What is neurodiversity?

Neurodiversity refers to the variations we all have in terms of our individual neurocognitive ability. Everyone has diverse talents and individual struggles. However, for some people the variation between those strengths and challenges is more pronounced and a neurodiversity condition may be present. The PSW service supports doctors in training to recognise if they may have any neurodiversity condition which may be impacting on areas of their training and provides coping strategies to overcome these and give them the best chance to succeed. 

What are examples of neurodiversity conditions?

The below are the most frequent occurring conditions identified in the workplace - these are classed as disabilities under the Equalities Act 2010:

• Dyslexia: A general term for disorders that involve difficulty in learning to read or interpret words, letters, and other symbols, dyslexia does not affect intelligence.

• Developmental Co-ordination Disorder (DCD): (formerly known as Dyspraxia): a common disorder that affects movement and co-ordination, DCD does not affect intelligence but can affect tasks requiring balance, sports, learning to drive and your fine motor skills such as writing and using small objects.

• ADHD (Attention Deficit and Hyperactivity Disorder): Adult ADHD is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behaviour.

• Autism and Asperger’s syndrome: generally characterized by social and communication difficulties and by repetitive behaviours. Often, severe forms of ASD are often diagnosed in the first two years of a child's life, but high-functioning individuals may not be diagnosed until much later in life

• Mental Health: an impairment of mental functioning that is often accompanied by distress.

• Tourette Syndrome (TS): a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics.

• Acquired Brain Injury: refers to any type of brain damage that happens after birth. Causes of ABI include disease, blows to the head, alcohol and drug use, or oxygen deprivation.

• Chronic neurological conditions: any disorder of the nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. There are many recognized neurological disorders, some relatively common, but many rare

What are the indicators for a neurodivergent condition?

Neurodiversity can often be undiagnosed into adulthood. Some individuals with neurodiversity have been finding ways to cope in their youth which may have manifested as depression, anxiety, low self-esteem and the feeling that they are not as good as others, are slower and need more time to understand instructions. Stress is a big factor associated with the difficulties reported by trainees who may be neurodivergent and this may be a trigger for seeking help - doctors in training who have benefited from a neurodivergent assessment include those who have reported difficulties in the below areas:

• Time management

• Planning and prioritising

• Organisation

• Distractions

• Working Memory weaknesses

• Processing Speed

How can I find out if I have a neurodiversity condition?

The PSW can offer screening to determine if there are any strong indicators of a neurodiverse condition (this is a series of 40 questions based on the above difficulties and how you function). The screening results will determine if there is a need for a full cognitive assessment to investigate your possible neurodiversity - this assessment is performed virtually by an Educational Psychologist and you will be given a report detailing their findings.

Please note the PSW are not able to fund standalone assessments for ADHD.  So for further investigation of ADHD alone and any potential medical treatment, you would need to seek a medical referral via your GP, in line with NICE Clinical Guidance 2008. There can be a waiting list therefore it is important that you be proactive and speak to your GP as soon as possible if you want to explore a diagnosis.

Further information can be found here: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/

The ADHD UK website may helpful to guide you further.

 What support is available from the PSW if I may have a neurodivergent condition?

Employers are obliged to put in place reasonable adjustments for employees with disabilities under the Equalities Act 2010. The PSW service can support you with:

• Screening, as mentioned above

• Study support techniques specifically aimed at trainees who may be neurodivergent

• Coaching to help with memory, time management, stress/anxiety and organisation skills

• In some cases a referral for an Occupational Health assessment to seek support for reasonable adjustments  

What support can I expect from my Training Programme if I have a confirmed neurodiversity condition?

We have developed guidance for both doctors in training and training programmes to assist them in supporting doctors who have a confirmed neurodiversity condition:

• Guidance for trainees
• Guidance for training programmes and educators
• Flowchart showing key support considerations following the diagnosis of a neurodiverse condition

I am entitled to support with Access to Work - where can I find out more information?

Find your way through Access to Work: https://diversityandability.com/nhs-toolkit/health-professionals-atw/

Access to Work Mental Health Support Service: https://www.remploy.co.uk/employers/mental-health-and-wellbeing/workplace-mental-health-support-service-employers/

What is Coaching?

Coaching can be defined as unlocking a person's potential to maximise their own performance. The aim of coaching is to find holistic and personalised ways to manage challenges both in your work and home life. It is a journey where the process of learning is as important as the knowledge and skills gained.

Many doctors in training feel coaching has helped them with:

• Managing anxiety

• Strengthening communication and team working skills

• Building confidence

• Navigating cultural barriers

• Building motivation

• Organisation and time management skills

• Techniques to help pass practical exams

Who delivers Coaching?

We use a wide range of external providers who deliver up to 8 hours of free one-to-one coaching support. Whilst not clinicians, our providers have vast experience of supporting doctors in training progress with their postgraduate medical training. 95% of doctors completing feedback felt that coaching helped them overcome barriers with progressing with their training. The support is flexible and will be tailored to your individual needs.

Please note that the initial support package is at no cost to the doctor in training - any additional sessions may need to be self-funded.