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FAQ Empowering Neurodivergent Registrars
Neurodiversity in General Practice
Neurodivergent individuals, including those with ADHD and autism, bring unique strengths to medical practice. However, without adequate support, they may struggle with the demands of general practice training. They may come into general practice training with a diagnosis, or somewhere on their journey of learning more about their neurodiversity.
ADHD is a disorder of regulation. Approximately 4% of Australians under age 45 have a diagnosis of ADHD. Cognitive, physical and emotional dysregulation all feature to some degree in all people with ADHD. Doctors with ADHD often have strengths in creativity and cognitive dynamism. They may have excellent problem-solving skills and have clinical courage. In general practice, they may be excellent diagnosticians and have the capacity to manage uncertainty. However, they may struggle with overly creative lists of differential diagnoses and be prone to over-investigation.
To have been successful in medical studies with ADHD, a doctor must have a high intellect and resilience. They often have high energy, take calculated risks and exhibit attention variability. They can excel in environments where quick thinking and adaptability are required. If undiagnosed and untreated, they may struggle with executive dysfunction, time management, organisation and attention. Exam preparation can be very challenging and ultimately impact success.
Autism is a difference of communication and affects approximately 1% of Australians. Autistic people often have strengths in attention to detail, ethics, rules and heightened sensory awareness. Again, these can be very beneficial traits for diagnostic medicine and creating evidence-based management plans. Autistic doctors are deeply empathetic (emotional empathy is over-developed while cognitive empathy is reduced) with obvious benefit in the general practice environment. Evidence has shown that when appropriately supported autistic people are highly productive.
Many neurodivergent doctors face stigma, with some reluctant to disclose their diagnosis due to fear of discrimination. In those undiagnosed, stigma can lead to a blind spot in professional awareness and personal development. With the constant demands of masking in an environment with high level communication, autistic doctors are at a higher risk of burnout. Anxiety and depression are much more common in the autistic population. In a recent survey by Autistic Doctors International, as many as 77% had ever considered suicide. Autistic doctors may misunderstand hierarchy and have been labelled as demanding, or troublemakers, having only been victim of “talking truth to power”.
HOW SHOULD SUPERVISORS RAISE THE SUSPICION OF NEURODIVERSITY WITH A REGISTRAR?
When discussing neurodiversity with a registrar, it’s important to approach the topic sensitively and compassionately, as neurodivergent conditions can be stigmatised. A supervisor may notice issues like executive dysfunction, anxiety, feeling overwhelmed, exam difficulties, or feedback on communication from staff or patients. Supervisors might consider raising the topic by focusing on observed concerns. Instead of making a direct diagnosis, it is helpful to ask questions about potential underlying issues and offer support to help the registrar identify possible challenges. A compassionate and understanding approach is key.
HOW CAN SUPERVISORS SUPPORT NEURODIVERGENT REGISTRARS?
Supervisors can:
- Offer personalised accommodations for learning
- Be aware of and sensitive to the needs of neurodivergent registrars
- Focus on strengths and provide practical support to address challenges
- Foster a supportive, inclusive work environment that recognises the value of neurodiversity.
HOW CAN NEURODIVERGENT REGISTRARS BE SUPPORTED IN THE WORKPLACE?
Support can include reasonable workplace accommodations such as part-time work, flexible hours, and emotional support from supervisors. Structuring training requirements, like project planning and deadlines, can help neurodivergent registrars manage their tasks. Small group learning adjustments and informing medical educators about a registrar’s condition can also provide tailored support. Consider stepping through the Autistic SPACE model. ADHD Registrars may need assistance with directing the creative process and focusing on key features of a clinical presentation rather than becoming overwhelmed with masses of details.
WHAT EXTERNAL RESOURCES ARE AVAILABLE TO SUPPORT NEURODIVERGENT MEDICAL PROFESSIONALS?
There are various resources available for neurodivergent doctors, including psychologists, ADHD coaches, and professional job coaching services. Additionally, support groups like Autistic Doctors International and ADHD Coaches Australasia provide valuable connections and training for neurodivergent medical professionals.
WHAT ACCOMMODATIONS CAN BE MADE OFR NEURODIVERGENT REGISTRARS DURING EXAMS?
While exam formats remain the same, registrars with neurodiverse conditions may be eligible for accommodations such as extended time or breaks during exams. These adjustments can help registrars perform at their best without feeling overwhelmed.
Summary
What are the key points for medical educators and supervisors?
- The importance of adapting teaching and supervision methods to support neurodivergent registrars.
- A strengths-based approach that values the unique qualities neurodivergent doctors bring to the profession.
Date reviewed: 19 December 2024