Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK.
Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK.
Med Educ. 2023 Oct;57(10):971-979. doi: 10.1111/medu.15119. Epub 2023 Jun 1.
Increasing 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.
This 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.
Five 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"'.
Participants 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.
自闭症认知度的提高反映在对自闭症医护人员认识的提高上。监管机构,包括英国普通医学委员会和英国医学科学院理事会,已经发布了促进包容的指导方针。虽然许多自闭症医生和学生都表现出色,但许多人除非遇到困难,否则不会透露自己的诊断,这使刻板印象持续存在。没有研究探讨过自闭症医学生的经历。我们旨在做到这一点。
这是一项解释性现象学研究。通过 Facebook 公告招募自闭症医学生。参与者接受了录音、结构松散的访谈。录音被逐字转录,并进行了解释性现象学分析。
来自英国五所不同医学院的五名学生参与了研究。构建的主题包括:自闭症特征和刻板印象-“我和病人打交道比和同龄人、同事打交道要好得多,这让很多人难以理解”;感官处理和学习环境-“噪音真的伤我的耳朵……对很多人来说很难理解”;自我和掩饰-“所以,医学很难。但我也在研究自己,我在了解自己,那个学位更难”;社交世界-“我总觉得我在提防别人”;以及在系统中导航-“[他们说]“但你总有一天会成为一名医生,所以你需要习惯它””。
参与者渴望得到医学院的理解和支持。他们报告了孤立、欺凌和焦虑的经历。大多数人觉得自己是制度的受害者,他们被期望自己调整以显得非自闭症。当参与者因为自闭症而报告无法应对时,大多数人被建议“休息一下”。没有人被提供个性化的学习环境调整。所有人都报告了与自闭症相关的优势。这支持了自闭症患者可以成为安全、有效和熟练的医生的观点。