August 20, 2019 at 9:31 pm #125620
I am starting out as a new family medicine resident. I was diagnosed at the end of medical school with a ADHD and a profound working memory deficit. I’m struggling in residency to remember everything patients are telling (I write things down but can’t always get it fast enough), process things quickly enough to decide what to do, and it has been a struggle. I regularly feel frustrated and hopeless about things. I am not a candidate for stimulants (heart issues), and did not tolerate non-stimulants. Is there anyone else out there in medicine who has encountered these issues? Anyone found medication helped with working memory?
Thanks, any info is much appreciated!
August 20, 2019 at 9:43 pm #125621
First of all, you made it into med school, and then also through med school….
Give yourself some credit.
Some of us cant even function enough to leave the house….
So please be a doctor who finds a better way to treat
And now I’m 47 and just found this all out. So I have had to learn these things in the past year.
Accepting this is my brain has been probably the best “therapy” ever.
You can redirect, you can do the things you need to do, it isnt easy, but you do it. Else you wouldnt have made it this far.
You have to learn to give yourself a break.
Look into DBT, dialectical behavior therapy… it helped me, but vyvanse helped too… now I’m not on any thing, because a med screw up and I see how differently I am. I dont know if I will go back on them.
The meds didnt stop my ping pong thinking, but I had less anxiety and emotional regulation..
Neurofeedback (not biofeedback) helps too.
But make sure whom ever you pick for therapy is an ADHD familiar practitioner.
Keep the good work.
Take a walk barefoot in the grass.
Go for a run.
Or a walk or bike ride or workout and spend extra energy and the brain chills out too.
So go on DR.ADHD we need docs who “get it because they live it”….
Best wishes and congrats on med school
August 21, 2019 at 10:22 am #125634
I’d look for tools like the LiveScribe pen or NoteLedge or other similar tools that are made for recording lectures. This is what is recommended at the college counseling center my kid attends. You use special paper, which looks like ordinary paper, but the pen is recording the audio, you scribble whatever you are able to and when you go to review it later, you put your pen on a particular spot on the paper and it will replay the audio of what was being said at the time your pen was on that spot. There are other apps like this I think. Look for whatever tool does this function but is current and has good reviews (I don’t know the answer).
August 21, 2019 at 12:04 pm #125654
Neurofeedback therapy is a good suggestion, as is any therapy or coaching. You can always record the conversations on your phone so you have reference if you miss or forget something. Livescribe is along those lines too.
ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism
August 26, 2019 at 1:53 am #126433
Hey! I’m a med student too, and ADHDer, by the way congratulations!
Hm my psychiatrist always says that working on changing habits can be stronger than meds. BUUUUUT takes longer than just swallowing a tablet. You can always go for some cognitive behavioral therapy. Maybe you can use, as in emergency medicine, some algorithms of the most common consults. So, it can make you feel confident and less anxious. Also, you don’t need to write down EVERY SINGLE word they are telling you, just try to focus on the important info.
And you are on the residency, it means your working memory isn’t that bad! So, stay strong.
I’m aware I’m just a med student, I’m currently on my internship, and it has been challenging. So, hope it helps!
August 26, 2019 at 7:07 am #126443
Congratulations for making through Medical School. You already have the tools to succeed, you just need to maintain control of them.
If you are like me, you should write your notes and dont transcribe to a computer, do that later (it takes more time but you learn better) and will have a better memory of the interaction for when you see the patient again. A good therapist really helps, especially when you can’t use a stimulant to aid your executive functioning. Also, in practice, surround yourself with people that compliment your strengths and help cover some of your weaknesses. As you go into practice a good NP or RN will be an immense aid to you, especially if that person understands how you function. It’s not that they will do work for you but would be a good primer for getting you at the right starting point to access the information in your memory as you need it. One of the biggest problems with ADHD is where to start and what exactly you need to access from your working memory. A primer person can really assist in getting your focus in the right place. You may not work well in a major healthcare conglomerate since you will time limited constantly and the pressure to turn patients and paperwork over will be high. You will probably do best in a small private practice or specialty that allows you more time with a patient.
I am in the medical profession and have put myself in a research position. This allows me to think and ponder a little more without the pressure of a patient in front of me. I am also very shy and do not handle people well face to face. I progressed to this area naturally since I was not diagnosed until I was about 15 years into my career! You have a great head start to understanding yourself and can jump start your career in the right way.
You have a great gift in ADHD and can use it to benefit many patients since you will see things a little differently and may help them when they have not gotten answers in the past.
Congratulations for making it this far and here’s to a great career ahead!
August 26, 2019 at 9:11 am #126250
Opted to be a psychologist after struggling as Psych/PreMed and working for an ambulance company for real-world experience. For some reason, most of the MD’s with ADHD that I know work in the ED.
That and psychiatrists, but I honestly could not tell you if they are ADHD, something else, or just tapping into their own supply… which is a different conversation for a different day.
I am a fan of the Wacom Bamboo. It let’s me take freehand notes, but saves them digitally.
Unfortunately, my penmanship sucks too much for the script to text feature to work.
Unfortunately, I am very responsive to stimulants (1 hour medicated gives me 6 hours of unmedicated productivity) so I don’t have a lot of transferable advice.
August 27, 2019 at 8:40 pm #126631
Hi Dr D!
I am a lawyer with adhd. I’ve found that I really struggle to concentrate or take on information when I’m not interested in a particular area. In order to stay employed throughout my career, I had to learn to find aspects of areas that I can stay interested in enough to process information. I think you can kind of train your brain to get better at hyperfocussing so you actually stay productive.
So, I guess for you (maybe), the patient or their symptoms might be boring to you, but problem solving might be really interesting, so you look for the interesting/relevant information that will help you solve the problem.
The way lawyers are trained to fact find is actually really useful for everyday adhd life as well. I get people to tell me their story twice and I explain that I’m not going to take notes or ask any questions during the first round. During the second round I’m going to take notes, ask them to pause and also ask questions. This technique helps me and I also use it in my private life. People feel really heard and they love telling their story twice. Once I hear the story once, the white noise is reduced because the brain already has a sense of what is important and what can be tuned out and I can focus on the important things in the second round. Sadly this can’t be done in meetings.
Good luck and well done for getting through med school! It gets easier!
January 21, 2020 at 8:36 pm #139746
“I get people to tell me their story twice and I explain that I’m not going to take notes or ask any questions during the first round. During the second round I’m going to take notes, ask them to pause and also ask questions. This technique helps me and I also use it in my private life. ”
This is great advice!
January 21, 2020 at 8:48 pm #139747
You know, I think maybe talking to other doctors would be the best thing for you. I am a social worker with the same profile of difficulties, and I can understand why it’s not possible to use the usual methods (ex: recording patients). Often you have to digest information in disorganized or distressed forms, sometimes chaotic conditions, and be able to do a quick analysis. The working memory issue almost creates a bottleneck that means you might leave out details in your analysis and only realize after. I know that there are doctors who suffer from ADHD and I think they would be the best people to make concrete suggestions in consideration of your actual demands.
Hallowell Centers might be useful (Edward hallowell is a Child Psychiatrist with ADHD. I believe he still sees patients). Maybe a psychiatrist specializing in ADHD might be willing to give you some executive coaching. Reach out to your supervisor or chief resident who might be able to put you in touch with their friends who have ADHD. I think another MD with ADHD would be in the best position to coach you.
The lawyer above has presented a really awesome strategy. I think a lot of patients would be happy to repeat a story to their doctor, as many complain that doctors don’t listen. No one could make that complaint about you!
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