Dr Khalil Elgendy is a senior radiology trainee at Imperial College Healthcare NHS Trust and is a RadReach mentor.

2-8 April 2024 is World Autism Acceptance Week, focusing on the theme ‘Empowering Autistic Voices’. Autism is one of a number of neurodiverse conditions and while those living with each condition experience life differently and on a spectrum, they also face some common challenges.

Neurodiversity refers to the different ways in which the brain experiences the environment, both internally and externally. This will often lead neurodivergent individuals to experience a feeling of alienation, with an inability to fit in and not being part of the team. This may come out in a variety of ways; for example, they may have difficulty expressing their perspective, experience sensory overload (for example, noise, light or proximity to other people) and may experience difficulty in reading social cues.

Neurodiverse individuals can also offer many positive attributes. Attention to detail, hyperfocus and pattern recognition are a few examples that aid in developing exceptional problem-solving and rational decision-making skills – core components of medical practice. High energy, empathy, intensity of interest and a strong work ethic are other positive traits of neurodiversity that are needed in the current challenging healthcare environment.

One of the main challenges neurodivergent doctors face is the current stigma and stereotyping that comes with neurodiversity in general – and autism in particular. For example, there is a perception that neurodiverse doctors have difficulties getting into training programmes, passing exams, achieving clinical competencies or managing rotas. This would set the individual to start from a disadvantaged point and difficult place to navigate.

As a consequence, there is a current culture of non-disclosure of autism or other neurodiversity, which can have a great impact on the individual and their working environment and makes addressing such issues very difficult. Additionally, not all neurodivergent individuals have a formal diagnosis, with potential underdiagnosis in women in particular.

From my experience as a mentor, some neurodivergent individuals seek help when it's a bit too late and issues have already escalated. If they had felt able to speak up sooner, more could have been done to rectify the situation at an earlier stage. Sadly, a lot of good motivated and enthusiastic neurodivergent doctors experience these challenges and have either left their careers or are currently struggling with feelings of not belonging, of guilt or with a sense of failure or underachievement.

Yet with the right information and understanding, small achievable changes can improve the overall quality of the individual’s working life, as well as the quality of the working environment. This has the potential to be a win-win scenario, moving from crisis management into active planning and being proactive and pre-emptive rather than reactive. Part of the responsibility lies also within the individuals themselves, to understand themselves and be aware of their weaknesses as well as their strengths. Working with a mentor is one means of developing the skills and confidence to articulate those strengths, challenges and support needed to the right people.

We should all reflect on the opportunities we have to support our neurodivergent colleagues. This might include:

• An emphasis on clear communication, including empowering colleagues to contribute their views, particularly where these might differ from the perspectives shared by other colleagues.
• Seeking to better understand the unique talents and skills that each of our colleagues brings to the workplace and how best to harness these to find creative solutions to common problems.
• Creating links with local medical societies or support groups, or setting up buddying or mentoring schemes for neurodivergent doctors if none currently exist.

On a national scale, the support available to adults with autism is limited, especially if – outwardly – they are functioning as many would hope, or overachieving. There are other services available where generic support can be provided outside the working environment, but these are mainly targeting non-functioning young individuals and are not necessarily specific to medicine, although some such support networks do exist (for example, Autistic Doctors International). Occupational health and staff counselling can provide important support initially or for a short period of time but not necessarily for a longer period; however the specific support available may vary across employing trusts. This is why a holistic approach, including social support from family and friends and individual therapeutic or mentoring support, is crucial.

There is undoubtedly more work to do to raise awareness and build evidence for the effectiveness and value of mentoring to supporting neurodivergent doctors, in particular, to thrive. As well as providing guidance on how changes to ways of working can be most effective in supporting autistic and neurodivergent doctors to overcome the current challenges and successfully be part of the team. Mentoring offers an informal safe space to discuss different issues that may be more difficult to bring up within formal supervisory or training settings. But that is just the start! Providing workplace changes and support will offer opportunities for neurodivergent doctors to grow and nourish their special talents to help address the current challenges of healthcare, and to create the space to develop and contribute to creative solutions.

Medicine – and specifically radiology – provides a great space for different personalities with different knowledge, skills and abilities to flourish. By sharing our experiences, and with kindness and compassion, we celebrate diversity in many different forms, culturally, ethnically and with neurodiversity within our medical profession including radiology.

This brings us back to Autism Acceptance Week and the significant impact we can achieve by empowering the voices of our colleagues.  Communication, kindness and compassion are essential elements for successful working relationships, particularly when supporting neurodivergent individuals. I would encourage you to reflect on the invaluable support you could gain, and the difference you could make – as a junior or senior colleague – by participating in the RCR’s Mentoring Scheme as a mentor or mentee.