ADD among med students?

[Lizzie Bartlet]

I'm sure there are a lot of med students who were diagnosed with ADD when they were kids, but are there any on this board who were diagnosed while in med school? I just finished 1st year and my adviser thinks I should be evaluated for ADD.

I don't even know what evaluation entails. Anyone been there? Did it help once you had a diagnosis? I'm just getting by now and putting in so much effort just to get C's that it's making me insane.

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[tremulousNeedle]

It is not unheard of for adults to be diagnosed with ADHD, but it isn’t the most common thing in the world either.

This is the DSM-IV criteria for ADHD (Note the part where some symptoms must be present before age 7). Evaluation for the disorder would largely consist of seeing if you meet the criteria.


Attention-Deficit/Hyperactivity Disorder




Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder

1. Either (1) or (2):
   1. six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
      
      
      
      
      Inattention
      1. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
      2. often has difficulty sustaining attention in tasks or play activities
      3. often does not seem to listen when spoken to directly
      4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
      5. often has difficulty organizing tasks and activities
      6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
      7. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
      8. is often easily distracted by extraneous stimuli
      9. is often forgetful in daily activities
   2. six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
      
      
      
      
      Hyperactivity
      1. often fidgets with hands or feet or squirms in seat
      2. often leaves seat in classroom or in other situations in which remaining seated is expected
      3. often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
      4. often has difficulty playing or engaging in leisure activities quietly
      5. is often "on the go" or often acts as if "driven by a motor"
      6. often talks excessively
      Impulsivity (g) often blurts out answers before questions have been completed(h) often has difficulty awaiting turn(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
2. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
3. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
4. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
5. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

 

[Lizzie Bartlet]

Thanks for posting that. I looked up the symptoms already and a lot of them sounded familiar, but I thought there was more to it than that. I'm looking to see if anyone else has had this diagnosed in med school and if it made any difference in their performance? If I do have it, I'm kind of nervous about taking any drugs for it so I'm just looking for personal stories (not medical advice, Mods) to help me see what I'm in for.

 

[Momentum70]

Our child psych instructor(also head of psych program) told us it wasnt as uncommon as you think to be diagnosed as an adult in med school. He told us that the high IQs of med students compensate for the ADHD until they get to college or med school. Basically they are so smart it doesnt matter they cant pay attention or study well until they hit a huge amount of information they have to assimilate.

 

[MossPoh]

Our child psych instructor(also head of psych program) told us it wasnt as uncommon as you think to be diagnosed as an adult in med school. He told us that the high IQs of med students compensate for the ADHD until they get to college or med school. Basically they are so smart it doesnt matter they cant pay attention or study well until they hit a huge amount of information they have to assimilate.

I was diagnosed in med school. I didn't even want to go. My classmates and TAs were the ones that really pushed it. I just couldn't handle things like anatomy lab. There was such a sensory overload and any sound or movement would really distract me. I avoid taking medications whenever possible. One of the best things has been a rigid study schedule and a timer for breaks.

 

[seelee]

I wasn't diagnosed in med school but I'll put my two cents in anyway.

Initially dx'd in the 3rd grade, refused to take meds, struggled through middle school and high school.

Once in college, I realized that If I wanted to do well that I would have to "give in" and take medication. Saw a new doctor who put me on atomoxetine (Strattera) which is NOT a stimulant (rather a NE reuptake inhibitor). It works very well for me, though I know people who are on methylphenidate (Ritilin) and it works well for them.

Learning coping strategies and how to structure your time are helpful, but are not as effective as pharmacotherapy.

The toughest thing about ADHD is the (often self inflicted) stigma. ADHD is technically a mental illness, and that has a negative connotation. It implies that you are incapable of being "normal". Taking medication means you accept that you are not "normal" and that can be scary. A useful comparison is to think about myopia. If you were near-sighted, you would not hesitate to get glasses. Even though those glasses would mean that you were not normal, you would still wear them everyday. Medication for ADHD is similar. You take it to correct an imbalance. That's it. It enables you to use the tools that you have so that you can keep up with everyone else.

My advice is to talk to your doctor, look at your options, try out what he suggests. If it helps then that is all that matters.

Good luck.

 

[psipsina]

Our child psych instructor(also head of psych program) told us it wasnt as uncommon as you think to be diagnosed as an adult in med school. He told us that the high IQs of med students compensate for the ADHD until they get to college or med school. Basically they are so smart it doesnt matter they cant pay attention or study well until they hit a huge amount of information they have to assimilate.

Yep this is what I was told when I got diagnosed, that I had just compensated really really well up until then. I did ok academically my first two years without meds, but I was an emotional mess. I was so inefficient in my studying that I was always super stressed out and had a ton of anxiety. I started taking the meds and now I can study much more efficiently. I used to have to write out everything to hold my concentration, now I can just sit and read like so many of my other classmates. Its much easier to get started when I want to sit down and study. In the hospital I don't think I would have been able to listen to an attending round with 20 different conversations and phones ringing and alarms beeping all around me but now I can. I can read and write my patient notes with all that going on. And my anxiety level is way way down. I just feel calmer and centered. I'm so happy I gave this a chance. The evaluation is just sitting with a psychiatrist and doing a series of questions. I figured if I didn't like the way I felt on the meds I could always stop taking them, but I didn't want to go thru life struggling with something that might be easily remedied. I had just never considered that I could have ADHD because I had done so well academically in high school and college.

 

[MossPoh]

The hardest part is giving it a chance.

I found it kind of comedic that the people who DON'T have it all beg and scam for the pills. The people who DO have it will fight and argue to not take them.

My only problem with the meds has been that I really have to plan out when I take them or else my heart rate will be off the charts when I try to workout. It wouldn't be much of a problem for me if I were doing light cardio, but there were a few squat workouts that I had to sit down and wait about 5 or 6 minutes between sets to let my heart cool down.

The truth is. I don't really view it as a "problem" now. I just feel my brain works differently and it needs a little help to think the way that is demanded of me in traditional academics. I find that how I think completely changes on the meds. The capability to sit down and truly READ stuff without skipping every other line was foreign to me until last summer.

 

[Lizzie Bartlet]

Are you guys using the standard meds (adderall et al)? Do you take it everyday or just on school days or test days?

 

[seelee]

Some take stimulants like adderall or ritalin, others take non-stims like strattera.

Strattera takes about a week to start working, and you have to take it everyday.

Most docs will probably recommend you take meds everyday. Only taking meds once a day is like a near sighted person only wearing corrective lenses when he is going on a major road trip. Doesn't really make sense does it.

My personal opinion is that if you can do well enough in your work/studies on a daily basis to not need medication, then you don't have ADHD since one of the key factors is that your inattention/hyperactivity needs to be maladaptive and impairing of your work/social/personal life.

This is getting dangerously close to "medical advice" though. What you need to do is talk to your doctor and determine if you need medication, and work with him/her on dosing/treatment/schedule etc.

 

[Gabby]

You'd be amazed how many med students take adderrall. Some take it only during exam week or the week before exam week. Others take it every day. There was a girl in my class who has ADD and was on it. She took it for our first few blocks and did well. She stopped taking it during our fourth block because she hated how it made her feel. She failed that block. That's a classic case of someone who needs it. Would she need it in another field? Maybe not. But for med school, she does horribly if she doesn't take it.

Med school is rough. That's why so many people are diagnosed with learning disabilities here. People who've been able to compensate in the past can no longer do so as a medical student.

 

[familyaerospace]

I'm not a med student yet so I hope you don't mind me posting, but I was diagnosed as an adult right before I started my post-bacc (thus after I completed my bachelors and a masters.)

I wasn't even looking for the diagnosis but I changed doctors and as part of his standard work up he does screeners for depression and ADHD. Apparently I nearly maxed out the ADHD test (positive note, I wasn't depressed in the least.) When he found out I had degrees he said I must be incredibly intelligent to have been able to compensate for the attention problem.

Unfortunately, I have some problems taking the meds. I have mild controllable epilepsy and thus need to be careful with stimulants, plus I am hypersensitive to meds anyway. Strattera, the non-stim, gave me the worst batch of seizures and then when I came off of them I went suicidal. I have low doses of Adderall and Ritalin. My doctor wants me to take at least one of them every day, but I can't take either more frequently than 3 times a week without having other medical problems. Ritalin worked the best for me, but I tend to fall asleep on it and if someone just looks at me funny my pulse is ~150. My doctor has a love affair with Adderall which the only thing it does to me is make me unable to sleep. I hope my doctor figures out the appropriate dose for me before I go to medical school because as it stands I almost never take them.

 

[shilgy]

Hi,
Well after realizing during my first block, that if I continue to study for so many hours yet not accomplish much due to lack of concentration, I would not get through med school I decided to get tested. See i always knew that i had it, everyone would say something to me about, but I always was able to cram enough the night before the exam to do well. In med school i realized immedietely that would be impossible. So I went to a doc specializing in Adult ADHD, took a bunch of tests, got interviewed by a ton of ppl, and my wife and parents had to meet with the shrink also, I was diagnosed with ADHD inattentive type.
Since then, I wouldn't say that I got incredible grades, but I definitely am in the top 50 percent of the class, while managing a family and a commute (unlike anyone else in my class). The ritalin (long acting) with the cognitive behavior therapy really changed how I study and what I am able to accomplish. The CBT really showed me that I cannot underestimate the time i need.

I have not told my med school yet, but I am debating...Personally I struggle to finish exams in the time allotted. And if I want, I have the right to get more time. The question is whether I should do that. It is definitely a hard decision and a lot of factors involved. For me, the most important thing is whether I should try to get extra time for my USMLE exam. This test accomodation will show up on the USMLE transcript and I am afraid it may hurt my chances for a good residency...Any comments on that?

 

[teddybear]

I've had ADHD my whole life. I always knew something was wrong but never could figure out what it was until I was diagnosed. I've tried Straterra and it helped a lot.

 

[Perrotfish]

Funny how you're healthy until you hit a level of competition that you have trouble with, and then you have a 'disease'. I'm not saying the pills don't help, pills help everyone (which is why so many people buy them without a persecription). I'm not even saying don't take the pills. However, for your own sake, I am saying that you shouldn't buy in to the steaming pile that is the DSM-IV. If you get a diagnosis realize that you're a healthy person who is playing the system to get performance enhancing pills, not someone with a psych disorder.

 

[psipsina]

Funny how you're healthy until you hit a level of competition that you have trouble with, and then you have a 'disease'. I'm not saying the pills don't help, pills help everyone (which is why so many people buy them without a persecription). I'm not even saying don't take the pills. However, for your own sake, I am saying that you shouldn't buy in to the steaming pile that is the DSM-IV. If you get a diagnosis realize that you're a healthy person who is playing the system to get performance enhancing pills, not someone with a psych disorder.

I disagree. The idea is that someone is performing below the level that would be expected for their age and intelligence. If someone has the intelligence to succeed in medical school but struggles thats the same as someone with a lower intelligence who struggles in 7th grade. We were taught in psych that you can't use the same screening tools for ADHD in a MR kid because their intelligence is lower than the sample those screening tools are set for (of course they can't pay attention like a "normal" kid can). Similarly for those on the other end of the IQ scale it makes sense that they might not show glaring signs of disability until they are in more challenging scenarios.

For me medication had no effect whatsoever on my performance, it has simply given me back quality of life. I was so inefficient when I sat down to study that I had to spend WAY more time than my classmates to make the same grades. I had to write everything out as I studied just to hold my attention which takes forever and was really quite painful. I could never keep up with the material and so I was always anxious which in turn made me even less productive. A low dose stimulant hasn't turned me into an AOA student all of a sudden, its just made me able to simply read thru the notesets repeatedly and be able to retain like the majority of my classmates have been doing all along. And it has allowed me to be calmer and more centered while I do it. I sleep better at night. I have some time for social activities and the gym. Yes stimulants can be abused. If I took higher doses than prescribed or at an increased frequency I'm sure I could boost my performance a bit too. But thats not what this is about for me at all.

 

[teddybear]

Funny how you're healthy until you hit a level of competition that you have trouble with, and then you have a 'disease'. I'm not saying the pills don't help, pills help everyone (which is why so many people buy them without a persecription). I'm not even saying don't take the pills. However, for your own sake, I am saying that you shouldn't buy in to the steaming pile that is the DSM-IV. If you get a diagnosis realize that you're a healthy person who is playing the system to get performance enhancing pills, not someone with a psych disorder.

 

[DoctorDeMan]

Funny how you're healthy until you hit a level of competition that you have trouble with, and then you have a 'disease'. I'm not saying the pills don't help, pills help everyone (which is why so many people buy them without a persecription). I'm not even saying don't take the pills. However, for your own sake, I am saying that you shouldn't buy in to the steaming pile that is the DSM-IV. If you get a diagnosis realize that you're a healthy person who is playing the system to get performance enhancing pills, not someone with a psych disorder.

Have you even read the DSM-IV diagnostic criteria for ADHD? They are:

Six symptoms in the area of inattention or hyperactivity/impulsivity resulting in significant impairment in at least two settings, present before the age of 7.

It's a little hard to play the system before the age of 7. Now, the degree to which general physicians are adhering to the DSM-IV diagnostic criteria is surely debatable, but the diagnostic criteria for ADHD is not a "steaming pile" in any way.


References:
[SIZE=-1]American Psychiatric Association : Diagnostic and statistical manual of mental disorders. 4th edition American Psychiatric AssociationWashington, DC2000. [/SIZE]

 

[ChrisKnight]

I tend to agree with Perrotfish.

People love to be diagnosed with something, because it means two things:

1. They're not at fault.

2. It can be fixed with medication.

Especially to be diagnosed in medical school, and to say you are so smart that you compensated for so long is more of an ego boost than it is anything.

I really don't think you can treat medical school the same at any other point in life either. While it's by no means impossible, there are a million ways you can fail out of medical school. Putting it all on a diagnosis of ADD is a little suspect in my opinion.

And you can't exactly say that because drugs improve your focus, that alas it must be ADD. These drugs can improve the performance of any student, which is why there is rampant abuse among college and medical students.

So, I'm not saying people don't have ADD, they may indeed. But at some point I think you have to draw a line between a psychiatric diagnosis and medical school just being difficult.

 

[radiodoc99]

Yes it's common. Try to set small benchmarks like I want to read 2 pages in 10 mins and give yourself some incentive to stay focused. Sounds easy but hope you can do it

 

[seelee]

I will be the first to say that ADHD is definitely over diagnosed. Still, as opposed to other "throw away" diagnoses, I cant think of a single person with ADHD who likes being in the patient role. If anything, we are embarrassed by the fact that we have to take a pill just to do what other people do without it.

Before I was diagnosed as an adult, I could never hold down a job. I would get distracted from task to task. I would day dream, I would loose things, forget to finish things, get distracted, all on a daily, even hourly basis. I worked as a waiter, and I would go to the table, take their drink order, and go to the back of the kitchen and get totally distracted by something else, and not only forget to get the drink order, but even forget to check on the table until I walked back out and saw them staring at me.

I worked as a bank teller and i got fired because I forgot to close the gate to the vault. I would go through every day making mental lists of things I needed to remember to do at work. I would always forget one or two of them, and I would get in trouble. And i am not talking about forgetting major projects, but forgeting to lock my cash drawer when I walked away, forgetting to count my money two times.

I would loose my keys and wallet constantly. I would have something in my hand, put it down absentmindedly, and then spend 30 minutes looking for it. This would happen several times a week.

School was not difficult, I just would get distracted watching TV (the only thing that could hold my attention for hours).

After getting fired yet again, and realizing that if I didn't get some help I would be 45 years old still working as a waiter or in some burger king.

When I went to the psychiatrist, I explained everything above. i said to him. This wasn't some acute change or even a gradual decline. I cannot remember a time when i was not like this. I don't know if everyone has these kinds of problems, and they are just better at dealing with it than I am, or If there is something wrong with me.

Imagine if you were born far-sighted. Everything around you is blurry. You walk into walls, you can't read, you can't drive, but you have no concept of clear vision. Since your vision has always been that way, you assume that you are just as normal as your peers, except they don't run into walls, they can read, they can drive, etc. From this it is easy to see how you and others could think that you are stupid or incompetent.

For a person with ADHD, taking medication is like a far-sighted person putting on glasses. When I first started taking Strattera, I didn't feel any different, I took it for several months and wasn't sure if it was working or not. I didn't feel the way I had felt when I was taking Ritalin as a kid, and because I didn't feel drugged I wondered if the medicine was even working.

Then one night I went to my job as a waiter, and after about an hour of forgeting orders, getting distracted, and struggling in general I realized that that was exactly how my job would go before I started medication. It really shocked me that I had lived that way so long. I know not everyone has positive results, but the only time I could tell the medicine was working was when I would forget to take it and revert to my inattentiveness.

 

[MightyMoose]

Yep this is what I was told when I got diagnosed, that I had just compensated really really well up until then. I did ok academically my first two years without meds, but I was an emotional mess. I was so inefficient in my studying that I was always super stressed out and had a ton of anxiety. I started taking the meds and now I can study much more efficiently. I used to have to write out everything to hold my concentration, now I can just sit and read like so many of my other classmates. Its much easier to get started when I want to sit down and study. In the hospital I don't think I would have been able to listen to an attending round with 20 different conversations and phones ringing and alarms beeping all around me but now I can. I can read and write my patient notes with all that going on. And my anxiety level is way way down. I just feel calmer and centered. I'm so happy I gave this a chance. The evaluation is just sitting with a psychiatrist and doing a series of questions. I figured if I didn't like the way I felt on the meds I could always stop taking them, but I didn't want to go thru life struggling with something that might be easily remedied. I had just never considered that I could have ADHD because I had done so well academically in high school and college.

Did you notice any deficits anywhere else? I tried Methylphenidate for about a month and it had some really unwanted secondary and tertiary effects. I have always enjoyed the ability to multitask (eg. take notes on previous material while listening to new material), but once I started taking meds it really decreased my ability to "free think." I felt that this completely changed who I was as a person... How have you coped with life outside of studying while on meds? Do you feel it has had any other effects?

Funny how you're healthy until you hit a level of competition that you have trouble with, and then you have a 'disease'. I'm not saying the pills don't help, pills help everyone (which is why so many people buy them without a persecription). I'm not even saying don't take the pills. However, for your own sake, I am saying that you shouldn't buy in to the steaming pile that is the DSM-IV. If you get a diagnosis realize that you're a healthy person who is playing the system to get performance enhancing pills, not someone with a psych disorder.

You must be right, because nobody takes meds or gets treatment prior to medical school. Some disorders are made more apparent in certain situations. You notice these disorders more in certain circumstance than in others (i.e., when in med school ADHD/ADD would be much more apparent). Another comparable example would be dyslexia. Dyslexia is usually only very apparent as a disorder when someone is reading material or interpreting symbols, so when individuals who have the disorder work in professions where constant reading isn't a requisite, it can be relatively innocuous, but if those individuals desire positions that require reading and writing, the disorder must be dealt with in order to overcome the obstacles presented by the disorder. The DSM is a little more subjective than other diagnostic manuals, I agree, but it is still a very useful tool.

 

[psipsina]

Did you notice any deficits anywhere else? I tried Methylphenidate for about a month and it had some really unwanted secondary and tertiary effects. I have always enjoyed the ability to multitask (eg. take notes on previous material while listening to new material), but once I started taking meds it really decreased my ability to "free think." I felt that this completely changed who I was as a person... How have you coped with life outside of studying while on meds? Do you feel it has had any other effects?

The only real side effect I've had is a bit of dry mouth that is easily fixed with some gum or mints. I'm still a crazy multitasker in all aspects of my life. I feel like there's just less background noise in my head, when I want to not think about something else I can put it aside for a bit, which in turn makes me less anxious. For example if I'm broke and worrying about to best spread out the last bit of my money I can set that aside and think about whatever I'm studying, or on the wards I can stop thinking about everything I need to do later that day for my away applications. Before I had no choice but to multitask and sometimes it was overwhelming. Now I choose how to utilize that skill to my best advantage. Did your doctor ever mess around with doses for you? It took a few tries to get the right balance and the right timing for me.

 

[MightyMoose]

The only real side effect I've had is a bit of dry mouth that is easily fixed with some gum or mints. I'm still a crazy multitasker in all aspects of my life. I feel like there's just less background noise in my head, when I want to not think about something else I can put it aside for a bit, which in turn makes me less anxious. For example if I'm broke and worrying about to best spread out the last bit of my money I can set that aside and think about whatever I'm studying, or on the wards I can stop thinking about everything I need to do later that day for my away applications. Before I had no choice but to multitask and sometimes it was overwhelming. Now I choose how to utilize that skill to my best advantage. Did your doctor ever mess around with doses for you? It took a few tries to get the right balance and the right timing for me.

I'm really glad to hear that it is working out so well for you. It sounds like you're doing great with it. My doc wanted to mess with the dose, but I decided to stop after the first month because it was making me feel less like myself and more like some type of drone. It could have just been the med. He was going to try to switch from Ritalin XR to Adderall, but I didn't want to keep messing around with it. I might give it another shot in the near future, but I'll have to come to grips with the psychological ramifications of taking a med to function first. I think it was because my doc wanted me to be medicated pretty much all day, every day. Anyway, thanks for the info.

OP, I wouldn't worry about the stigma, I would worry about how YOU feel about the Dx. If you aren't sure you agree with it try some alternative fixes first: Diet, exercise, locations that are distraction free (I have to sit in a corner and stare at the wall with earplugs in - but the problem is you start to resent the corner & studying...), just make sure your study times are consistent and scheduled, then stick to them. I also found it helpful to use a stopwatch to calculate how much time I was actually studying and how much I was wasting. Stop the watch anytime your focus is distracted or you get up/start chatting, etc. (I actually spent 8 hours studying the first day, but only 3 hours was spent actually studying). Good luck!

 

[gulnosh]

while looking at all the above posts, i m sure i have ADHD..actualy once i went to a psychatrist and told him about concentration problems..and anxiety.He told me that its common to all the students(especially medical stud) and i should not take any medications and i can take propanolol for anxiety in case i insist..But now i think i should seriously think over my problem. anyway the post is great..

 

[seelee]

while looking at all the above posts, i m sure i have ADHD..actualy once i went to a psychatrist and told him about concentration problems..and anxiety.He told me that its common to all the students(especially medical stud) and i should not take any medications and i can take propanolol for anxiety in case i insist..But now i think i should seriously think over my problem. anyway the post is great..

You may want to consider a second opinion.

 

[hyperalgesia]

Who doesn't have ADD?

 

[qualquun]

I know someone that tests for ADHD (ADD doesn't actually exist, it's just a nickname for ADHD), and she said that she diagnoses a lot of medical students because they are extremely bright individuals for whom the work throughout elementary, middle, high school and college was so easy that it never challenged them enough to show ADHD symptoms. Once they get into medical school, the work is so much harder and is more on their level, thus the ADHD finally proves to be a problem. Once they are finally challenged, ADHD rears it's ugly head.

 

[Lizzie Bartlet]

Psych doesn't think I have ADD. Back to square one......

 

[PharmaTope]

Yep this is what I was told when I got diagnosed, that I had just compensated really really well up until then. I did ok academically my first two years without meds, but I was an emotional mess. I was so inefficient in my studying that I was always super stressed out and had a ton of anxiety. I started taking the meds and now I can study much more efficiently. I used to have to write out everything to hold my concentration, now I can just sit and read like so many of my other classmates. Its much easier to get started when I want to sit down and study. In the hospital I don't think I would have been able to listen to an attending round with 20 different conversations and phones ringing and alarms beeping all around me but now I can. I can read and write my patient notes with all that going on. And my anxiety level is way way down. I just feel calmer and centered. I'm so happy I gave this a chance. The evaluation is just sitting with a psychiatrist and doing a series of questions. I figured if I didn't like the way I felt on the meds I could always stop taking them, but I didn't want to go thru life struggling with something that might be easily remedied. I had just never considered that I could have ADHD because I had done so well academically in high school and college.

I disagree. The idea is that someone is performing below the level that would be expected for their age and intelligence. If someone has the intelligence to succeed in medical school but struggles thats the same as someone with a lower intelligence who struggles in 7th grade. We were taught in psych that you can't use the same screening tools for ADHD in a MR kid because their intelligence is lower than the sample those screening tools are set for (of course they can't pay attention like a "normal" kid can). Similarly for those on the other end of the IQ scale it makes sense that they might not show glaring signs of disability until they are in more challenging scenarios.

For me medication had no effect whatsoever on my performance, it has simply given me back quality of life. I was so inefficient when I sat down to study that I had to spend WAY more time than my classmates to make the same grades. I had to write everything out as I studied just to hold my attention which takes forever and was really quite painful. I could never keep up with the material and so I was always anxious which in turn made me even less productive. A low dose stimulant hasn't turned me into an AOA student all of a sudden, its just made me able to simply read thru the notesets repeatedly and be able to retain like the majority of my classmates have been doing all along. And it has allowed me to be calmer and more centered while I do it. I sleep better at night. I have some time for social activities and the gym. Yes stimulants can be abused. If I took higher doses than prescribed or at an increased frequency I'm sure I could boost my performance a bit too. But thats not what this is about for me at all.

very good informative posts about ADHD and how it can affect you.