Advice Needed: Dealing with ADD in Medical school

[akinyi]

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I am looking for advice from someone who may be dealing with ADHD Predominantly Inattentive (or ADHD or any kind) and how they have managed to cope with the fast pace of medical school.

I have always found it really difficult to concentrate in class and find that I often had to re-teach my self concepts in my own time... and go at my own pace. In addition, I need to study a lot to do well -- a lot more than the average student. In spite of this, I was able to maintain a decent GPA (3.8) and get into great dental schools. (I am posting here to receive more advice since the curriculum is similar).

If anyone out there has any experiences with ADD - inattentive, or has a friend that is dealing/dealt with it in medical school, please let me know.. I am just uncertain/worried that I will not be able to cope with the work load come this fall and want to make the right decision on whether I really should attend D school this fall..

🙁

Thanks!

 

[DocHawk117]

I think if it's what you want to do, it is absolutely feasible. You just have to find out what works best for you. Here are two different examples of how people I know handled situations similar to this.
1. She found out that class was just a waste of time (unfortunately) and did a lot better teaching herself. It was really hard for her to not feel guilty about skipping class, but if she went, she didn't learning anything. Eventually, she stopped going, worked through the material at her own pace, and was able to keep up and use her time more efficiently. She made condensed versions of the notes the first time through, so that she would be able to review it faster later on.
2. He goes to class, jots down notes when he's paying attention, and marks the parts of lecture he missed so that he can review them later. When studying for exams, he takes frequent breaks. The Pomodoro system works really well for him (25 min study, 5 min break). That way, he knows exactly how much more time he has to focus for and looks forward to the break.

 

[DeDO]

One of my classmates has ADHD and is on medication. He gets extra time for his exams and otherwise copes well and passes the exams.

 

[JimmyD123]

I have a few different learning disabilities (dyslexia, ADHD...). Med school has defiantly challenged me and pushed me far beyond what I thought I was capable of doing. And for sure at times I have thought there was no way I could get through it. With that said, if your smart enough to get in, then you are smart enough to make it through, it will all depend on how much you are willing to sacrifice to get through it. And that equation of what you give up versus how much you want it is entirely a personal decision, but you won't know where you stand until you try it out. So my advice would be to start in the fall, expect to struggle and plan on sticking with it for the first year. Then next summer, take some time and decide if school is really for you.

As for a bit more specifics about my own experience:
-Prior to med school, I never really thought about how I studied, I just sort of learned cause I liked to learn and was smart enough to get good grades.
-Also never used meds or accommodations.

Since starting:
I have just kept refining how I do things and have started to get up to speed where I am learning at a rate that is similar to my classmates. The key things for me to realize were:
-The way I think and learn is different then everyone else. So if I go about something differently, it isn't necessarily wrong. (Basically, text book reading is really low yield for me, and I am very poor at just looking a list and doing the word association thing). Probably relates more to the dyslexia.
-There are some days when I just can not get anything going when I am studying. And on those days, I just sort of have to accept where I am at and stop. And likewise, when I am on a roll I just keep going after it. This means that I need to be a bit more flexible with my plans. And I try to sit down and study every day.
-Most importantly my mental stamina has progressively increased and I have gotten better at school.

-Finally, this spring I decided to try medications. It has taken a bit of getting used to, but ultimately they have been helpful. But I am glad that I first worked on my study habits and added the meds in after I got my feet on the ground.

But the biggest thing is to be proactive in how you study. Always think about what is working, what is not and modify and tweak your approach. Don't be afraid to use the academic resources at your school, whether there is a dean that helps direct students, available tutors, just try it all out.

Finally, just take small bites and keep after it.

 

[ebbandflow83]

One of my classmates has ADHD and is on medication. He gets extra time for his exams and otherwise copes well and passes the exams.

This is a slightly off topic question but I thought I may ask it here. Do you get extra time to take the MCAT or USMLE if you have an ADHD diagnosis? Because I know that you can get extra time for in class exams but I'm wondering if that extends to timed standardized tests. Thanks!

 

[normtheniner]

I am looking for advice from someone who may be dealing with ADHD Predominantly Inattentive (or ADHD or any kind) and how they have managed to cope with the fast pace of medical school.

I have always found it really difficult to concentrate in class and find that I often had to re-teach my self concepts in my own time... and go at my own pace. In addition, I need to study a lot to do well -- a lot more than the average student. In spite of this, I was able to maintain a decent GPA (3.8) and get into great dental schools. (I am posting here to receive more advice since the curriculum is similar).

If anyone out there has any experiences with ADD - inattentive, or has a friend that is dealing/dealt with it in medical school, please let me know.. I am just uncertain/worried that I will not be able to cope with the work load come this fall and want to make the right decision on whether I really should attend D school this fall..

🙁

Thanks!

You're going to be fine. I know people in my class who are doing quite well with ADHD. They study about the same amount as me (and other classmates) and do just as well (I don't have ADHD as far as I know).

With that being said, professional school is rough for everyone. If I could do my first year over, I'd study A LOT from the beginning and then taper it down to a level where I could find a good balance in my life.

 

[seelee]

Only one person mentioned medication. Maybe the OP is already on it. If you aren't then go see your doctor and talk to them about it.

Proper medication will make more of a difference than any thing else. That being said, you do need to be flexible and find out what works best for you. As for myself, I had to learn that cramming is useless for me. I can't stay focused for that long on a subject. Instead of "bolusing" my information, I preferred to learn "on a drip". 1-2 hours of (additional studying) every day. I'd review my lectures, and tack on an additional 1-2 hours of review (flash cards, etc.) and I'd call it good.

Also, watching lecture online at 2X speed actually helped me retain the information better.

And anyone who says that taking stimulants is cheating. **** you.

 

[illegallysmooth]

I have inattentive ADHD and several of my friends also do. We take meds and using strategies that work for us, and we're doing great. My doc told me I'd be surprised how many doctors have it.

 

[572776]

Hey guys, I'm starting med school this year and I'm getting really nervous about being able to focus. Throughout undergrad I had a lot of issues with being able to pay attention in class even with coffee, so I just kind of studied on my own and somehow did ok. I am not diagnosed officially with ADD and would like to see my pcp about it, but I'm worried that the doc might label me as one of those kids looking to get an advantage over others to be competitive...well you know, but then again I don't want to fail out because I can't pay attention to save m life, so I was wondering if anyone had those issues when you tried to get meds for your add?

Sorry to steal your thread op, but since we are on this topic, I thought I'd ask.

 

[SpecterGT260]

I may have missed it, but whenever this topic comes up I have to ask...

do you have a legitimate diagnosis? Way too many people just claim to have ADD/ADHD offhandedly, similar to the people who like to claim OCD when they explain why they always like to turn their coke can tab a certain direction or something silly like that.....

Obviously ADD/ADHD can make any learning experience more difficult. Some schools will make arrangements for tests, but this will usually end after pre clinic years and much of your clinic grades will be dependent on how you are in situations which can very well exacerbate the problem. So be aware of that. Otherwise, getting on a good treatment plan and really sitting down to try to come up with a workable strategy is about all you can do.

 

[realmeaning]

I'm not in med school, and I don't have a formal diagnosis of ADHD, but I struggled a lot with inattentiveness and inability to concentrate in undergrad after being a great student my whole life. I was really clueless as to what was up. In addition to meds and study techniques, I'd recommend looking at your diet. A gluten free (or avoidant) diet has been known to do wonders for ADHD-- I say this as a former research assistant on a clinical study and also on a current gluten-free diet myself.

Just something to think about. Good luck to you.

 

[SpecterGT260]

Many people feel overwhelmed ot discouraged when they dont retain information like they think they should.... this is why a formal diagnosis is important. It is too convenient to blame attentiveness.

Can you link some sources which support this gluten free diet hypothesis? Because it is also hip to cite gluten as a bad guy in today's society.....

 

[realmeaning]

Many people feel overwhelmed ot discouraged when they dont retain information like they think they should.... this is why a formal diagnosis is important. It is too convenient to blame attentiveness.

Can you link some sources which support this gluten free diet hypothesis? Because it is also hip to cite gluten as a bad guy in today's society.....

I'm not saying I have AD(H)D, sorry for the confusion. I agree that there can be other factors at play like self-discipline, study habits, etc.-- but diet is also a real factor in these symptoms, and gluten is a huge problem for some people (like myself). I never thought I had a problem with it, but having gone GF, I've noticed a huge difference in my ability to concentrate, amongst other things.

Unfortunately, I don't have any studies to cite off the top of my head-- basically we'd both be doing the same thing if we looked for results, which is Googling. While not everyone has a gluten intolerance (hence it's not a bad guy for everyone), it's a fact that it's made a relatively recent entry into our diet compared to other grains and proteins that aren't cultivated. Its very nature (of it being a binding agent, and providing that awesome texture in breads and such) makes it dense and harder to digest than most proteins and complex carbohydrates, and certainly fruits and vegetables. While this difficulty in digestion doesn't present a significant problem for some people, for those with gluten intolerance it can have a huge impact that's so generalized it feels normal, until one tries a GF diet. In addition to inattentiveness and 'foggyheadedness,' gluten has been linked to joint pain and depression.

 

[Cinclus]

I found out I had celiac disease in grad school. After being on a strict gluten-free diet for the past 2+ years, I have to say that I remain as gloriously inattentive as ever.

 

[SpecterGT260]

I'm not saying I have AD(H)D, sorry for the confusion. All I know is that it was harder for me to concentrate, and now that I'm gluten-free, it's much easier.

Unfortunately, I don't have any studies to cite off the top of my head-- basically we'd both be doing the same thing if we looked for results, which is Googling. While not everyone has a gluten intolerance (hence it's not a bad guy for everyone), it is true that in those who do, it doesn't necessarily fit the description of an allergy, and thus has delayed results with little or no association. In addition to inattentiveness and 'foggyheadedness,' gluten has been linked to joint pain and depression. All of these symptoms eased up when I went GF.

But you said you were claiming this gluten free idea as a research assistant.... if it linked show me the link and not just your own personal account which is inescapably biased...

I dont think you understand out outrageously inappropriate it is to give advice and claim "and I say this as a research assistant on the subject" and then when asked you cant produce any papers.
We would not be doing the same thing.... and it is just as inappropriate to imply that common ignorance on a subject is as supportive to a claim as unsupportive. YOU make a claim so YOU are burdened with backing it. I challenged your claim so I am not under any additional pressure to prove that my criticism is valid..... that is the way science works.

 

[SpecterGT260]

I'm not saying I have AD(H)D, sorry for the confusion. I agree that there can be other factors at play like self-discipline, study habits, etc.-- but diet is also a real factor in these symptoms, and gluten is a huge problem for some people (like myself). I never thought I had a problem with it, but having gone GF, I've noticed a huge difference in my ability to concentrate, amongst other things.

Unfortunately, I don't have any studies to cite off the top of my head-- basically we'd both be doing the same thing if we looked for results, which is Googling. While not everyone has a gluten intolerance (hence it's not a bad guy for everyone), it's a fact that it's made a relatively recent entry into our diet compared to other grains and proteins that aren't cultivated. Its very nature (of it being a binding agent, and providing that awesome texture in breads and such) makes it dense and harder to digest than most proteins and complex carbohydrates, and certainly fruits and vegetables. While this difficulty in digestion doesn't present a significant problem for some people, for those with gluten intolerance it can have a huge impact that's so generalized it feels normal, until one tries a GF diet. In addition to inattentiveness and 'foggyheadedness,' gluten has been linked to joint pain and depression.

this statement just demonstrates a fundamental misunderstanding of physiology. digestion = broken down and absorbed. If you are claiming gluten intolerance = inability to digest, please propose a mechanism to how ingesting gluten will result in particles that can interfere with the nervous system.

I'm sorry to dog on you like this.... but your previous comment about about a research assistant and then lacking any real evidence to your claim REALLY irks me. This is how bad treatments get started and this is how lay-person patients are harmed by reckless medicine. Do not support a claim with coincidental and unlinked qualification. I have been a research assistant (which is quite different than an undergrad lab tech which is what i think you were describing, a lab tech, and a medical student researcher..... i cannot whimsically apply these titles to my own personal anecdotes in order to give them an air of credibility. That is simply wrong and dangerous. being a research assistant does not mean you can just start tagging that title onto personal opinions.... ok.... /rant. sorry man, you just hit a real sore spot with the tone of modern american medicine.....


Go look up celiac disease. Many (if not most) people are HLA mutants. This is not an argument to suggest that people were not "meant" to digest grains.... it is more an argument that lower "fitness" mutants have been allowed to propagate in our populations. the "wildtype" humans digest grains just fine. I am not an anthropologist by any means... but I think it is inappropriate to equate "agriculture" with "entry of gains into diet". I think grains have always been a staple of human diet when available. It was not more recently that we started eating them, just more recently (that 5000 years that you edited out...) that we started growing them ourselves.

 

[realmeaning]

But you said you were claiming this gluten free idea as a research assistant.... if it linked show me the link and not just your own personal account which is inescapably biased...

I dont think you understand out outrageously inappropriate it is to give advice and claim "and I say this as a research assistant on the subject" and then when asked you cant produce any papers.
We would not be doing the same thing.... and it is just as inappropriate to imply that common ignorance on a subject is as supportive to a claim as unsupportive. YOU make a claim so YOU are burdened with backing it. I challenged your claim so I am not under any additional pressure to prove that my criticism is valid..... that is the way science works.

Whoa there. Taking this a bit personally?

I'm sorry that I don't have a link to studies off the top of my head, and it's fine if that reduces my claim to being anecdotal.

I posted this as a suggestion, not a guarantee, to OP, and my only intention was to help, not to get into a heated argument.

 

[realmeaning]

I found out I had celiac disease in grad school. After being on a strict gluten-free diet for the past 2+ years, I have to say that I remain as gloriously inattentive as ever.

Sorry to hear that! I guess it works differently for everyone.

 

[SpecterGT260]

Whoa there. Taking this a bit personally?

I'm sorry that I don't have a link to studies off the top of my head, and it's fine if that reduces my claim to being anecdotal.

I posted this as a suggestion, not a guarantee, to OP, and my only intention was to help, not to get into a heated argument.

not personally. It is just indicative of the problem with medicine today (in my own opinion). 😉 That is why I pre-emptively apologized for being so harsh 👍 but I harbor no hard feelings.

 

[Bananainpajamas]

OP, ADD/ADHD can be a really frustrating disorder. First of all, the use of amphetamines is definitely stigmatized, as you can tell from other threads about using/abusing them for testing purposes. Secondly, everyone has problems with concentrating at times, so it is difficult to distinguish the line between normal and pathologic. I had several friends in college who had been diagnosed with ADD and were on stimulants for it. We all went on vacation to a ranch once and it became evident pretty quickly who actually had ADHD and who didn't. They all quietly and voluntarily sat on the porch reading while I paced back and forth and jumped around from activity to activity. I have always had the classic ADHD signs- couldn't sit still, interrupted people, easily distracted, etc. But I found my own coping mechanisms that were more than adequate through college, so I never sought help. The first time that I had any issues academically was in an undergraduate biochem course. This was my first science based course with a high volume of information and details to memorize where we were not given any slides or notes. We were expected to write down everything that the professor said...and that does not work well for someone who had never actually listened to a whole lecture before!

Fast forward to medical school. It became evident pretty quickly that my symptoms were going to be a problem. I think they may have also be exacerbated by the increased number of hours that I was spending attempting to study. I would sit in the smallest, quietest study room I could find, but my mind still jumped around so much (it's kind of like trying to watch TV while someone's flipping the channels). I was too stubborn to admit that I needed help for an entire year, and I am sure that my grades suffered because of that. My school (and most others) offers free mental health services. I went and spoke to a psychiatrist and also took some questionnaires (one of which I scored 3x the threshold for ADHD diagnosis). We discussed some other coping mechanisms and I also got a prescription for adderall. I must admit that I really hate the idea of having to use medication to study. However, I went from struggling to be a B student to being a solid A student within a month. I think a lot of my improvement came from finally having the confidence that I could study and concentrate (also, that TV-channel flipping sensation stopped 🙂 ). I also had never realized the extent to which my ADD was affecting my life outside of school, especially in my relationships.

A few other things have helped. I get plenty of exercise so that I'm not quite so "on edge" when I go to study. I eliminate as many distractions as possible so that I can work efficiently. I don't even bother trying to study out in open parts of the library, at Starbucks, in big groups, etc. I also always had a lot of motor symptoms. I would constantly be playing with something in my hands. So now I use that to help me study. I always have pieces of scrap paper around when I am studying. If I am testing myself on something or working through some pathway, I always write it out. Most of the time I end up with sheets of illegible scribbles, but stopping involuntary movements into purposeful ones tied to what I was learning really helps keep my mind focused.

Bottom line: If you think you may have ADD, then make use of your school's mental health services and do it early! Not being able to sit and concentrate on lectures for hours and hours on end is absolutely normal. On the other hand, if you think that you have symptoms that are affecting your life (not just ability to get A's in school), then you may benefit from talking to a psychiatrist and figuring out what's the best treatment strategy for you is.

Also, an ADD diagnosis does not get you extra time or special accommodations for exams. It also should not have any effect on medical licensing, etc.

 

[Abdi509]

I dont think i have ADD, however i can only study for about 50mins and must take 20 minute break before even contemplating to study again

 

[SpecterGT260]

Also, an ADD diagnosis does not get you extra time or special accommodations for exams. It also should not have any effect on medical licensing, etc.

You sure?

 

[tiedyeddog]

I dont think i have ADD, however i can only study for about 50mins and must take 20 minute break before even contemplating to study again

Our study specialist has told us 50 minutes is the maximum most humans can study in one stretch without losing all focus. I think what your describing sounds normal.

 

[SpecterGT260]

ya. go for a walk or do something for 10 min to refresh then start again. no big deal 👍

 

[JackShephard MD]

this statement just demonstrates a fundamental misunderstanding of physiology. digestion = broken down and absorbed. If you are claiming gluten intolerance = inability to digest, please propose a mechanism to how ingesting gluten will result in particles that can interfere with the nervous system.

I'm sorry to dog on you like this.... but your previous comment about about a research assistant and then lacking any real evidence to your claim REALLY irks me. This is how bad treatments get started and this is how lay-person patients are harmed by reckless medicine. Do not support a claim with coincidental and unlinked qualification. I have been a research assistant (which is quite different than an undergrad lab tech which is what i think you were describing, a lab tech, and a medical student researcher..... i cannot whimsically apply these titles to my own personal anecdotes in order to give them an air of credibility. That is simply wrong and dangerous. being a research assistant does not mean you can just start tagging that title onto personal opinions.... ok.... /rant. sorry man, you just hit a real sore spot with the tone of modern american medicine.....


Go look up celiac disease. Many (if not most) people are HLA mutants. This is not an argument to suggest that people were not "meant" to digest grains.... it is more an argument that lower "fitness" mutants have been allowed to propagate in our populations. the "wildtype" humans digest grains just fine. I am not an anthropologist by any means... but I think it is inappropriate to equate "agriculture" with "entry of gains into diet". I think grains have always been a staple of human diet when available. It was not more recently that we started eating them, just more recently (that 5000 years that you edited out...) that we started growing them ourselves.

😕

You're trying to be an authority here but you clearly aren't.

digestion = broken down and absorbed. If you are claiming gluten intolerance = inability to digest, please propose a mechanism to how ingesting gluten will result in particles that can interfere with the nervous system.

? A simple pubmed search yields over 80 papers with the key words neuropathy and gluten sensitivity. If you don't know, it's ok to say so.

Many people lose mental clarity when exposed to certain allergens. To say that something that irritates the gastrointestinal system couldn't affect the nervous system is ridiculous. Go eat 3 supersize meals at McDonalds before a long study session and tell us how sharp your mind is.

I think grains have always been a staple of human diet when available. It was not more recently that we started eating them, just more recently (that 5000 years that you edited out...) that we started growing them ourselves.

Sources? Or are this just your unprofessional opinion?

 

[SpecterGT260]

😕

You're trying to be an authority here but you clearly aren't.



? A simple pubmed search yields over 80 papers with the key words neuropathy and gluten sensitivity. If you don't know, it's ok to say so.

Many people lose mental clarity when exposed to certain allergens. To say that something that irritates the gastrointestinal system couldn't affect the nervous system is ridiculous. Go eat 3 supersize meals at McDonalds before a long study session and tell us how sharp your mind is.



Sources? Or are this just your unprofessional opinion?

Im trying to use his own previous definitions for terms to show how the logic spins back on itself.... your pubmed results simply do nothing to detract from the point being made... I even highlighted the problem in my quote (the post from which you quoted...) I am a little confused how you think that calling him out for claiming to be a research assistant and then claiming that this immune disorder is somehow digestive in nature makes me so off base here....

if you read again carefully i said "and if you are claiming that gluten intolerance = inability to digest....". I wasnt saying that allergy couldnt cause other problems, I was saying that his proposed mechanism wouldnt work (and.... it wouldnt...)

and what sorts of sources would you like? I get the feeling that this is another case where you should just re-read what I said because i think you missed something in there. we could go here: http://wholehealthsource.blogspot.com/2008/07/grains-and-human-evolution.html if you trust a blog or otherwise wnat to coax me into doing any more searching than that 😀

this aint bad either http://www.dw.de/dw/article/0,,6126777,00.html
although i am not taking responsibility for credibility here...

 

[urbanclassic]

I would also like to know how medical students with ADHD cope.

My story:
I've had mild social anxiety and mild depression for years, but around oct 2011 I wasn't truly convinced that that was all that was going on. At first I thought I had Asperger's, then CAPD and those were both ruled out. I never thought I had ADHD because my brother has classical ADHD and we're pretty different... I looked up some symptoms of ADHD and realized the the inattentive subtype fit me pretty perfectly. So I went to a specialist for ADHD and after a comprehensive history evaluation and about 5 hours of neuropsych tests I was diagnosed with ADHD-PI. Just note, I didn't really "want" the diagnoses of ADHD, because of the stigma and the fact that it really can't be "fixed" like social anxiety or depression, but I was glad to have some answers and clarity to what went/is going on in my life.

I was accepted to med school for class of 2016, and my school has a program that helps student preview medical school and boy is it overwhelming. Like we're preview anatomy lecture and lab, and it just seem like everyone else have retain some information that they get from lecture and can apply it the lab, and for me I'm just so lost, I can't process the information fast enough, and it's really kind of embarrassing.

I started a low dose of adderall xr a couple weeks ago and it hasn't really helped much... My old psychiatrist and psychologist are in a different city, so it's impossible to see them and get my medication situated to the correct dosage... I'm obviously not good at planning stuff... I should have had this done before the program started... but I am plugged in with the school psychologist who seems like they would be helpful to me to organize and learn strategies to study and for school in general... also I will see the school psychiatrist in a couple of weeks..

Anyway, I'm rambling on about nothing...