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Attention Deficit Hyperactivity Disorder Accommodations for Psychiatry Residents

Received March 13, 2006; revised August 25, 2006; accepted October 11, 2006. Drs. Elliott, Arnold, Brenes, and Rosenquist are affiliated with the Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Dr. Silvia died in September 2006. Address correspondence to Dr. Elliott, Wake Forest University School of Medicine, Department of Psychiatry and Behavioral Medicine, Medical Center Boulevard, Winston-Salem, NC 27157; helliott{at}wfubmc.edu (e-mail).

OBJECTIVE: With the increase in diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in adults, it is expected that more resident physicians will require accommodations so that their academic performance and clinical competency can be measured adequately. The authors provide an overview of the requirements and issues regarding the provision of ADHD accommodations for psychiatry resident physicians as well as recommendations regarding policy development in this area. METHOD: The authors review the symptoms of ADHD, proper documentation of ADHD, and the rationale and legal basis for providing accommodations to resident physicians with ADHD. RESULTS: Executive functioning, attention, and affect regulation are three domains that could negatively affect the functioning of a resident physician with ADHD. Possible accommodations specific to each general competency are described. CONCLUSIONS: In order to comply with existing guidelines, training programs should be proactive and have a procedure in place that 1) requires adequate documentation; 2) ensures confidentiality; 3) grants accommodations which measure core knowledge and not the limits of the disability; and 4) does not alter the core curriculum of the program.

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