Operating theatres
10. Duong, D. & Vogel, L. (2022). Untapped potential: embracing neurodiversity in medicine. JAMC
https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC9299741/
11. Major, R. & Tetley ,J. (2019). Effects of dyslexia on registered nurses in practice. Nurse Education in Practice. ELSEVIER.
12. McVey, C. How many doctors have ADHD? Attention Deficit Doctor, 10 March 2024, https://
www.attentiondeficitdoctor.co.uk/1105060-2
13. Moore, Shirley et al. Autistic doctors: overlooked assets to medicine. The Lancet Psychiatry, Volume 7, Issue 4, 306 – 307
Further reading 14.
https://autisticdoctorsinternational.com/ 15.
https://www.attentiondeficitdoctor.co.uk 16. Brown, K, Navigating surgery with ADHD and autism. BMJ, 8 October 2024. https://doi. org/10.1136/bmj.q1834
17. Brennan CM & Harrison W, The dyslexic surgeon, The Bulletin of the Royal College of Surgeons of England, Published Online 2 March 2020.
https://doi.org/10.1308/rcsbull.2020.72
18. Autistic Doctors: Breaking Barriers in Medicine, August 2024. Accessed at: https://neurolaunch. com/autistic-doctor/
19. Doctors with ADHD, Thriving in Medicine, December 2023, Accessed at: https://www.
adhdguide.com.au/articles/doctors-with-adhd
20. ADHD in surgeons: an inside view. The Bulletin of the Royal College of Surgeons of England, Published Online 30 June 2024. Volume 106, Number 5.
https://doi.org/10.1308/rcsbull.2024.98
21. The Chartered Institute of Personnel and Development, Neuroinclusion at work report (2024),
www.cipd.org/uk/knowledge/reports/ neuroinclusion-at-work/
COMMENT with JAMES HENDERSON
A call for change to break down barriers
James Henderson is a Plastic and Hand Surgeon and Confederation of British Surgery* Co-opted Member (Neurodiversity Lead). He believes we need to break down barriers for neurodivergent surgeons. As a neurodivergent consultant surgeon, I often feel thankful that I was not diagnosed with autism until I was 48. By that time, I had established myself in both my professional and personal life, and my diagnosis could not possibly thwart me on either front. This is a different story for many neurodivergent trainees, and surgeons diagnosed early in their careers. Often, they are told that it is not possible to have a successful surgical career, are shamed into giving up their dreams altogether. Those who persist are rarely offered any specific support. Reactions to neurodiversity among surgeons span from denial or passive resistance to accommodating changes, to outright refusal. Requested changes are generally quite small, but may spell the difference between a surgeon being able to work comfortably and not. For example, it is not possible to have my own office in my current workspace; the alternative is a noisy open plan office with shared desks that I am unable to use. Providing me with a Trust laptop allowed me to do all my administrative tasks in a place I feel comfortable, or from home. I am the deputy leader of Autistic Doctors International (ADI)**. It is telling that four of the
17 doctors on its leadership team are anonymous, and 29% of all autistic doctors conceal their diagnosis because of fear of workplace discrimination. ADI is a voluntary group, and we do our best within this limitation to provide support and mentorship to everyone who needs it. In doing so, it is highlighted just how little support there is for neurodivergent surgeons. When I speak to managers, it is clear that they do not want, do not know, or do not understand how to make practical changes that could support me and others. It is 2025: how can we still be losing talented surgeons from the profession through stigma and ignorance? As far as I know, I am the only openly autistic consultant surgeon in the UK, and this speaks volumes about the stigma attached to neurodivergence in the surgical community. Nobody knows how many surgeons are autistic because they are too afraid to declare or even to seek a diagnosis. So, what needs to change? For a start, the NHS must stop paying lip service to
About the author
Dorota Maria Bilan has 25 years of experience in nursing within a variety of specialties, including operating theatres. In addition to her work as a scrub nurse, she has also completed an MSc degree, Enhanced Professional Practice. She is currently working as a Surgical Care Assistant Trainee, with a Gynae-Oncology Team.
22
www.clinicalservicesjournal.com I April 2025
neurodiversity and start effecting tangible change. We need dedicated teams to help guide hospitals in how to make reasonable adjustments. The guidelines from the National Autism Implementation Team (NAIT), a Scotland-based practitioner researcher partnership, have yet to be implemented widely. Autism is still viewed through a deficit-based lens, forgetting - or ignoring - our strengths, which include attention to detail, reliability, persistence and integrity. A struggle to communicate or understand social nuances does not mean that we lack empathy, yet this is widely believed to be fact. I will not give up. I’m the neurodiversity lead for CBS, I’m deputy leader of ADI, and I’m starting a project with the Royal College of Surgeons of England. I will hopefully be able to influence change at a higher level now. I’m passionate about shaping the way forward for neurodivergent surgeons; we must ensure these issues are addressed with the urgency they deserve, and the barriers being faced by so many, daily, are torn down. If you’re a neurodivergent surgeon struggling with support or adjustments, I encourage you
to seek support. There are groups like ADI that are here to help. And if you’re facing challenges at work, I’d recommend connecting with the Confederation for British Surgery (CBS), which offers support and signposts for neurodivergent surgeons. Visit:
www.cbsgb.co.uk
* The Confederation of British Surgery is a union for the whole surgical team and provides support for members in difficulties, as well as advocating for the surgical profession. * * Autistic Doctors International represents a community of over 1000 autistic medical doctors and medical students. It provides free peer support and a safe space for members.
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