Overview
On any given ward round in any given hospital, a student might be struggling. Not due to lack of preparation, but because the environment wasn’t built for their brain.
Neurodivergent medical students and doctors – including those with ADHD, autism, dyslexia, or dyspraxia – find clinical environments both rewarding and challenging. Recognising signs such as sensory overload, information fatigue, or processing difficulties allows timely support before confidence erodes. These challenges highlight how medicine often privileges one way of thinking over many others.
The Hidden Curriculum
Medicine relies heavily on unspoken rules. Students are expected to learn by observation: decoding hierarchies, shifting communication styles, and subtle social cues. Understanding these norms quickly is essential but can be overwhelming for neurodivergent learners.
Without clear expectations or supportive supervision, talented students may begin to question themselves rather than the system. This can contribute to stress, anxiety, and reduced engagement during placements.
Evidence
The 2025 Disability and Neurodivergence Survey (1) found over half of disabled and neurodivergent doctors believe ableism is more common in medicine than in wider society. Many have considered leaving the profession due to inadequate support, and even after disclosure, reasonable adjustments are often not implemented.
Psychological safety is essential for learning. Neurodivergent trainees frequently report feeling pressure to mask differences in order to fit in, which can result in exhaustion, burnout, and decreased wellbeing.
The Role of Clinical Educators
Educators play a pivotal role but often lack training in neurodivergence. With greater awareness, supervisors can provide clear guidance, structured teaching, and empathetic support, creating an environment where all learners can thrive.
Common Barriers
- Unclear expectations about assessment and performance
- Rapid, unstructured teaching with little consolidation
- Overstimulation from busy clinical environments
- Vague or inconsistent feedback
- Stigma or misunderstanding around disclosure
Inclusive Design
True inclusion should not rely on disclosure. Placements can be designed to be accessible from the outset. Simple measures can have wide-reaching impact:
- Clarity: Provide written and verbal instructions and set clear learning objectives early
- Predictability: Communicate schedules and expectations in advance
- Constructive feedback: Ensure feedback is specific, balanced, and behaviour-focused
- Sensory awareness: use quieter spaces, limit unnecessary noise, and allow short breaks
- Normalise difference: Treat variation in learning as standard rather than exceptional
From Awareness to Action
Educators: Ask learners how they learn best, encourage reflection, and seek training on neurodivergence.
Institutions: Embed neurodivergence in quality and diversity training, review assessments for unnecessary barriers, and offer mentoring and occupational health support.
Peers: Challenge stigma, avoid assumptions, and provide clarity and patience.
Looking Forward
The NHS cannot afford to lose talented clinicians due to inflexible systems. Neurodivergent doctors are essential to healthcare’s cognitive diversity and resilience. Supporting them ensures retention, safer practice, and higher-quality care. Medicine must adapt to the learners it aims to train, not expect learners to adapt to outdated structures.
References:
- British Medical Association, 2025. Disability and Neurodivergence Survey Interim Findings. London
Written By Dr Holly Smith, FY1, Maidstone and Tunbridge Wells Hospital
