The experiences of autistic doctors: a cross-sectional study

Abstract

IntroductionMedicine may select for autistic characteristics. As awareness and diagnosis of autism are growing, more medical students and doctors may be discovering they are autistic. No studies have explored the experiences of autistic doctors. This study aimed to fill that gap.MethodsThis is a cross-sectional study. A participatory approach was used to identify the need for the project and to modify a pre-existing survey for use exploring the experiences of autistic doctors.ResultsWe received 225 responses. 64% had a formal diagnosis of autism. The mean age of receiving a formal diagnosis was 36 (range 3–61). Most were currently working as doctors (82%). The most common specialties were general practice / family medicine (31%), psychiatry (18%), and anesthesia (11%). Almost half of those working had completed specialty training (46%) and 40% were current trainees. 29% had not disclosed being autistic to anyone at work. 46% had requested adjustments in the workplace but of these, only half had them implemented.Three quarters had considered suicide (77%), one quarter had attempted suicide (24%) and half had engaged in self-harm (49%). 80% reported having worked with another doctor they suspected was autistic, but only 22% reported having worked with another doctor they knew was autistic. Having never worked with a potentially autistic colleague was associated with having considered suicide.Most preferred to be called “autistic doctors” (64%). Most considered autism to be a difference (83%). Considering autism to be a disorder was associated with preference for the term “doctors with autism,” and with having attempted suicide.ConclusionAutistic doctors reported many challenges in the workplace. This may have contributed to a culture of nondisclosure. Mental health was poor with high rates of suicidal ideation, self-harm, and prior suicide attempts. Despite inhospitable environments, most were persevering and working successfully. Viewing autism as a disorder was associated with prior suicide attempts and a preference for person-first language. A neurodiversity-affirmative approach to autism may lead to a more positive self-identity and improved mental health. Furthermore, providing adequate supports and improving awareness of autistic medical professionals may promote inclusion in the medical workforce.

The experiences of autistic medical students: A phenomenological study

“…The importance of autistic role modelling in medicine is further supported by wider research, which shows that having never worked with another doctor they suspected of being autistic was actually associated with higher rates of suicidal thoughts in autistic doctors. 38 It is therefore tempting to ask, 'how many senior doctors (and medical teachers) are autistic?' It is likely that most people would suggest that many doctors they had encountered exhibited autistic characteristics to some degree.…”

“…It is therefore important for autistic students to have access to autistic peers and role models within medicine 37 — not only to promote peer support and camaraderie but also to allow for improved social modelling, self‐efficacy and motivation. The importance of autistic role modelling in medicine is further supported by wider research, which shows that having never worked with another doctor they suspected of being autistic was actually associated with higher rates of suicidal thoughts in autistic doctors 38 . It is therefore tempting to ask, ‘how many senior doctors (and medical teachers) are autistic?’ It is likely that most people would suggest that many doctors they had encountered exhibited autistic characteristics to some degree.…”

“…The community preference reflects the identity‐nature of autism and empowers autistic people to embrace their differences without the appendage of disorder — a negative thing they have. Within autistic doctors, a preference for person‐first language has been associated with considering autism a disorder, which was, in turn, associated with higher rates of suicide attempts 38 Autism isn't something a person has, or a ‘shell’ that a person is trapped inside … It is not possible to separate the autism from the person – and if it were possible, the person you'd have left would not be the same person you started with 52 …”

The experiences of medical students with ADHD: A phenomenological study

“…This pervasively impacted their whole lives, in and outside of their medical studies–putting strain on their relationships, their mental health, for example. This may, in part, explain the higher rates of mental ill health that neurodivergent doctors seem to experience [ 42 ].…”

Have you considered autism?

“…I did not need to be Autistic to be a physician, but the qualities of having deep interests to the exclusion of all else are common to both autism and the field of medicine. 7 As a hospitalist, I work better with fewer interruptions and a quiet place to work; reducing unnecessary input allows me to focus.…”