cary Payne (Program Director, Nephrology Fellowship, University of Washington) about navigating fellowship with a psychiatric disability—and how trust, humility, and creative flexibility built a training experience defined by healing and growth.

Together, they retrace Justin’s decision to pursue fellowship after a traumatic residency, his choice to lead with authenticity during the match, and the risks and rewards of disclosure in GME. They unpack how structured accommodations provided protection, why early defensiveness softened into trust, and the profound impact of Cary’s disarming leadership approach: “It’s not your job to teach us.”

Listeners will hear advice for residents and fellows (consider strategic disclosure, seek accommodations as protective, build trusted provider teams) and for program directors (lead with humility, embrace uncertainty, and center accommodations in creativity rather than dogma). At its heart, the episode explores how one program became not just a safe space, but a place of healing—and why that benefits trainees, programs, and patients alike.

This episode accompanies the open-access perspective This Armor of Mine: Perspectives of a Bipolar Physician and Program Director (Bullock & Payne, Chest, 2024)

This episode is part of the ACGME/DWDI Disability Resource Hub, supported by the Josiah Macy Jr. Foundation Catalyst Award, it’s a powerful reminder that access isn’t accidental—it’s built intentionally, one relationship at a time.

Transcript: https://docs.google.com/document/d/1R_FlMU-qOOVKPiaBMLc0VqQ3DVX8rjhQ16ZAZZnv_TM/edit?usp=sharing

Bios: 

Justin Bullock, MD, MPH

Justin Bullock is an Assistant Professor in Nephrology at the University of Washington School of Medicine and the Co-director of the Docs with Disabilities Initiative. Justin is passionate about creating safe environments in medicine where everyone in the hospital is able to bring their authentic selves to work in the spirit of healing. Justin is a passionate medical educator: a teacher, researcher, and lifelong learner. His primary research focus centers on how educators can foster identity safety in the learning environment, where all members of the healthcare team can be their authentic selves in the workplace. When not at work, Justin enjoys running and cooking with his partner.

 

Cary Payne, MD

Cary grew up in the Pacific Northwest. He studied Biology and Philosophy at Washington University in St Louis before attending medical school at the University of Chicago. He then returned to the northwest where he completed his residency in internal medicine and fellowship in nephrology at the University of Washington, after which he remained on faculty at UW and established the UW Kidney-Liver Program, a subspecialty nephrology service dedicated to caring for patients with concomitant liver and kidney disease. In addition to his clinical work, Cary serves as the medical director for inpatient dialysis at the University of Washington and the UW Nephrology Fellowship Program Director. When not at work he enjoys reading and hiking with his wife Gretchen and his three children.

 

Key Words:  

·       Disability Inclusion

·       Residency

·       Fellowship

·       Accommodations

·       Program Directors

·       Graduate Medical Education (GME)

Produced by: Lisa Meeks 

Resources: 

Article: Perspective of a Bipolar Physician and this program director. https://www.chestnet.org/guidelines-and-topic-collections/publications/chest-advocates/this-armor-of-mine

Disability Resource Hub: https://dl.acgme.org/pages/disability-resource-hub

Case Studies in Disability Resource Hub: https://dl.acgme.org/pages/disability-resource-hub#case_studies

UME to GME Toolkit: 

https://dl.acgme.org/pages/disability-resource-hub-transitions-toolkit-introduction

Policy Toolkit: 

https://dl.acgme.org/pages/disability-resource-hub-policy-toolkit

Disability in Graduate Medical Education Program: 

https://www.docswithdisabilities.org/digme