Brighton and Sussex Medical School, Brighton, East Sussex, United Kingdom.
Department of Medical Education, Brighton and Sussex Medical School, Brighton, East Sussex, United Kingdom.
PLoS One. 2023 Aug 22;18(8):e0290513. doi: 10.1371/journal.pone.0290513. eCollection 2023.
Attention Deficit/Hyperactivity 'Disorder' (ADHD) is a form of neurodivergence, characterised by lifelong differences in attention, impulsivity, and hyperactivity. University students with ADHD underachieve academically and tend to have lower levels of self-esteem. Medical schools have an obligation to minimise barriers for students with ADHD. Understanding the experiences of medical students with ADHD is vital to promote inclusive approaches. Our exploratory research question was: "What are the experiences of medical students with ADHD?" This was an interpretive phenomenological study. Loosely structured interviews were conducted with participants (medical students with ADHD) over Zoom. Subsequent transcripts were analysed using interpretive phenomenological analysis. Six people participated. Our analysis identified the following themes: Identity and diagnosis; ADHD profile; system issues; conflict, competition and compensation; improving the experience. Participants reported experiences of bullying and isolation at medical school, perpetrated by doctors and peers, as well as feelings of alienation when unable to conform on placement and in exams. From this, participants adopted survival strategies, such as masking, to avoid being ostracised. All recognised their ADHD status when their mental health deteriorated during their medical studies. Of those who disclosed their diagnosis, none were offered personalised support. Participants feared disclosure, largely due to weaponised professionalism and the effects of toxic competitiveness in medicine. They yearned for a sense of belonging. Participants reported strengths associated with ADHD such as empathy and working well under pressure, which are highly desirable aptitudes for doctors. This study has highlighted areas where medical schools can be instrumental in cultivating an environment where medical students with ADHD can thrive, not just survive. This may take the form of peer support groups, alongside reasonable adjustments throughout medical school-particularly for Objective Structured Clinical Examinations, for example. Enabling these students to thrive may help to prevent early burnout and subsequent attrition from medicine.
注意缺陷多动障碍（ADHD）是一种神经多样性，其特征是注意力、冲动性和多动性终生存在差异。患有 ADHD 的大学生在学业上表现不佳，自尊心往往较低。医学院有义务为患有 ADHD 的学生减少障碍。了解患有 ADHD 的医学生的经历对于促进包容性方法至关重要。我们的探索性研究问题是：“患有 ADHD 的医学生的经历是什么？”这是一项解释性现象学研究。通过 Zoom 对参与者（患有 ADHD 的医学生）进行了松散结构的访谈。随后使用解释性现象学分析对转录本进行了分析。共有 6 人参与。我们的分析确定了以下主题：身份和诊断；ADHD 特征；系统问题；冲突、竞争和补偿；改善体验。参与者报告了在医学院受到医生和同龄人欺凌和孤立的经历，以及在实习和考试中无法适应时感到疏远的经历。由此，参与者采用了生存策略，例如掩饰自己，以避免被排斥。所有参与者在医学学习期间心理健康恶化时都意识到自己的 ADHD 状况。那些透露自己诊断结果的人中，没有人得到个性化的支持。参与者担心透露自己的病情，主要是因为武器化的职业素养和医学中有毒竞争的影响。他们渴望归属感。参与者报告了与 ADHD 相关的优势，例如同理心和在压力下工作的能力，这些都是医生非常需要的能力。这项研究强调了医学院可以在哪些方面发挥作用，为 ADHD 医学生创造一个能够茁壮成长的环境，而不仅仅是生存。这可能采取同伴支持小组的形式，以及在整个医学院期间的合理调整——例如，对于客观结构化临床考试。使这些学生茁壮成长可能有助于防止早期倦怠和随后从医学领域流失。
