Dyslexia ADHD as adult

[IMGASMD]

Was reading a resident who had trouble passing board exams after med school, so step 3.

Is that a psychiatric diagnosis? Who is best to help assess the testing “accommodation”? School psychologist? Specialized pediatrician?

Trying to pick some brains here.

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[calvnandhobbs68]

You'd need way more information than this to try to figure out next steps.
Is what a psychiatric diagnosis "inability to pass step 3"? Not seeing it my copy of DSM 5.

 

[IMGASMD]

You'd need way more information than this to try to figure out next steps.
Is what a psychiatric diagnosis "inability to pass step 3"? Not seeing it my copy of DSM 5.

Do you believe people can be diagnosed with dyslexia NOS or ADHD as adults?

 

[WisNeuro]

Do you believe people can be diagnosed with dyslexia NOS or ADHD as adults?

First diagnosed as an adult, with symptoms present in childhood? Yes. Symptom onset in adulthood? No.

 

[IMGASMD]

First diagnosed as an adult, with symptoms present in childhood? Yes. Symptom onset in adulthood? No.

Then let’s assume it’s the right diagnosis, just late…. What then?

 

[WisNeuro]

Then let’s assume it’s the right diagnosis, just late…. What then?

If they are requesting accommodations, they would presumably need to be evaluated, ADHD is a diagnosis by clinical history, but dyslexia can be objectively evaluated. Psychologist/neuropsychologist's can do this if it's their practice area. If the med school is affiliated with a university, there may be a clinic that can do it through the uni.

 

[clozareal]

If it's ADHD, then a psychiatrist, executive functioning coach, or a therapist who is versed in this can help.

If it's dyslexia (specific learning disorder, with impairment in reading), it's very unusual not to pick this up as a child since most schools are required to screen for this, but of course there is a possibility depending on other factors that may have masked this. Getting neuropsychological evaluation from someone who does this in the area would be the best way to get assessed.

This can also be diagnosed through certain apps such as neurolearning, but this wouldn't help you parse through the differential for learning difficulties which include more common things like depression, anxiety, sleep disorders, etc which even a basic neuropsychological evaluation would.

But there's a ton of reasons not to be able to pass step 3 and many of them don't involve a psychiatric diagnosis.

 

[PikminOC]

If it's ADHD, then a psychiatrist, executive functioning coach, or a therapist who is versed in this can help.

If it's dyslexia (specific learning disorder, with impairment in reading), it's very unusual not to pick this up as a child since most schools are required to screen for this, but of course there is a possibility depending on other factors that may have masked this. Getting neuropsychological evaluation from someone who does this in the area would be the best way to get assessed.

This can also be diagnosed through certain apps such as neurolearning, but this wouldn't help you parse through the differential for learning difficulties which include more common things like depression, anxiety, sleep disorders, etc which even a basic neuropsychological evaluation would.

But there's a ton of reasons not to be able to pass step 3 and many of them don't involve a psychiatric diagnosis.

I have seen many schools pass this off to their hired gun who diagnoses ADHD.

 

[calvnandhobbs68]

Then let’s assume it’s the right diagnosis, just late…. What then?

I mean why would someone be able to pass Step 1 and Step 2 but not Step 3 due to dyslexia? How does this even logically make sense? Again, would need a ton more historical information. I agree that this could be missed in childhood but Step 3 actually tends to be the least demanding of the exams.

That's why my response was what it was. Not really sure if there's a real formulated question here besides "why can't this person pass step 3".

 

[IMGASMD]

That’s what I told him would be the general responses from the community. Skeptical at best.


I can offer a possible scenario. Someone who immigrated to this country at a older school age. Never went through neuropsychological testing, for ADHD or dyslexia. Worked very hard and compensated all throughout college and med school. All along deficiencies have been attributed to English as second language.

Someone who compensated well by listening to lectures in college and first two years of med school. During clinical years, there are no more lecturers to distill words anymore.

Lastly, a kid who never had an opportunity to be tested for ADHD, learned to compensate by only study in a place without any distraction and alone, always.

We are all skeptical of diagnosis made by other people. Part of the reason why I asked how you feel about “childhood” diagnosis being made in adulthood. Just imagining if some of these adults were diagnosed properly rather than med school or even by step 3….. how much better their journey could have been.

So far, I’ve heard neuropsychological testing by a big institution as a pathway forward. Any other takers?

 

[calvnandhobbs68]

That’s what I told him would be the general responses from the community. Skeptical at best.


I can offer a possible scenario. Someone who immigrated to this country at a older school age. Never went through neuropsychological testing, for ADHD or dyslexia. Worked very hard and compensated all throughout college and med school. All along deficiencies have been attributed to English as second language.

Someone who compensated well by listening to lectures in college and first two years of med school. During clinical years, there are no more lecturers to distill words anymore.

Lastly, a kid who never had an opportunity to be tested for ADHD, learned to compensate by only study in a place without any distraction and alone, always.

We are all skeptical of diagnosis made by other people. Part of the reason why I asked how you feel about “childhood” diagnosis being made in adulthood. Just imagining if some of these adults were diagnosed properly rather than med school or even by step 3….. how much better their journey could have been.

So far, I’ve heard neuropsychological testing by a big institution as a pathway forward. Any other takers?

Neuropsych testing is going to be your best bet...I'm not sure you're going to get many other answers besides this. They'll take a much more comprehensive history along with the actual testing. I'm not saying I'm skeptical but there's so many reasons this could be occurring and so little info to go off of that it's going to be difficult to get a real answer outside of an in depth interview.

why difficulty with this exam in particular after doing presumably well enough on an MCAT to get into medical school, passing Step 1, Step 2 and then now struggling with Step 3. If this is in the context of longstanding global academic struggling, that's a bit of a different thing. If they immigrated at an older age, did they have academic difficulties in their native language prior to immigration? Many (I'd venture to say most?) people need to study in a place without any distraction, alone without having ADHD. English proficiency skills can be tested (TOEFLs for instance) which can give some insight into if language difficulties are still contributing to testing difficulties.

 

[ObsequiousAplomb]

So in this example they have always compensated by studying alone without distraction? Have they tried that for step 3? Among the steps, step 3 is the one most likely to not be studied for alone in a quiet place. Usually people are working full time and trying to balance studying with a full caseload.

Someone who could successfully compensate for all the necessary testing prior to this one, independent of whether they have had ADHD all along, would best be served by their usual compensatory measures.