Embracing Neurodiversity in Medicine: Insights Into Autism | PCOM
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Embracing Neurodiversity in Medicine: 
Insights From an Autistic Medical Student

April 11, 2024
By Fox Ryker (DO ’27)
Headshot photograph of first-year medical student Fox Ryker (DO '27)

Two decades ago, I received a medical diagnosis that would change my life.

Diagnosed with moderate autism spectrum disorder, my physicians at the time were unsure whether I would be able to live independently. I was nonverbal until I was four, went to four different elementary schools, two different middle schools, and received a decade of therapy.

Today, I am a first-year osteopathic medical student at Philadelphia College of Osteopathic Medicine (PCOM) and have continued to defy expectations and preconceived notions surrounding my diagnosis.

April is World Autism Month and Celebrate Diversity Month, and an opportunity to recognize the unique talents, insights and strengths our diversity—in all its forms—brings to the community. As an autistic medical student, I know firsthand that the perspectives, experiences and identities we each bring to the table strengthen our collective understanding of the world around us, and will ultimately make us better doctors.

As children, we take in verbal and nonverbal cues and gestures from those around us, helping us formulate our own ability to communicate both smoothly and effectively. For those with autism, this can be a struggle, and the process must be actively reinforced.

Family photograph of Fox as a child

When I was a child, I took social dynamic classes, learning how to initiate conversation, respond to others, read facial expressions, understand social cues, and so much more. In a typical conversation, I often have to consciously reference those lessons, and systematically apply them to every aspect of my interactions with others. Am I maintaining eye contact? Am I matching their body language? Am I sharing the appropriate amount of information?

The best analogy I’ve come across to describe this process is when someone is speaking a language other than their native language. They will usually have to consciously refer back to their first language, which can be exhausting and mentally draining. For me, I am actively listening, but also, simultaneously, employing a technique referred to as masking. Masking is when an autistic person suppresses their autistic traits (stimming, oversharing, hyperfocusing, etc.) in order to conform to socially compatible mannerisms. When a person is very good at masking, you’ll often not even realize they’re doing it.

Having developed these skills over the years, I feel confident in my ability to communicate with my medical school peers, but can sometimes miss nuances or come off as awkward. Autistic people tend to think very literally, so recognizing idioms, sarcasm, and passive-aggressiveness can be a struggle. This, in turn, might make us appear to be instigative, when in fact we might have completely misunderstood one’s point. And though they often struggle with outwardly expressing their feelings, almost every autistic person I’ve ever met has been empathetic and compassionate.

Family photograph of Fox as a baby

Autism is just one disorder under the neurodivergent umbrella and, according to the CDC, 1% of the world population is autistic. That would suggest that, statistically, there are other autistic medical students at PCOM, all with their own perspectives to share. Whether autistic, allistic, neurodivergent, or neurotypical, we all possess traits that are unique to us. Our neurodiversity is not a hindrance, but a strength in our ability to become good doctors. These strengths are shown through our unique lived experiences. In my case, my therapy has allowed me to excel in nonpharmacological approaches to de-escalating crisis moments. As an emergency room technician prior to coming to PCOM, for example, my experience as an autistic person made me a valuable contributor whenever an autistic patient presented to the emergency room.

The relationship between one’s diversity and their health is also affirmed through the Tenets of Osteopathic Medicine that all student doctors agree to uphold, and its understanding is paramount in providing effective treatment and compassionate care. Our differences can also provide perspective in fostering the holistic approach to patient care for which PCOM is known.

All of the challenges I’ve described from my own experience and for others with autism or other neurodivergencies are things we manage on a day-to-day basis. This is also true for the multitude of other diverse groups that make up the PCOM community. Those challenges—and all of our differences—form the basis of our experience and are what make us unique. They are worth celebrating and will make us better doctors, and ensure our patients are seen and heard.

Fox Ryker is a first-year medical student from Coatesville, Pennsylvania, and contributed this article in recognition of World Autism Month and Celebrate Diversity Month, each recognized every April to encourage inclusivity, celebrate differences and honor the diversity of the world around us.

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  • About Philadelphia College of Osteopathic Medicine

    For the past 125 years, Philadelphia College of Osteopathic Medicine (PCOM) has trained thousands of highly competent, caring physicians, health practitioners and behavioral scientists who practice a “whole person” approach to care—treating people, not just symptoms. PCOM, a private, not-for-profit accredited institution of higher education, operates three campuses (PCOM, PCOM Georgia and PCOM South Georgia) and offers doctoral degrees in clinical psychology, educational psychology, osteopathic medicine, pharmacy, physical therapy, and school psychology. The college also offers graduate degrees in applied behavior analysis, applied positive psychology, biomedical sciences, forensic medicine, medical laboratory science, mental health counseling, physician assistant studies, and school psychology. PCOM students learn the importance of health promotion, research, education and service to the community. Through its community-based Healthcare Centers, PCOM provides care to medically underserved populations. For more information, visit pcom.edu or call 215-871-6100.

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