The experiences of autistic medical students: A phenomenological study

Abstract

BackgroundIncreasing recognition of autism is reflected in the growing awareness of autistic health care providers. Regulatory bodies including the UK General Medical Council and the UK Medical Schools Council have published guidance fostering inclusion. Whilst many autistic doctors and students are thriving, many may not disclose their diagnosis unless difficulties arise, which perpetuates stereotypes. No studies have explored the experiences of autistic medical students. We aimed to do this.MethodsThis was an interpretive phenomenological study. Autistic medical students were recruited using Facebook announcements. Participants underwent audio‐recorded, loosely structured interviews. Recordings were transcribed verbatim and underwent an interpretive phenomenological analysis.ResultsFive participated from five different UK medical schools. Constructed themes included: Autistic profiles and stereotypes—‘I'm a lot better with patients than I am with my peers, with staff, which is hard for a lot of people to understand’; sensory processing and the learning environment—‘noises really hurt my ears … It actually hurts’; me, myself and masking—‘so, medicine's hard. But I'm also studying myself and I'm figuring myself out and that degree is harder’; the social world—‘I always feel like I'm watching my back’; and navigating the system—‘[they say] “but you're going to be a doctor one day, so you need to get used to it”’.ConclusionParticipants longed for understanding and support from their medical schools. They reported experiences of isolation, bullying and anxiety. Most felt themselves to be victims of the system, whereby they were expected to adapt themselves in order to appear non‐autistic. When participants reported not coping due to being autistic, most were advised to ‘take time out’. None were offered personalised adjustments to their learning environment. All reported strengths associated with being autistic. This supports the assertion that autistic people can be safe, effective and skilled doctors.

The experiences of medical students with ADHD: A phenomenological study

“…Thus, illustrating the need for doctors with ADHD to be openly visible as role models, showing they can be successful with ADHD, not despite it. This is in keeping with previous research, which found that autistic medical students desired openly autistic role models within the medical profession [ 14 ]. Here, if our participants’ desires for positive role modelling are met, it may well steer them onto a path of increased self-confidence and reduced internalised ableism–helping them to pursue their dreams and advocate for their needs–instead of one that leads to burnout and attrition [ 22 ].…”

“…However, due to their communication differences, it is possible that medical students with ADHD may be at a further disadvantage here. Previous research has certainly supported this assertion in the case of autistic medical students [ 14 ].…”

“…Thus, those appearing socially different to the majority may risk falling foul of this culture through their observed differences. In the case of neurodivergent medics, this has taken the form of bullying and isolation from their peers, leading to a sense of learned helplessness [ 14 , 15 ]. Furthermore, the learning process itself is important to consider here.…”

Students with autism can also be good doctors: promoting an inclusive medical education system

“…We have recently read the phenomenological study by Shaw et al 1 . on the challenges that students with autism face in medical schools in terms of acceptance, inclusivity, and trust.…”