Attention Deficit Disorder and Residency

[K9VET]

Hi folks,

I wonder if anybody in this forum struggles with attention deficit disorder. If so, could you share your experiences/problems and how you're dealing with them? I imagine that multi-tasking and getting full attention during a demanding residency program must be overwhelming for those with ADD. This is complicated by the long hours, fatigue and dealing with a multitude of highly stressed/cranky people like mentors & supervisors who all expect different things from those in training. I am going through this hell myself.

Please, share your views. I'd appreciate.

Thanks!

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[turquoiseblue]

some programs are demanding, some arent. hopefully you're in one that isn't demanding. i was once in IM and i felt like i had ADD, but i dont have it. that was because i was constantly multitasking or interrupted while in the middle of doing something and interrupted in the middle of that,, and so forth, etc, makes you feel like you have ADD because you can forget what you're doing with so many interruptions. later on, i was in a calmer more organized program. i felt that i was more in control and focused. i think it is normal to feel ADD in some programs. that's just how hard residency can be, especially when you're first starting out, until you learn the ropes of how not to forget things (maybe by writing things down), organization, multitasking, and priortitizing. eventually you catch on and it becomes second nature.

i think if you are getting treated for it via ritalin or some sort of amphetamine your symptoms won't be so bad (are they??) and you probably must be taking them if you were diagnosed with that. if they are bad even with meds, maybe you need a dose or medication adjustment or even behavioral psychotherapy--you should ask your psychiatrist about that.

 

[thesauce]

An interesting article I read the other day:

http://news.yahoo.com/s/csm/20100819/cm_csm/320628

 

[K9VET]

Hi Turquoise,
Thanks for your notes. I am struggling a lot as I am doing my training at a relatively busy practice. I have been away from clinics for 10 years and now started my vet career all over again. So, I am really very confused with all the ins and outs of how a busy hospital runs. Multi-tasking, calling clients to report on the status of their pets, writing reports, etc... I am often letting things slip through my fingers and that is not pleasing my mentors. I forget things and get distracted very easily. Just started on Reglin but it will take a while to find out if it is helping or not. I agree with "the sauce" article. To some extent, ADD may likely be the result of all the insane pressures of our "developed world" that we have allowed to crush us leading to fatigue, depression, stress, anxiety, poor nutrition and sleeping habits....
K9VET

 

[Dakayus]

There's a bunch of us that have it (I mean 4 of us) at my school and granted were not in residency yet, but doing Q4 14hr days with 36hr call is close enough. Usually I'm using adderall and that helps TREMENDOUSLY! It helps my mood as well as ability to not procrastinate and be able to have the impetus to want to do thing. I'd say that when I have adderall I can take way more crap from people while not caring and be 300% more efficient.
The VERY best thing is to carry sticky notes and I put them down in my mini notebook of tasks to do. Every hour I check my list and throw em away as they pile up so I don't get overwhelmed. It works very well good luck!

 

[Human resident]

Hi there!

Oh boy! I know where you are coming from. Maybe this can help:

I'm in my last year of a surgical residency program, and I have ADD. It has been quite the interesting voyage, with ups and downs. Here's a summary of what went on for me in the last five years. In medical school, I was a little more slow than the average clerk, and communicating patient history for me was always my biggest difficulty. My disorganization wasn't so apparent at that moment, because my attitude and high energy were dominant. Then in residency, I faced several challenges that are not easy to overcome. I had several meetings with program directors and attendings in order to help me succeed. They saw that I was motivated to succeed, and therefore, they persisted. I compensated by studying alot, scoring well on in house exams and being extremely persistent. I had consulted a psychologist specialized in helping students with learning difficulties at a high level. He helped me identify my anxiety as being a part of the issues I was facing. Working on this allowed me to reduce the performance anxiety that would limit me. Then, I suffered another blow, when I was again told that my organization and efficiency were still problematic. At this point, I had asked myself if I could have ADD, and then I said: "IMPOSSIBLE! I can concentrate really well." Also, my mom (who also has ADD) would say: "No way! You don't have ADD, you're just like me!" But after several times of forgetting things, I started to catch on. One evening, I had a rotten day, and finished late, after having helped patients, etc. (probably trying to compensate for my weaknesses), I got to my car in the far-away parking, and realized, that I had forgotten my car keys in my locker. I didn't feel like going to get them. I wished I could just sit beside my car...But it was cold, and I was hungry. Soon after that, I spoke to a trusted mentor, who asked me if I thought it might be possible that I had ADD. He made me realize alot of things. So I consulted, and sure enough, I had all of the criteria for attention deficit disorder. Just knowing that you have it helps enormously, because you can work on it. I read two books that are excellent for adults dealing with a diagnosis of ADD: ADD stole my car keys, and ADD friendly ways of organizing your life. I laughed so much, because I recognized so much of myself in those books. So medication helped me shift my attention more easily from one task to another, and not getting lost in my thoughts. It did increase my anxiety in some way, but decreased it in other ways (more confidence in myself; more presence of mind). Medication is not a cure however, and fatigue, and stress can bring you down. The next best thing that I discovered in my adventure was meditation, and I am convinced that it changed my life. You become more able to identify your thoughts, and you don't have to "TRY" and focus on the moment, you LIVE the moment. Being able to take criticism positively is very important, because when the doctors you work with want you to succeed, they make it their duty for you to succeed. They do get stressed though, because they don't have an easy task, and so you have to be patient with them, and not let negativity take a hold of you. Meditation helps with that too. You need time to yourself in order to calm your thoughts, and enjoy life and work as well. They seem to forget that you have ADD when you are able to enjoy what they are teaching you, etc. Don't forget what your strengths are, because these are your assests. If you got into medicine with ADD, you definitely have a high IQ. I found out that people with ADD have a very visual memory. So pattern recognition and drawings help a lot. Stay tough, don't feel sorry for yourself, because you probably have a great view on life, and a creative side that is strong. Help your patients, and find ways to help them the most you can, but don't expect to be an amazing doctor. There are no "AMAZING" doctors. There are people who care, and don't care, and we are all human beings. - Human resident

 

[Human resident]

Oh, and one more thing! Here's my favourite quote:

"I've failed over, and over, and over again...and that's why I succeed." - Michael Jordan

 

[Crayola227]

Great story.

Some people have the idea if you can get to/through medical school, one cannot have ADD. That's malarky and shows a real misunderstanding of the condition.

Some find themselves having a tendency to *hyperfocussing* because the real issue in ADD is difficulty *directing* one's attention, that being the deficit. Essentially, one may find themselves over-focussing on things, or under-focussing, despite "wanting" to better regulate and move their attention from one issue to the next, and hold it there an appropriate amount of time, before moving on. This is really quite complex process from a cognitive standpoint. There can be a challenge in changing the direction of one's attention. It's more like a failure of attention management, like how we think of time management, like it would be more than just being late, in terms of complexity.

As far as how severe the condition, how good the coping skills, and how far one has to be pushed to have distress on the clinical level, well, this is what makes it variable when signs become apparent or troublesome or difficult to continue surmounting without addressing specifically. Intelligent people with lots and lots of persistence can often get along. When you add in a severe time crunch were exceptional organization, not just physically but mentally, and where even minutes can count, and ain't nobody got time for their lost keys, it can finally emerge as a barrier in that scenario.

What I think is great as well, if that you include non-pharmacological intervention methods as well.

Thanks for sharing your story.

Nice necrobump, by the way

PS- in the future, some link breaks in your post might make them more readable (I am hardly the role model, but I want you to do better than me on this site )

 

[Apollyon]

PS- in the future, some link breaks in your post might make them more readable (I am hardly the role model, but I want you to do better than me on this site )

That's like when they used to say that the best class to take in high school was typing. It seems pedestrian or quotidian, but it's true! (Or was, back in THOSE DAYS.)

 

[AlmostAnMD]

I went into Emergency and fit in