Exploring Experiences of Applying to US-Based Medical Schools from a Neurodivergent Viewpoint: An Interpretive Phenomenological Study

Abstract

Despite the growing recognition of neurodiversity in higher education, neurodivergent (ND) individuals are significantly underrepresented in U.S. medical education (AAMC Medical School Graduation Questionnaire, 2021). This gap reflects not only the limitations of individual disclosure decisions but also how historically entrenched ableist admissions structures privilege neurotypical norms of communication, professionalism, and productivity. This study examined how ND medical school applicants and students experience admission as processes that function as gatekeeping and deny their different ways of being and knowing, resulting in a lack of recognition for their belonging in medicine. The research questions focused on how ND applicants and students experience medical school admissions in the U.S. and how these experiences inform future strategies to empower emerging scholars in medicine. This study centered the lived experience of ND medical student applicants and students using an interpretive phenomenological approach (van Manen, 2016). I used semi-structured interviews to gain insights on how participants made meaning of neurodivergence during the admissions process, with attention to institutional norms, interpersonal interactions, and broader cultural expectations within medical education. Using inductive data analysis (Adams, 2015) of interview transcripts, findings revealed how barriers to access and belonging are primarily systemic rather than individual. Participants described key obstacles such as rigid evaluative metrics, implicit behavioral expectations of normativity, and institutional cultures that conflate professionalism with neurotypicality. These conditions often required applicants to manage, minimize, or conceal aspects of their neurodivergence to give the perception of themselves as legitimate applicants. At the same time, participants named how their ND is a source of clinical strength, as they think of themselves as individuals with enhanced empathy, pattern recognition, and novel problem-solving, challenging deficit-oriented assumptions, traits not easily recognized through admissions process. This study reframes medical school admissions as a relational and boundary-crossing process, where difference is actively negotiated rather than passively assessed. By situating ND experiences within historical and structural contexts, findings highlight the limitations of accommodation-only approaches and underscore the need for institutional accountability in fostering inclusion. Future research should attend to the development of admissions frameworks that value cognitive diversity as a scholarly and clinical asset, training admissions committees to recognize non-normative excellence, and advancing research that positions ND scholars as leaders in shaping the future of medical education. Empowering the next generation of scholars requires moving beyond access toward systemic transformation that recognizes difference as a source of innovation and growth within medicine.