The Experiences of Autistic Doctors Transitioning into Clinical Practice in the UK: A Phenomenological Study

Autistic doctors bring valuable contributions to healthcare but face challenges like managing healthcare's unpredictable nature and difficult colleague interactions. Significant life changes, such as the shift from medical student to resident doctor, can be stressful for autistic people. No research yet has examined how autistic doctors experience and make sense of the critical transition from medical student to qualified doctor, which is what this study aims to do. We utilised an interpretive phenomenological approach for this study, conducting qualitative interviews between October 2024 and February 2025 that we subsequently analysed using interpretive phenomenological analysis. Participants were UK-based doctors recruited through the Autistic Medical Students or the Autistic Doctors International online support groups. Ethical approval was obtained from the Brighton and Sussex Medical School Research Governance and Ethics Committee. Five people took part in the study, and we identified five Group Experiential Themes (GETs). Participants felt powerless due to a system driven by luck (GET 1), where their placements and support were unpredictable, leaving them with little control or agency. This feeling of powerlessness (GET 2) was compounded by a medical culture that felt misaligned with their identities as autistic doctors and made them feel subordinated and excluded from the rest of the medical team. This led to attempts to claw back control (GET 3) by carefully managing their identity, staying hypervigilant of social dynamics, and lowering their expectations. However, this led to internal conflict, exhaustion, and sacrifices in their personal lives to survive in this system (GET 4), leading participants to struggle to reconcile their professional identity (GET 5) with the expectations placed on them. This study highlights how transitioning into a work environment can be stressful for newly qualified autistic doctors and how work environments can inadvertently exacerbate this experience by disrupting long-developed coping strategies, pressuring autistic people to mask and increasing stress and isolation. Creating environments that embrace diversity and support autistic doctors' needs is vital for them to thrive.