Autistic Medical Student

[psypiral]

Recently, I met a student who made me curious about the interview process. I am an MD/PhD student and was doing a lab rotation over the summer (before MS1). A medical student from another school was doing summer research in the same lab. He very visibly had mild autism (noted by a few of the postdocs/residents/fellows in the lab, not just myself). Some of the symptoms included rocking back and forth, lack of any eye contact, unusual posture, a speech impediment, trouble conversing, etc.

He was very intelligent, though, and currently goes to a top 25 med school. (Multiple publications, including first author IF 5- 10 and a second author Nature as a traditional student before applying). I wasn't about to ask him his GPA/MCAT, but I presume they were quite high.

I'm sure he would have gotten into a top 10 med school, if he could interview reasonably well. I'm happy for him, but I'm surprised he was able to get accepted at all. Maybe he prepped incredibly hard for the interview and came off okay, but based on my limited interaction with him, the mannerisms/speech impediment alone may have hurt him.

Have any of the adcoms ever interviewed someone like this? At some (pretty high) critical point of intelligence, does the interview become irrelevant at some schools, or was someone in the admissions office willing to take a stand for him?

---

Members don't see this ad.

 

[womanofscience]

I'm curious about this as well. Maybe medicine and research are in his realm of focused interest so he could carry on an informed conversation. I imagine his applications were probably spot on since many autists can articulate well in writing (Loud Hands is a really good compilation of writing).

I know that I was initially diagnosed with selective mutism, but I'm now curious if it was actually true since I still struggle with social norms and such. Hopefully someone on an adcom can give some insight since I'm particularly passionate about mental health/neuroscience/ASD.

 

[psypiral]

The only time I remember him initiating a conversation was when discussing research, and it seemed like he really loved medical science. Maybe that came through during his interviews.

 

[hoihaie]

it was probably an exception or something since he obviously has amazing talents for research and medical science.

 

[PreciousHamburgers]

My experience with the Autism spectrum has led me to believe that a lot more of us may fall on the less severe side of it than we think. The diagnosis seems to have a degree of subjectivity when it comes to 'mild' cases. Not really answering your question exactly, but something I have been thinking about...

 

[claduva94]

Wow. Good for him. From the way you describe it he is definitely focusing more on the research side though? I wonder if anyone applying solely MD has been successful...

 

[LizzyM]

The goal of the MD/PhD program, as you well know, OP, is for the applicant to be 90% time in lab and 10% time in clinic as an attending. Those docs are often super-subspecialists who see referrals for complex medical conditions related to their area of research and not primary care providers. So, personality might not be as highly valued as intellectual horsepower and "good hands". I could see a Medical Science Training Program (MSTP) taking someone with a 4.0/40 and a strong research portfolio despite some deficits in interpersonal skills.

 

[psypiral]

The goal of the MD/PhD program, as you well know, OP, is for the applicant to be 90% time in lab and 10% time in clinic as an attending. Those docs are often super-subspecialists who see referrals for complex medical conditions related to their area of research and not primary care providers. So, personality might not be as highly valued as intellectual horsepower and "good hands". I could see a Medical Science Training Program (MSTP) taking someone with a 4.0/40 and a strong research portfolio despite some deficits in interpersonal skills.

Sorry, my initial post was unclear. I was doing a rotation in a lab at my school. He was a summer student (summer after MS1) from another school. He was MD only, which was surprising to me. He was still pursuing academic medicine - just not MD/PhD, so the same probably holds true.

 

[LizzyM]

That doesn't surprise me @psypiral . Some schools put a big emphasis on numbers (scores & grades) and research and less on interpersonal skills. Other schools will take a pass after meeting the applicant on interview day.

 

[sobored]

Recently, I met a student who made me curious about the interview process. I am an MD/PhD student and was doing a lab rotation over the summer (before MS1). A medical student from another school was doing summer research in the same lab. He very visibly had mild autism (noted by a few of the postdocs/residents/fellows in the lab, not just myself). Some of the symptoms included rocking back and forth, lack of any eye contact, unusual posture, a speech impediment, trouble conversing, etc.

He was very intelligent, though, and currently goes to a top 25 med school. (Multiple publications, including first author IF 5- 10 and a second author Nature as a traditional student before applying). I wasn't about to ask him his GPA/MCAT, but I presume they were quite high.

I'm sure he would have gotten into a top 10 med school, if he could interview reasonably well. I'm happy for him, but I'm surprised he was able to get accepted at all. Maybe he prepped incredibly hard for the interview and came off okay, but based on my limited interaction with him, the mannerisms/speech impediment alone may have hurt him.

Have any of the adcoms ever interviewed someone like this? At some (pretty high) critical point of intelligence, does the interview become irrelevant at some schools, or was someone in the admissions office willing to take a stand for him?

How can you have "very visible mild autism"? Seems somewhat contradictory. And how do you know he falls in the autism spectrum and not just social anxiety? Seems kind of arrogant and inappropriate for you and your lab colleagues to label him like that.

 

[Dr. Retractor]

How can you have "very visible mild autism"? Seems somewhat contradictory. And how do you know he falls in the autism spectrum and not just social anxiety? Seems kind of arrogant and inappropriate for you and your lab colleagues to label him like that.

A. Mild autism is still visible because the individual's behavior deviates from social norms. It sticks out like a sore thumb, albiet not as much as a thumb snapped in half. You notice when someone has blatant disregard for what others think, or when someone is extremely arrogant or self-confident because it deviates from what you consider normal. And those are likely not involved with a mental disorder.


B. OP listed the symptoms he observed. Have you met someone with social anxiety that has a speech impediment? With unusual posture?


C. He wasn't "labelled" as autistic because that has a negative connotation that suggests he was ostracized because of his condition. That was clearly not the case. Based on observed behaviors, OP and his/her lab colleagues drew the conclusion that the person has a mild form of autism, and OP clearly respects him and had at least a conversation with him, showing they didn't just "label" him as autistic.

 

[mik30102]

There is a DO near me who has aspergers who actually advertises his self as such. I believe he is a family medicine physician.

 

[sobored]

A. Mild autism is still visible because the individual's behavior deviates from social norms. It sticks out like a sore thumb, albiet not as much as a thumb snapped in half. You notice when someone has blatant disregard for what others think, or when someone is extremely arrogant or self-confident because it deviates from what you consider normal. And those are likely not involved with a mental disorder.


B. OP listed the symptoms he observed. Have you met someone with social anxiety that has a speech impediment? With unusual posture?


C. He wasn't "labelled" as autistic because that has a negative connotation that suggests he was ostracized because of his condition. That was clearly not the case. Based on observed behaviors, OP and his/her lab colleagues drew the conclusion that the person has a mild form of autism, and OP clearly respects him and had at least a conversation with him, showing they didn't just "label" him as autistic.

http://www.ncbi.nlm.nih.gov/pubmed/11195567?
http://apt.rcpsych.org/content/12/1/63.full.
http://www.ncbi.nlm.nih.gov/pubmed/21337214
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915144/

I didn't realize we had so many arm chair psychiatrists here. What exactly makes you qualified to diagnose autism? There's more nuance to developmental disorders than you appreciate. Also, what else would you call labeling then? If you don't know someone has a disorder, yet you paint a picture of that person for us to perceive in a certain way, I'd go out on a limb and call that labeling.

 

[Perrotfish]

I didn't realize we had so many arm chair psychiatrists here. What exactly makes you qualified to diagnose autism? There's more nuance to developmental disorders than you appreciate. Also, what else would you call labeling then? If you don't know someone has a disorder, yet you paint a picture of that person for us to perceive in a certain way, I'd go out on a limb and call that labeling.

+1. Autism is really about patterns of speech and brain development, its not a symptomatic diagnosis you make without a childhood history. Most kinds of awkward people aren't actually autistic. Other possibilities on my differential:

1) He has a cluster C disorder: he's shy and awkward, though he craves human contact

2) He has a cluster A disorder: he's odd and doesn't particularly crave human contact

3) He has poorly controlled depression

4) He's overmedicated for bipolar disorder

5) He's a well controlled but heavily medicated schizophrenic

6) He has a primary speech impediment and has learned to avoid casual social situations because of it.

7) He does not have a medical disorder and you just don't care for his personality.

8) He is suffering from PTSD, insomnia, pain, or stress and it is carrying over into his social skills

9) He is drunk or high.

10) He hates the members of his lab group but doesn't want to abandon the group itself because he likes the research and his overall career trajectory. You are mistaking good conflict avoidance skills for a medical disorder.

 

[Dr. Retractor]

+1. Autism is really about patterns of speech and brain development, its not a symptomatic diagnosis you make without a childhood history. Most kinds of awkward people aren't actually autistic. Other possibilities on my differential:

1) He has a cluster C disorder: he's shy and awkward, though he craves human contact

Based on the OP, he doesn't seem to crave human contact. That would have probably been noted.

2) He has a cluster A disorder: he's odd and doesn't particularly crave human contact

People with Cluster A disorders usually have distorted thinking (source: DSM V, I'm sure you have a copy). Good luck finding someone with distorted thinking in a top 25 MD program.

3) He has poorly controlled depression

Would someone with poorly managed depression seek out research opportunities over the summer, and presumably travel to them (I'm assuming the student goes to a medical school far enough away from OPs school to require temporary relocation)?

4) He's overmedicated for bipolar disorder

I don't know that much about this, so I can't comment.

5) He's a well controlled but heavily medicated schizophrenic

So heavy medication of schizophrenia can cause speech impediments? Ha.

6) He has a primary speech impediment and has learned to avoid casual social situations because of it.

Doesn't explain his unusual physical manifestations like rocking back and forth and having unusual posture.

7) He does not have a medical disorder and you just don't care for his personality.

A group of people (grad students, residents, and fellows, no less) coming to the same conclusion mediates the mistakes of any individual member of the group.

8) He is suffering from PTSD, insomnia, pain, or stress and it is carrying over into his social skills

Again, doesn't explain the physical manifestations or speech impediment.

9) He is drunk or high.

Lol.

10) He hates the members of his lab group but doesn't want to abandon it because he likes the research and his overall career trajectory while he's in it. You are mistaking good conflict avoidance skills for a medical disorder.

Good conflict avoidance causes speech impediments, rocking back and forth, and the unusual posture?

He wasn't just "awkward" or "weird", he exhibited symptoms that point pretty clearly to a mild form of autism (based on OP's statements).

Cue the "pre-med vs. Resident, resident must always be right because pre-meds don't know jack ish" BS.

 

[psypiral]

Later on in the summer, he did mention he had autism. However, whether or not he had autism wasn't the purpose of my question. I'm sure many forms go practically unnoticed. The purpose of my post was to illustrate that this particular individual had a very apparent social disorder -- one that could be observed immediately after speaking or even just seeing him. In spite of this, I was wondering how he overcame the interview process.

 

[JPA178]

My experience with the Autism spectrum has led me to believe that a lot more of us may fall on the less severe side of it than we think. The diagnosis seems to have a degree of subjectivity when it comes to 'mild' cases. Not really answering your question exactly, but something I have been thinking about...

I agree with this. My younger brother is very severely autistic, to the point where he basically does not communicate even by writing. Considering a number of aspects of my personality, I've often wondered if I might fall somewhere on the very mild end of the spectrum, and my dad as well.

 

[PreciousHamburgers]

I agree with this. My younger brother is very severely autistic, to the point where he basically does not communicate even by writing. Considering a number of aspects of my personality, I've often wondered if I might fall somewhere on the very mild end of the spectrum, and my dad as well.

Me too! Except my younger brother is very high functioning (enough so to be an Afghanistan vet!) I notice quirks about my personality and that of my father and siblings...

 

[womanofscience]

I agree with this. My younger brother is very severely autistic, to the point where he basically does not communicate even by writing. Considering a number of aspects of my personality, I've often wondered if I might fall somewhere on the very mild end of the spectrum, and my dad as well.

Broad autism spectrum disorder is a thing. Often, relatives of a person with an ASD will exhibit certain tendencies or traits.

As for this particular student, he could be a systematizer. For myself, I went through a stringent period of training by my custodial guardians where I was taught the "correct" responses and how to control my facial expressions during conversations since it was either respond correctly or face physical punishment.

(I am particularly passionate about ASD and neurodiversity in general)

 

[NonTradJp]

That guys is amazing. He is clearly intelligent and capable. And probably had the passion and self-knowledge to answer any questions that may have come up regarding his social interactions to get through the interviews.

 

[Hospitalized]

He is probably extremely brilliant. Usually the most brilliant people do have difficulty with social situations. That doesn't mean he can't treat and take care of people, but he probably is not in medicine to become a family physician. But, research and brilliant minds are needed in medicine. Said school saw this and snapped him up because he undoubtedly has great potential.