new diagnosed ASD, trying to get through med school intact

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zoidbreezy
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29 Dec 2014, 6:07 pm

Hello,

I was diagnosed with Asperger's (well, ASD-mild) in October. I'm in the middle of medical school, and I recently transitioned from the classroom-based preclinical portion (the first two years) to the clinical rotation portion.
It hasn't been going too well. We seem to mostly be graded on our personality (ie, the closer your personality matches the evaluator, the better the evaluation you'll get) and not how much work you put into the day. I don't have the typical "type A" personality that most med student (and most full grown doctors) have.
I naively thought that I would do well during the clinicals, but I guess I didn't realize how much the Aspergers affects how people see me. On one rotation that I loved, I got a horrible evaluation...they basically banished me from pursuing that specialty, I just did not realize that people weren't liking me. On my next two rotations, I just kept my mouth shut, and just try to be the best team player I can be. My result? "Passes"..which is actually the grade reserved for the bottom 15% of the class.
I just feel terrible...like I'm stumbling through the clinicals, working very hard but getting mediocre evals. I usually get averages, but a smattering of "belows" in certain areas, like "oral presentations." I'm trying hard to be more fluid in my presentations, but I don't think I'll ever be as fluent at some of my classmates in this area. This really sucks because the presentations of the patients is the part of the day where the doctors see you the most (they usually disappear for the rest of the day), and thus really plays into how they view you. Plus I've gotten comments like "Zoidbreezy should try to look people in the eye," and "sometimes Zoidbreezy focuses too much on details at opposed to the big picture." EEk those are Asperger-type symptoms.
I'm just worried because too many "belows" could one day lead to dismissal...I feel like I'm walking through a minefield.



Ajk
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29 Dec 2014, 6:29 pm

If you are "bright" enough to get to where you are you will make it if you are still sure you want to - spend a little time looking at the reasons you went to mend school are they still valid?
Then use your intellect to save yourself- look at every negative report and learn from it - need to make more eye contact- if you can and believe me I do not underestimate the difficulty of this fake it not the eyes use the eyebrow practice practice practice until you can without distraction what are your strengths use them then work on those areas that are not fitting if and only if you want to be a doctor will the end justify the means for you . Is there a student counseling service or disability support that can help but make sure of confidentiality before you approach a good wAy is to frame a question as hypothetically and if would it be reported to the med school in summary consider do you want to spend your life doing this? Can a learn to fake what is needed? Can I use my existing skills more ? Can anyone else help? Many do come through med school with asd pm if you think it will help
Good luck



ASPartOfMe
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29 Dec 2014, 9:49 pm

Would you be in the research part of medicine?


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DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person. - Sara Luterman


zoidbreezy
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30 Dec 2014, 1:16 am

ASPartOfMe wrote:
Would you be in the research part of medicine?


No matter what I end up doing after graduation...still gotta make it through the clinical years.
I actually do think my interests are more suited towards specialties with lots of research potential and/or will have a few patients during the day...but you would get to spend a lot of time with them and really delve into their cases. Thinking at this point: peds genetics, behavioral neurology, child or adult psychiatry, rheumatology.

Even med students who didn't get surprised with an ASD (...and ADHD) diagnosis in the middle of medical school are having trouble adapting to clinicals. Many of us didn't realize how mean residents/attendings could be in their evals. For example a friend of mine basically got this comment: "Terrible clinical knowledge. Will make the worst doctor evar!! !! !". This was one of her first rotations too...and it was family medicine, not even one of rotations where the attendings are notoriously mean to students like surgery or ob/gyn.

And these comments happen even after we seek weekly feedback from the staff. It almost feels like a gigantic hazing ritual.

These rotations are also forcing me to confront skills I didn't know that I didn't have (if you get what I mean), doing well in the classroom is waaay different than the clinicals. For the first two years, you can literally just skip all the classes and study at home/in the library and watch the lectures online at 2.5x speed if you want and only come in for occasional labs and exams. So, I actually do have a meeting with disability services set up, but just for some technical stuff: I realize that I might have dysgraphia (as in I can't write legibly no matter how hard I try...which sucks when I'm taking notes while interviewing patients. I'm wondering if I could carry a portable electronic word processor to type notes as I interview...I don't see how that would be a big deal). I'm afraid of bringing up the ASD stuff though. I casually inquired to them if ASD was a common diagnosis disclosed to the med school disability office, and they said it was pretty rare for med students to have that as an official diagnosis on file, so I'm wondering how much help they would be able to be. I think it's so new for milder cases to be diagnosed and many people still have certain prejudices against people with autism, and I don't want to be treated differently by the disability coordinator. I already get the "well aren't you special " treatment from the front desk when I go to see the "Aspergers therapist" at the psychology clinic. :(

I'm definitely going to work on eye contact because that comment really stung. I actually even had to defend myself against receiving a "fail" for a rotation because the site director felt that I wasn't paying attention to her during afternoon conferences. The fact is, I was listening to her but I was looking at the table instead of at her. I brought up the fact that I participated and asked questions during the conference as evidence that I was paying attention, but to think about how close I came to a fail scares me. :pale:
Eye contact IS so hard for me to do though, I can't pay attention to what anyone is saying when I look them in the eye. I started recently practicing by looking at people's foreheads and/or mouths, but even then I find myself squinting oddly. Looking at mouths is easier, but I feel like I'm still looking "too low."

I do want to make it through medical school though. Being a doc would be a great, fulfilling career. And since my diagnosis, I can tell that there a many, many people with either undiagnosed or undisclosed ASD/BAPish people in medicine (two of the interns in my internal med rotation definitely have it, and several people in my class), so there is hope.



Waterfalls
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30 Dec 2014, 6:32 am

What's the "well aren't you special" treatment at the psychogy clinic?



zoidbreezy
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30 Dec 2014, 1:08 pm

Waterfalls wrote:
What's the "well aren't you special" treatment at the psychogy clinic?


Oh, I guess it's really nothing overtly bad. I think I'm just projecting things, but I just feel uncomfortable right now telling anyone about this diagnosis, but you have to tell the receptionists that you have an appointment with THE Asperger's therapist. One receptionist looked at me skeptically and said "Are you on the spectrum? He only sees people on the spectrum." I had to quietly answer yes, and then sit in the lobby where everyone waiting probably heard.

The therapist himself is pretty nice though.



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30 Dec 2014, 1:41 pm

zoidbreezy wrote:
Waterfalls wrote:
What's the "well aren't you special" treatment at the psychogy clinic?


Oh, I guess it's really nothing overtly bad. I think I'm just projecting things, but I just feel uncomfortable right now telling anyone about this diagnosis, but you have to tell the receptionists that you have an appointment with THE Asperger's therapist. One receptionist looked at me skeptically and said "Are you on the spectrum? He only sees people on the spectrum." I had to quietly answer yes, and then sit in the lobby where everyone waiting probably heard.

The therapist himself is pretty nice though.

Well, that's just rude of the receptionist, it's not their job to assess you, especially not in front of other people. :?



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30 Dec 2014, 2:05 pm

I don't suppose there's any way you could connect with an ASD or Autistic mentor? Someone who could teach you specific work-arounds or parts of the social script you've been missing? I'm not sure how you might do this, but if it were me, I'd ask at my school's career services dept.



Ajk
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30 Dec 2014, 6:07 pm

Coming back to the eye contact thing
Before my teenage daughter was diagnosed she got a lot of hassle about apparently not listening to teachers because she listened without the distraction of looking two things helped a bit buddy holly glasses with thick frames which are quite fashionable but give a little protection in some way for her from gaze learning to look at foreheads/ mouths and putting her eyes a bit out of focus not sure how she does it but she can



zoidbreezy
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30 Dec 2014, 6:12 pm

MissDorkness wrote:
zoidbreezy wrote:
Waterfalls wrote:
What's the "well aren't you special" treatment at the psychogy clinic?


Oh, I guess it's really nothing overtly bad. I think I'm just projecting things, but I just feel uncomfortable right now telling anyone about this diagnosis, but you have to tell the receptionists that you have an appointment with THE Asperger's therapist. One receptionist looked at me skeptically and said "Are you on the spectrum? He only sees people on the spectrum." I had to quietly answer yes, and then sit in the lobby where everyone waiting probably heard.

The therapist himself is pretty nice though.

Well, that's just rude of the receptionist, it's not their job to assess you, especially not in front of other people. :?


I know. Not to get too off topic on my own thread, but I've noticed this quite a bit with receptionists at both the psychology and psychiatry clinics I attend. One patient asked if he could leave message about a med refill for his psychiatrist and the receptionist ask: WHAT MEDICATION ARE YOU TAKING??? And the patient kind of paused for a second, and then said: "um, wellbutrin." This never happens at other medical clinics...



zoidbreezy
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30 Dec 2014, 6:23 pm

Ajk wrote:
Coming back to the eye contact thing
Before my teenage daughter was diagnosed she got a lot of hassle about apparently not listening to teachers because she listened without the distraction of looking two things helped a bit buddy holly glasses with thick frames which are quite fashionable but give a little protection in some way for her from gaze learning to look at foreheads/ mouths and putting her eyes a bit out of focus not sure how she does it but she can


I was actually thinking of getting some sort of tinted glasses. But I'm sure I'd get written up for being "unprofessional" for wearing sunglasses on the job.

I think currently, I'm putting people's faces out of focus when I look at them, but it's pretty obvious because I'm heavily squinting when I do this...which probably looks just as weird to the other person.



Waterfalls
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30 Dec 2014, 6:33 pm

Can you concentrate while taking notes? It may look a bit weird, but it's a familiar behavior that fills in a blank In people's minds about odd or absent eye contact.



Ajk
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30 Dec 2014, 6:38 pm

What a sensible idea about taking notes then you could not be accused of not paying attention:)



zoidbreezy
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30 Dec 2014, 6:38 pm

BetwixtBetween wrote:
I don't suppose there's any way you could connect with an ASD or Autistic mentor? Someone who could teach you specific work-arounds or parts of the social script you've been missing? I'm not sure how you might do this, but if it were me, I'd ask at my school's career services dept.


It is probably something like this. There must be something I'm doing, or giving off that is off-putting to people. I wonder if I'm not using enough facial expressions or something? Maybe my voice is too monotone, am I too wooden in my gestures? I'm going to see my therapist next week, I'll ask him if there is anything that he thinks I should work on in my interpersonal interactions...I think I've seen him enough for him to give me a good opinion.

As for a specifically "autistic" mentor. I'm not sure there is something like that at my school...especially in the medical field where the mantra is Doctor's don't have disabilities...especially icky BRAIN disabilities (funny how the suicide rate is so high among docs too). I'd probably just have to find an attending that I can relate to (ie, they are probably somewhere on the spectrum, knowingly or unknowingly) in the fields I'm interested and try to latch on and see how they do things.



zoidbreezy
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30 Dec 2014, 6:41 pm

Waterfalls wrote:
Can you concentrate while taking notes? It may look a bit weird, but it's a familiar behavior that fills in a blank In people's minds about odd or absent eye contact.


I did take notes a lot of the time during those conferences. But some days I just listened...should have just pulled out a notebook and pretended to write things down...probably would have saved me the hassle of defending my grade in one of my most important rotations!



Ajk
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30 Dec 2014, 7:10 pm

There is such a big pressure on you to be perfect do you speak with your counsellor about adjusting to your diagnosis in general, it took me nearly a year to make my peace with the late diagnosis of a family member so I would imagine if you are recently diagnosed in must be tricky to come to terms with