From medical school to foundation training: supporting autistic doctors in early medical careers

AIMS AND METHOD: To explore existing knowledge on autism in medical education and early clinical training, examine the lived experiences of autistic doctors, review relevant National Health Service policies and legal frameworks, and propose a practical framework for improving inclusion. This study comprised a narrative review of the published literature on autism in medical education, foundation training and healthcare settings, supplemented by a positionality statement informed by the author's clinical experience. RESULTS: Common barriers include the hidden curriculum of clinical placements, neurotypical templates in communication assessment, sensory demands of clinical environments, significant risks associated with disclosure and inadequate supervisor awareness. Masking imposes substantial psychological costs, including risk of autistic burnout. Legal frameworks exist but are inconsistently applied in practice. The SUPPORT framework is proposed as a structured model: Structured learning environments, Understanding neurodiversity, Predictability, Practical adjustments, Open culture, Relationships and mentorship, and Trainee well-being. CLINICAL IMPLICATIONS: Autistic doctors bring valuable strengths to clinical practice. The barriers they face during the transition from medical school to clinical practice are documented and preventable. Despite legal protections and growing awareness of neurodiversity, National Health Service training frameworks do not consistently address the needs of autistic clinicians. The SUPPORT framework provides a practical, low-resource approach to addressing these barriers, with implementation requiring greater awareness and institutional commitment. These findings identify the need for medical training to move past recognition of neurodiversity and towards creating clinical environments in which autistic doctors can thrive.