As someone who was diagnosed with ADHD in residency, I think the IQ testing really helped make the case. The first time I saw a psychiatrist, it was for depression during med school. ADHD wasn't even remotely on my mind (this was long before the Tik Tok ADHD fad, all I knew about ADHD was that hyperactive kids had it). The psychiatrist I saw at the time was a triple-boarder (psych/child psych/peds) and he was like, "listen, you're not really suffering from MDD. It's that you're struggling with med school because it's taxing you beyond your mental capability." He said he's pretty good at estimating IQ and estimated mine to be between 105 and 110 and that what was happening was a classic case of someone exceeding their academic potential and struggling with med school, thus leading to symptoms of depression. He rx'ed an SSRI, told me to just truck through pre-clinicals, and try to match FM.
Ngl, I legit came out of that convinced I was just dumb. Didn't take the SSRI and just struggled through pre-clinicals. Anki and a pre-made Anki deck is the only reason I passed pre-clinicals and even then, just barely. I did alright on Step 1, about 60th percentile, which was a massive relief because prior to finding that Anki deck, I highly doubt I would've gotten a passing score. Clinicals were a whole different ballgame and I did better there. Finally saw another psychiatrist as an intern when I started slipping up on documentation and making what looked like careless mistakes. I was literally sitting in didactics where the subject was ADHD and I remember thinking, "Wait, what? This isn't just describing everyone?" I still have a text from that day where I texted my wife, "Lol, they're literally just describing normal behavior and calling it ADHD." My wife was like.....no, they're describing you, not everyone. I had really good insurance that covered neuropsychological testing surprisingly (out-of-network at that!) so sought that out and came out with a clear diagnosis of ADHD, combined type. IQ came back as 144 and the neuropsychologist said that really explained how I'd made it as far as residency with what seemed outwardly like no impairment (there was plenty of impairment when he asked thorough clinicals questions, things I hadn't even considered).
Long story short, IQ testing is now what I consider the single most important test outside the clinical interview. I've seen it both ways. Patients with high IQs that explains how they compensated, at least academically, for ADHD. And patients with low IQs that explains why they're struggling (had a recent patient enrolled in a master's program who sought evaluation for ADHD, came back with an IQ of 82).
Ngl, I legit came out of that convinced I was just dumb. Didn't take the SSRI and just struggled through pre-clinicals. Anki and a pre-made Anki deck is the only reason I passed pre-clinicals and even then, just barely. I did alright on Step 1, about 60th percentile, which was a massive relief because prior to finding that Anki deck, I highly doubt I would've gotten a passing score. Clinicals were a whole different ballgame and I did better there. Finally saw another psychiatrist as an intern when I started slipping up on documentation and making what looked like careless mistakes. I was literally sitting in didactics where the subject was ADHD and I remember thinking, "Wait, what? This isn't just describing everyone?" I still have a text from that day where I texted my wife, "Lol, they're literally just describing normal behavior and calling it ADHD." My wife was like.....no, they're describing you, not everyone. I had really good insurance that covered neuropsychological testing surprisingly (out-of-network at that!) so sought that out and came out with a clear diagnosis of ADHD, combined type. IQ came back as 144 and the neuropsychologist said that really explained how I'd made it as far as residency with what seemed outwardly like no impairment (there was plenty of impairment when he asked thorough clinicals questions, things I hadn't even considered).
Long story short, IQ testing is now what I consider the single most important test outside the clinical interview. I've seen it both ways. Patients with high IQs that explains how they compensated, at least academically, for ADHD. And patients with low IQs that explains why they're struggling (had a recent patient enrolled in a master's program who sought evaluation for ADHD, came back with an IQ of 82).
