How Medical Students and Resident Doctors with ADHD Can Manage Failure and Thrive in Training
- Dr. Gemma Goodliffe
- Mar 25
- 4 min read
In my NHS role within the PGMC, supporting resident doctors who are struggling, as well as through my coaching practice working with consultants, GPs and doctors in training, managing failure is something that frequently comes up in sessions.
Medical training is demanding for everyone. But for medical students, resident doctors, and even those who have finished training - consultants, SAS doctors or GPs - if you have ADHD, the journey can feel even more intense.
Deadlines, exams, long shifts, constant information processing, and high expectations can amplify common ADHD related challenges, such as:
Difficulty sustaining attention during long study sessions
Struggles with organisation and time management
Procrastination followed by periods of intense last-minute effort
Sensitivity to criticism or negative feedback
Feeling overwhelmed by administrative tasks
When something doesn’t go well—for example an exam result, feedback from a supervisor, or a difficult clinical experience—it can feel like confirmation of an internal fear:
“Maybe I’m not cut out for this.”
But many highly capable doctors have ADHD. The key difference isn’t whether challenges occur—it’s how they are understood and managed.
Why Failure Can Feel Especially Difficult with ADHD
Many students and resident doctors with ADHD have experienced years of mixed or inconsistent feedback.
You may have been told you are:
“Very capable but inconsistent”
“Bright but disorganised”
“Not working to your potential”
Over time, these messages can shape how setbacks are interpreted.
A single difficult moment—such as struggling with an exam, receiving critical feedback, or facing a complaint—can trigger intense self-criticism or self-doubt.
This experience is often linked to rejection sensitivity, which is common in people with ADHD.
Case Example: Exam Failure and Self-Doubt
A resident doctor I worked with had failed one of their specialty membership exams on several sittings and only had one attempt left.
Their immediate reaction was:
“This proves I’m not cut out to be a consultant.”
But when we explored it further, the issue wasn’t knowledge—it was inconsistent revision strategies and structure.
They were:
Revising in long, unfocused blocks
Avoiding difficult topics until the last minute
Once they introduced:
Short, structured revision sessions
External accountability through body doubling
A clear study plan
They passed comfortably on their final attempt.
The “failure” wasn’t about ability—it was about strategy.
Reframing Setbacks When You Have ADHD
Medical training requires the development of many skills that are not always naturally aligned with ADHD brains—such as sustained attention, administrative organisation, and long periods of passive learning.
This does not mean someone with ADHD cannot succeed in medicine.
In fact, many ADHD doctors bring valuable strengths to clinical practice.
The challenge is often not intelligence or clinical ability—but developing systems that support how your brain works.
Case Example: Negative Feedback on Ward Round
An F1 I worked with received feedback that their handovers were:
“Disorganised and difficult to follow.”
They interpreted this as:
“I’m a poor doctor and not as good as my peers.”
In reality:
They were thinking quickly but jumping ahead to conclusions without clearly working through differentials
They weren’t using a consistent structure
They relied on memory and missed key information
With simple changes—such as practising structured SBAR-style handovers, introducing templates, and using written prompts—their presentations became clear and confident.
They no longer feared handovers.
Again, this wasn’t a lack of ability—it was a structure mismatch.
A Practical Framework for Managing Setbacks
Throughout our medical careers, we are expected to engage in reflective practice.
But without structure, reflection can quickly turn into self-criticism.
Here’s a more supportive framework:
1. Pause Before Interpreting
ADHD brains often process emotional reactions quickly and intensely.
2. Separate the Event from the Story
Event: You struggled to stay focused and underperformed
Story: “I’m not capable of being a good doctor”
The story is often far harsher than the reality.
3. Identify Practical Factors
Many challenges are strategic—not personal failures.
4. Adjust the System
Small structural changes can make a significant difference.
5. Keep Moving Forward
Confidence rebuilds through action, not avoidance.
Would you like a practical way to manage this? I’ve created a short Managing Failure with ADHD reflection tool that you can use after difficult shifts, exams or feedback that feel like failure or setback. You can download it below.
Case Example: Missed Tasks on the Ward
A registrar I worked with became overwhelmed with the volume of information they needed to retain and repeatedly forgot small but important tasks after ward rounds.
They began to feel unreliable and anxious.
Instead of assuming they were “not cut out” for the role, we looked at systems.
They introduced:
A simple written task list added to their handover sheet
Delegation to SHOs while maintaining oversight
Timed reminders
A consistent end-of-day review
Within weeks, their performance improved significantly.
The issue wasn’t motivation—it was externalising memory and structure.
How Coaching Can Help Doctors with ADHD
This is where coaching can bridge the gap between insight and practical change.
While reflection is encouraged in medical training, many doctors struggle to find strategies that actually work for them.
ADHD coaching focuses on working with the brain rather than fighting it.
It can support with:
Creating practical systems
Managing emotional responses to feedback
Addressing imposter syndrome
Building sustainable confidence
Case Example: From Overwhelm to Control
One ST1 I supported felt constantly behind—missing tasks, struggling to revise, and feeling overwhelmed.
They described feeling like they were:
“Just about coping” “Going to be found out”
Through coaching, we:
Broke work into smaller, manageable steps
Introduced a daily prioritisation system
Built accountability into their routine
Within weeks, they felt more in control and less anxious.
Not because the workload changed - but because their approach did.
Final Thoughts
Medical training is challenging, and traditional learning environments are not always designed with neurodiversity in mind.
But difficulties along the way do not define your capability as a future doctor.
With reflection, supportive systems, and sometimes coaching, setbacks can become opportunities to develop strategies that allow you to thrive.
Because success in medicine is not about being perfect.
It is about becoming a thoughtful, resilient, and continually learning clinician—in a way that works for how your brain functions.
Ready to Work With Your Brain (Not Against It)?
If this resonates with you, ADHD coaching can help you build systems that work with your brain—not against it.
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