Studying medicine with dyslexia
Best practice guidance from the BMA medical students committee (MSC)
May 2006
- Foreword
- Introduction
- What is dyslexia?
- Dyslexia and studying medicine
- Diagnosing dyslexia
- Implications of the diagnosis
- Support
- Applying to medical school with dyslexia
- Personal perspectives from medical students with dyslexia
- To find out more
Medicine is a demanding subject, requiring a lifelong commitment to learning and hard work. Its practice is a combination of science and art. Knowledge of science forms the foundation for understanding the cause of the illness. The art is combining this knowledge with clinical judgment to determine a diagnosis and management plan.
Studying in a competitive field, such as medicine can be a daunting challenge. For individuals with a learning disability, such as dyslexia, the ability to cope with the transition to an independent learning style can carry additional difficulties. However, these difficulties can be overcome with appropriate support. Despite this, there are still many questions that remain unanswered surrounding the learning disability dyslexia, such as:
Can I become a doctor if I’m dyslexic?
What support is available at medical school?
Will disclosing dyslexia affect my application?
These guidelines aim to answer questions, provide information, and quash myths. They are relevant for students already at or applying to, UK medical schools; or for medical students who think that they may be dyslexic.
This guidance has been produced by the BMA Medical Students Committee and we welcome any comments or questions you may have. Contact details can be found at: www.bma.org.uk/students, or alternatively email info.students@bma.org.uk.
Harnaik Bajwa and Matthew Forbes
Members of the BMA Medical Students Committee 2005-06
The British Medical Association's annual representative meeting in 2006 passed the following resolution:
"That this Meeting believes:
(i) that dyslexia is not a barrier to becoming a doctor;
(ii) that students who are dyslexic should receive additional support during their undergraduate medical training; and resolves that medical schools should adopt the BMA MSC Dyslexia Guidance as best practice and widely promote the availability of this guidance to medical students."
Introduction
Medicine is a subject that requires a focused learning style and strategy. Studying medicine can be made more difficult, when strategies for coping with dyslexia developed at school, are not effectively adapted to meet the demands imposed by the course. It is therefore of utmost importance to detect and support dyslexic students early, enabling them to maximise their potential.
It is encouraging to know that within the field of science a number with the gift of dyslexia have gone on to do great things:
| Albert Einstein: | Theoretical physicist, who authored the special and general theories of relativity |
| Alexander Graham Bell: | Inventor, who was widely considered to have invented the telephone |
| Thomas Edison: | Inventor, alteration of the lightbulb |
| Michael Faraday: | Chemist and physicist, contributed significantly to the fields of electromagnetism and electrochemistry |
| Steven Hawking: | Theoretical physicist, proved the first of many singularity theorems |
| Harvey Cushing: | Surgeon, pioneer of brain surgery |
| Isaac Newton: | Mathematician, described gravitation and three laws of motion |
| Louis Pasteur: | Microbiologist and chemist, discovered pasteurisation and created the first vaccine for rabies |
These guidelines will inform those who want to find out more about dyslexia but more specifically they consider:
- What is dyslexia and how will it affect you studying Medicine?
- Diagnosing dyslexia
- Implications of the diagnosis and how is it supported?
- Applying to medical school with dyslexia
- A student's perspective and how to find out more
The Greek definition of the word dyslexia means difficulty (dys) with words (lexia).
Here are some commonly used definitions of dyslexia:
'Dyslexia is primarily a difficulty with the automatic processing of language based information, especially the written word. It is important to understand that evidence points to a constitutional origin, possibly genetic, and that is not related to intelligence.” (British Dyslexia Association. Go to reference 1)
'Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and / or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge” (The International Dyslexia Association. Go to reference 2)
'Dyslexia causes difficulties in learning to read, write and spell. Short-term memory, mathematics, concentration, personal organisation and sequencing may also be affected. Dyslexia usually arises from a weakness in the processing of language-based information. Biological in origin, it tends to run in families, but environmental factors also contribute. Dyslexia can occur at any level of intellectual ability. It is not the result of poor motivation, emotional disturbance, sensory impairment or lack of opportunities, but it may occur alongside any of these. The effects of dyslexia can be largely overcome by skilled specialist teaching and the use of compensatory strategies.” (The British Dyslexia Institute/Dyslexia Action. Go to reference 3)
Dyslexia affects people to varying degrees, meaning that individuals may be strong in some areas while weak in others. It can present in a number of ways, with problems ranging from:
- Reading- hesitantly and misreading
- Spelling- usually erratic
- Writing- often untidy
- Sequences- getting dates the wrong in order
- Organisation and time management
- Organising thoughts
- Short term memory, mathematics and concentration
It occurs at all levels of intellectual ability, in all socio-economic groups and is not a result of a lack of motivation or emotional disturbance.
Somewhere between 4 and 5 percent of the population are thought to be affected. However, in adults many cases remain unrecognised, as personal compensatory mechanisms develop over the years, making detection increasingly difficult.
Dyslexia and studying medicine
Nationwide, the structure of the undergraduate medical degree programme varies between Universities. Depending on the course structure, different forms of dyslexia support are often recommended. On a traditional, lecture-intensive programme, suitable support may be in the form of printed copies of the lecture notes or a Dictaphone to record lectures. Whereas on a Problem Based Learning (PBL) course, advice on time management and organisation skills may be deemed more appropriate.
Support requirements may also change in the transition from pre-clinical to clinical medicine. Most dyslexic students find that being in hospitals undertaking the clinical element of their course demonstrates a stronger side to their abilities. For this reason, it is recommended that if students need support they should make use of the support services within their medical school.
If you feel you are being unfairly treated, it is worth remembering that higher educational institutions fall under part 4 of the Disability Discrimination Act. This means that universities (and medical schools) are legally obliged to make reasonable adjustments to accommodate students with disabilities, and provides that students with disabilities (including dyslexia) should not be treated less favourably, without justification.
Diagnosing dyslexia
Different people find out that they have dyslexia at different stages in life. For some, it is clear from an early age that they have the condition, for others it might only become apparent whilst studying at University.
Dyslexia is formally diagnosed by an educational psychologist, or a specialist teacher with qualifications in the area. It is the first step in an attempt to compensate for the learning difficulties being experienced.
If you think that you may be dyslexic you may want to ask yourself the following 12 questions (Go to reference 4). The questions are ranked in order of importance and have been shown to be good discriminators between dyslexic and non-dyslexic individuals. Read the questions carefully and answer ‘yes’ or ‘no’, if you aren’t sure pick the response which is true most often:
1. When writing cheques do you frequently find yourself making mistakes?
2. When using the telephone, do you tend to get the numbers mixed up when you dial?
3. Is your spelling poor?
4. Do you mix up dates and times and miss appointments?
5. Do you find forms difficult and confusing?
6. Do you find it difficult to take messages on the telephone and pass them on correctly?
7. Do you mix up bus numbers like 95 and 59?
8. Do you find it difficult to say the months of the year forwards in a fluent manner?
9. Did you find it hard to learn your multiplication tables at school?
10. Do you take longer than you should to read a page of a book?
11. Do you find difficulty telling left from right?
12. When you say a long word, do you sometimes find it difficult to get all the sounds in the right order?
If you answered ‘yes’ to the majority of these questions, it is likely that you have dyslexic tendencies. However, it is important to realise that these questions should only be used as a guide. A more in-depth screening test is available through your Local Dyslexia Association or at university.
The definitive test is the specialist dyslexia assessment, which can be arranged through your university’s disability support service. If you are a student the cost of this assessment is covered by the university. The assessment takes approximately 2.5 hours and comprises a number of tests. The results of these tests are then analyzed and form the basis of a written report. This report explains the results and provides feedback about your strengths and weaknesses along with a definitive diagnosis.
Implications of the diagnosis
Dyslexia is not a disease; it is a learning disability, which can be overcome with appropriate support. A positive diagnosis will not only enhance a persons understanding of how they process information, for some it might also help explain why they have been struggling in certain areas. Dyslexia support tools such as study skills support and specialist equipment further enable dyslexics to maximize their potential.
There are many benefits to being dyslexic, dyslexic individuals are often:
- Innovative lateral thinkers
- Excellent trouble shooters
- Intuitive problem solvers
- Creative
- Good at 'hands-on learning'
- Better verbal communicators
If you are diagnosed at university it is important that you inform your medical school at the earliest possible opportunity. Arranging a meeting with an appropriate member of staff to discuss the educational support which is available through the university and medical school is recommended.
Support
If you are diagnosed as dyslexic it is important to obtain educational support as soon as possible. A referral is arranged by your university to obtain a ‘professional needs’ assessment. Your support requirements are assessed at an Access Centre and a recommendation is sent to your Local Education Authority (LEA).
As a dyslexic student you may be entitled to the following:
Disabled Student Allowance (DSA) (go to reference 5) this is used to cover the cost of:
- Computer equipment
- Specialist software (e.g. Text Help and mind mapping software)
- Dictaphone to record lectures
- Study skills support
- Photocopying allowance
- Broadband internet allowance
Extra time in exams – usually and additional 25% in written examinations, and this should be available in all years of study at medical school
Copies of lecture notes and handouts prior to lectures (in colours that are easier to read e.g. beige)
Extended library loans
Access to a Study Support tutor
For further help in understanding dyslexia, the book 'Use Your Head' by Tony Buzan, published in 2000, is highly recommended. Copies are usually available through your medical school or university library.
Applying to medical school with dyslexia
If you are applying to medical school as a dyslexic, you may feel that it will count against you. To ensure equality in the admissions process, the Council of Heads of Medical Schools (CHMS) (go to reference 6) has published guidelines for prospective students with learning disabilities. The important points to note are:
- Applicants to Medical School should disclose dyslexia on their UCAS application form
- Medical Schools should give equal consideration to dyslexic applicants with the relevant academic criteria
- Evidence of dyslexia, as assessed by an educational psychologist/specialist teacher and any recommendations for support should be provided
Students should not feel obliged to discuss their dyslexia at their interview for admission to medical school.
Personal perspectives from Medical students with dyslexia
What difficulties are faced by students studying Medicine with dyslexia? Does your dyslexia cause any limitations in your studies? What support is available? Do you feel your dyslexia has disadvantaged you? These are some of the overhanging questions that face students studying Medicine with dyslexia. As dyslexia can affect students in varying ways, who better to find out the answers to these questions than the views of the students’ themselves:
So what are the difficulties faced by students studying Medicine with dyslexia? A 3rd year Brighton and Sussex student says “my dyslexia causes my reading and writing to be extremely slow and I have difficulty in retaining spellings of new words (so I spell phonetically)”. Two 3rd year Nottingham students have had differing experiences “in the first two years there were problems with some lecturers not providing notes for lectures. This made it difficult to keep up, resulting in me having to borrow notes from friends and seek help from my dyslexic tutor. Starting clinicals has not caused any real problems apart from trouble with drug names for which there is no real advice or support”. In contrast another student says that “I have had no major difficulties during the course with my dyslexia. The University student support team have been fantastic and help is always available if needed”.
Does your dyslexia cause any limitations in your studies? A 3rd year Dundee student says “at Dundee I have been very lucky as the exams are short answer questions, if you don’t know your stuff then you will get the marks. However if I had had to write essays I am sure I would find life a lot harder”. A 3rd Year Brighton and Sussex student found that “in the 3rd year I can see some of the limitations my dyslexia may cause, such as patient note taking. I am unable to keep up if someone else takes the history and the notes I make may have spelling mistakes”.
What support is available? Brighton and Sussex 3rd year describes his experience “after notifying my school at the beginning of the course, the school has made every effort to provide extra support. I receive 25% extra time for my exams, my essays are marked under the knowledge that I am dyslexic, I have been offered with extra help with tutorials and extended loans for my library books. I have also received valuable help from mature students on the course (who previously did English), which has vastly improved my essay writing”.
Do you feel your dyslexia has disadvantaged you? Sheffield 5th year provides a clear answer “dyslexia has not been a problem for me, from applying to medical school I was completely upfront about the fact that I was dyslexic and I got 4 offers! So far in medical school, not one the doctors I’ve been on placement with has given me a hard time. In fact more often than not people tend to go out of their way to help you. So in conclusion there is no need to worry about dyslexia, it’s no big deal!”
Further information:
The British Dyslexia Association
98 London Road,
Reading,
RG1 5AU.
Tel: 0118 966 2677
Fax: 0118 935 1927
Email: admin@bdadyslexia.org.uk
Go to the website at - www.bdadyslexia.org.uk
The Dyslexia Institute
Park House,
Wick Road,
Egham,
Surrey,
TW20 0HH.
Tel: 01784 222 300
Fax: 01784 222 333
Go to the website at www.dyslexia-inst.org.uk
Disability Rights Commission
DRC Helpline,
FREEPOST MID02164,
Stratford Upon Avon,
CV37 9BR.
Tel: 08457 622 633
Fax: 08457 778 878
Go to the website at www.drc-gb.org
Local Education Authorities
Various addresses
Go to the website at www.dfes.gov.uk/leagateway
Skill: National Bureau for Students with Disabilities
Chapter House,
18-20 Crucifix Lane,
London,
SE1 3JW.
Infoline: 0800 328 5050
Fax: 020 7450 0650
Email: info@skill.org.uk
Go to the website at www.skill.org.uk
References
1. Source: The British Dyslexia Association - go to their website at www.bdadyslexia.org.uk
2. Source: The International Dyslexia Association - go their website at www.interdys.org)
3. Source: The Dyslexia Institute/Dyslexia Action - go to their website at www.dyslexia-inst.org.uk
4. Source: The British Dyslexia Association - go to their website at www.bdadyslexia.org.uk
5. This is available to all UK domiciled dyslexic students in higher education
6. CHMS is the authoritative voice for all Deans of medical schools in the UK.