Specific Learning Difficulties in GP Training
Dyslexia doesn't mean you can't be a brilliant doctor. It means you see things differently — and sometimes, that's exactly what a patient needs.
Dyslexia, dyspraxia, dyscalculia, and related conditions affect a significant number of GP trainees. This page covers everything — recognition, assessment, exam adjustments, workplace support, and how to thrive through training and beyond.
📅 Last updated: April 2026
Handouts, Summaries & Teaching Extras
Ready when you are — whether for revision, a tutorial, or a last-minute rescue before a tricky conversation with your trainer.
A hand-picked mix of official guidance and real-world GP training resources. Because sometimes the best pearls are not hiding in the official documents.
📌 Official & Core Resources
UK's leading dyslexia charity. Find local assessment centres, self-help tools, workplace guidance.
Adult-focused information on dyspraxia (DCD), support, and strategies.
UK charity for DCD/dyspraxia. Resources for adults, professionals, and workplaces.
How to apply for extra time and adjustments for the AKT and SCA. Apply early — deadlines are strict.
Specific guidance on 25% extra time, paper-based AKT options, reader/scribe requests.
What adjustments are available for the SCA. Note: consultation time extensions are rarely granted for SpLD alone.
📚 Research & Further Reading
Landmark study: with adjustments, AKT pass rates for dyslexic candidates are comparable to others.
Key study showing dyslexia was associated with lower CSA pass rates despite adjustments — especially interpersonal skills domain.
Broader study showing SpLD affects AKT, CSA, RCA, and WPBA-ARCP outcomes. Calls for more tailored support.
Qualitative study of 18 GP trainees with SpLDs. Rich insights into lived experience, barriers, and what helps.
Wessex offers SpLD screening to all ST1s. Excellent model for early identification.
Free structured self-assessment by the British Dyslexia Association. A reasonable first step — not a diagnosis.
Free AI scribe widely used by UK GP trainees. Especially helpful for those with documentation difficulties. Use thoughtfully.
A scanning pen that reads text aloud. Useful for trainees who struggle with dense written material.
🔍 Self-Assessment & Screening Tools
⚠️ Important — What Screening Tools Can and Cannot Do
Self-assessment and screening tools can give a useful indication of whether further investigation is worthwhile. They are a reasonable first step — not a diagnosis. A formal diagnosis requires a full assessment by a qualified specialist. Screening tool results are not accepted by the RCGP as evidence for reasonable adjustments in the AKT or SCA — a full psychological assessment report with raw scores is required for that.
| Tool | Cost | What It Is | Status |
|---|---|---|---|
| BDA Adult Dyslexia Checklist bdadyslexia.org.uk | Free | Structured self-report checklist from the British Dyslexia Association. Download as PDF. Good first step for adults. | ✅ Active |
| BDA Dyslexia Screening Overview bdadyslexia.org.uk | Free page | BDA's explanation of dyslexia screening options for adults, with links to approved tools. Start here for current guidance. | ✅ Active |
| Spot Your Potential spot-your-potential.com | ~£30 | Online dyslexia screening tool originally recommended by Bradford VTS. A 'rough and ready' indicator — not a diagnosis. | ⚠️ Uncertain — verify before using |
dore.co.uk | Was free | Originally a free dyspraxia screening test linked from Bradford VTS. The Dore programme closed in 2008. | ❌ Defunct — do not use |
| Dyspraxia Foundation — Adults Section dyspraxiafoundation.org.uk | Free | Current resource for adult dyspraxia. Replaces the defunct Dore test. Includes information on recognition, support, and finding assessment. UK's leading DCD charity. | ✅ Active |
equality.leeds.ac.uk | Was free | A quick online test that was previously available from the University of Leeds. The original link no longer exists — the page has been restructured. | ❌ Link defunct |
| University of Leeds — Disability Services students.leeds.ac.uk | Free | Current Leeds University disability support page — replaces the old screening link. Includes information on accessing SpLD assessments. | ✅ Active (current URL) |
| Do-IT Profiler — Neurodiversity Profiler doitprofiler.com | ~£60 | Well-regarded UK neurodiversity screener covering dyslexia, dyspraxia, ADHD, autism, and dyscalculia in one tool. Produces a personalised report. Used by many UK universities, employers, and NHS services. | ✅ Active |
Not about intelligence
SpLD reflects a different cognitive style. Research consistently shows dyslexic learners often have above-average intelligence and creative strengths.
Get diagnosed early
A formal diagnosis by a chartered psychologist unlocks RCGP exam adjustments. Don't wait until after a failed attempt.
AKT: adjustable
With 25% extra time, AKT outcomes for dyslexic candidates are comparable to non-dyslexic peers (Asghar et al. 2018).
SCA: more complex
Dyslexia is associated with lower CSA/SCA pass rates — especially interpersonal skills. Targeted consultation practice is key.
Legal duty
The Equality Act 2010 requires employers and exam bodies to make reasonable adjustments. Know your rights.
Tell your trainer
A good trainer who knows will adapt their teaching style, spot difficulties early, and help you access support.
💡 The single most important insight from the research
Candidates who declare dyslexia before their first AKT attempt do far better than those who declare it after a failure. Early declaration isn't admitting weakness — it's accessing the level playing field you deserve. Don't wait.
It's more common than you think
Around 10% of the population have at least one SpLD. In a Bradford VTS cohort of 20 trainees, roughly 2 may have undiagnosed or undisclosed dyslexia. Many have spent their entire career masking — successfully, until GP training's demands outpace their coping strategies.
GP training is uniquely demanding
Reading dense referral letters under time pressure. Consulting with a timer running. Typing EMIS records while talking. Sitting high-stakes exams. All of this amplifies SpLD difficulties that may not have surfaced in hospital posts.
The stakes of missing it
Research shows repeated exam failure without a diagnosis leads to anxiety, depression, loss of confidence, and trainees leaving the programme. Getting the diagnosis changes everything — not just exam scores, but mental health and training experience.
It's not about capability
Some of medicine's most exceptional clinicians have SpLDs. The strength of dyslexic thinking — holistic reasoning, creativity, and pattern recognition — makes for outstanding GPs. This is about removing unfair barriers, not lowering standards.
🗺️ Leeds to Birmingham — Ram's Analogy
Think of the journey from Leeds to Birmingham. Most people take the M1 or M62 — and therefore see the same things every time. Being dyslexic is like taking a different route. Perhaps a motorway-and-A-road combination. Yes, it might take a little longer. But you will arrive at the same destination, and you will see more interesting things along the way. Your route isn't defective — it's different, and different has value.
Specific Learning Difficulties (SpLDs) are a family of related neurodevelopmental conditions. They often co-exist in the same person. None of them are diseases, and none are related to intelligence.
Dyslexia
"Dys" = difficulty. "Lexia" = language. Difficulty with reading, spelling, phonological processing, and word retrieval. The most common SpLD.
Dyspraxia / DCD
"Dys" = difficulty. "Praxis" = doing. Developmental Co-ordination Disorder — affects motor planning, sequencing, organisation, and spatial awareness.
Dyscalculia
"Dys" = difficulty. "Calculia" = calculating. Difficulty with numbers, arithmetic, and mathematical concepts. Often overlooked in medical training.
Dysgraphia
"Dys" = difficulty. "Graphia" = writing. Difficulty with the mechanics of writing — handwriting, letter formation, writing speed, and written expression.
ADHD
Attention Deficit Hyperactivity Disorder. Affects attention, impulse control, and executive function. Often co-occurs with dyslexia. Increasingly recognised in adult trainees.
Autism Spectrum
ASD / Autistic Spectrum Condition. Affects social communication, sensory processing, and cognitive flexibility. Often co-exists with other SpLDs.
🔗 Key Point: SpLDs Overlap
The RCGP's reasonable adjustments policy covers all of the above under the umbrella of SpLD. Up to 40–50% of people with dyslexia also have dyspraxia. ADHD co-occurs in around 30–40% of those with dyslexia. A trainee may have multiple SpLDs without realising it, particularly if they have developed sophisticated coping strategies over years of education.
Dyslexia — What's Actually Happening in the Brain?
When a dyslexic person sees letters or words reversed or jumbled, there is usually nothing wrong with their eyes. The difficulty lies in phonological processing — the way the brain maps written symbols to sounds. It is also associated with differences in working memory, processing speed, and automaticity of reading. Think of it as an optical illusion that happens involuntarily, every time, with ordinary text.
| Feature | Dyslexia | Dyspraxia (DCD) | Dyscalculia |
|---|---|---|---|
| Core difficulty | Language / reading / spelling | Motor coordination / sequencing | Numbers / calculation |
| Memory affected | Working memory, verbal memory | Procedural / short-term memory | Numerical working memory |
| Strengths | Creative, holistic thinking, visual-spatial | Often strong verbally | Good verbal/language ability |
| GP exam most affected | AKT reading speed, SCA written tasks | SCA structuring, consultation flow | AKT statistics / data questions |
| Prevalence | ~6–10% population | ~5–6% population | ~5% population |
| Often co-exists with | Dyspraxia, ADHD | Dyslexia, ADHD, ASD | Dyslexia, ADHD |
Signs in adults are often more subtle than in children — many adult trainees have developed coping strategies that mask their difficulties. Below are the characteristic features of each SpLD.
Signs of Dyslexia in Adults
Click each area to expand.
📖 Reading & Spelling▼
- May see letters appear to jump, blur, or reverse on the page
- Confusion between similarly shaped letters (b/d/p/q; o/e/c)
- Words appear jumbled, bunched together, or out of order
- Can read the words but cannot retain meaning from a passage — re-reading the same paragraph multiple times
- Unable to connect letters reliably to sounds (phonological decoding)
- Difficulty recognising words previously seen — each encounter feels like the first
- Frequent transposition of letters within words or syllables between words (spoonerisms)
- Headaches or visual fatigue when reading for prolonged periods
- Reads slowly and loses place easily — particularly under time pressure
💡 The 'Spooning' Sign — Ram's Trainer Tip
A classic trainee marker: first letters of adjacent words are swapped — so "car park" becomes "par cark." Also try asking a trainee to say a word backwards (e.g., "LONDON" → "NODNOL") — dyslexic persons find this genuinely difficult, whereas most people find it surprisingly easy.
🗣️ Hearing, Speech & Language▼
- Difficulty expressing thoughts verbally — speaks in halting phrases, leaves sentences incomplete
- Mispronounces long or unfamiliar words; transposes syllables when speaking under pressure
- Difficulty finding the right word (word-finding difficulty — "tip of the tongue" frequently)
- May have a heightened auditory sensitivity — picks up and processes ambient sounds very easily, which causes distraction
- Stutters or loses fluency under stress, time pressure, or when multitasking
🧠 Memory & Cognition▼
- Excellent long-term memory for experiences, faces, and places — but poor recall of sequences, lists, and abstract information
- Weak working memory — difficulty holding multiple items in mind simultaneously
- Thinks primarily in images and feelings rather than words or internal language (reduced internal monologue)
- Poor memory for facts and information that has not been experienced or contextualised
- Difficulty with instructions given verbally — especially multi-step instructions
🧭 Behaviour, Organisation & Personality▼
- Frequent left-right confusion
- Disorderly — or compulsively and rigidly orderly (as a coping mechanism)
- Strong sense of justice and fairness; emotionally sensitive
- Strives for perfectionism — which can paradoxically lead to procrastination
- Symptoms increase noticeably under time pressure, emotional stress, or when unwell
- May appear disorganised or late — not from laziness but from sequencing difficulties
Signs of Dyspraxia (DCD) in Adults
Click each area to expand.
🏃 Gross Motor Skills▼
- Balance difficulties — unsteady on uneven ground, going up/down stairs
- Poor hand-eye coordination — difficulty with ball sports, catching, batting
- Tends to fall, trip, bump into things or people more than average
- Lack of rhythm — difficulty with dancing, aerobics, or following physical sequences
- Exaggerated arm or body movements when running or walking quickly
✋ Fine Motor Skills▼
- Poor manual dexterity — difficulties with cutlery, buttons, zips, tying shoelaces, cooking
- Handwriting difficulties — poor pen grip, pressing too hard, difficulty writing on lines
- Slow or illegible typing, difficulty manipulating small objects
- Issues with personal grooming tasks: applying make-up, shaving, hair-styling
🗣️ Speech & Language▼
- May talk continuously and repeat themselves
- Difficulty organising the content and sequence of speech
- Unclear speech; difficulty pronouncing certain sounds or words
- Uncontrolled pitch, volume, or speaking rate
🧩 Perception, Learning & Memory▼
- Poor body awareness in space — bumping into objects, dropping/spilling things
- Little sense of time, speed, distance, or weight
- Difficulty with map-reading; poor left/right discrimination
- Difficulty planning and organising thoughts into a logical sequence
- Short-term memory difficulties — forgets and loses things
- Poor sequencing affects reading, maths, and written report-writing
- Difficulty multitasking — can do one thing well at a time but poorly when things compete
- Slow to finish tasks; tendency to daydream or wander
😔 Emotional & Behavioural Patterns▼
- Difficulty picking up non-verbal cues or judging tone of voice — can appear tactless
- Tendency to interrupt or talk over others; difficulty in group conversations
- Takes things very literally; difficulty interpreting sarcasm or social nuance
- Slow to adapt to new or unpredictable situations — may avoid them
- Impulsive; frustrated easily; seeking immediate resolution
- Tendency to opt out of things perceived as too difficult
- Prone to stress, anxiety, and low mood as a result of cumulative daily difficulties
- Sleep difficulties are common
⚠️ Masking — The Hidden Challenge
Many adult trainees with SpLDs have spent 20+ years developing sophisticated coping strategies. By the time they reach GP training, dyslexia or dyspraxia may not be obvious. The mask cracks under the combined pressure of GP training's time demands, clinical complexity, and high-stakes assessment. Trainers should be alert to the combination of difficulties — not expecting a textbook presentation.
Step-by-Step: From Suspicion to Diagnosis
Self-recognition or trainer concern
Trainee notices persistent difficulties, or trainer identifies characteristic signs. Informal screening tools (e.g. BDA online check) can flag if formal assessment is worthwhile.
Speak to your Educational Supervisor
Your ES or TPD can help you access support. Most deaneries have a process for funding or facilitating a formal assessment — especially before exam attempts. Ask early.
Formal psychological assessment
Conducted by a chartered educational psychologist or PATOSS-registered specialist teacher assessor. Takes approximately 2–3 hours. Costs typically £400–700 privately (costs vary by provider and location). Most deaneries will fund this — ask before paying out of pocket.
Important: A good assessment is both diagnostic — confirming whether an SpLD is present — and therapeutic. It should help you understand your own cognitive strengths and processing style, and identify specific strategies that will work for you. You should leave with a clear sense of what needs to change and how your training organisation can support you. If the session doesn't feel therapeutic as well as diagnostic, ask more questions — you deserve both.
Report produced
A detailed report covers the domains below. This report is what the RCGP requires for reasonable adjustments — it must include raw scores and be conducted post-16 by a qualified professional.
Apply for RCGP reasonable adjustments
Submit the online form + evidence at least 15 working days before the booking window. Apply separately for AKT and SCA. Approved adjustments apply to all future sittings unless circumstances change.
Workplace adjustments discussion
Your employer has a legal duty under the Equality Act 2010 to make reasonable workplace adjustments. Your assessment report will recommend specific ones. This should be discussed with your ES and practice.
What the Assessment Report Covers
A good-quality SpLD assessment is both diagnostic and therapeutic — it helps you understand your own processing style and plan strategies. Here is what it covers:
🧠 General Intellectual Abilities
- Overall cognitive ability score
- Non-verbal reasoning (usually normal in dyslexia)
- Verbal reasoning and comprehension
⚙️ Cognitive Processing Profile
- Auditory working memory (typically impaired in dyslexia)
- Processing speed (often impaired)
- Phonological awareness
- Visual-spatial processing
📖 Literacy & Reading Skills
- Word reading accuracy and speed
- Reading comprehension
- Phonemic decoding at speed
- Phonological processing
✍️ Written Language Skills
- Spelling accuracy
- Sentence structure and grammar
- Free writing and copying speed
- Handwriting quality
🎯 Strengths & Strategies
- Identified cognitive strengths
- Recommended learning strategies
- Recommended technology aids
- Recommended reasonable adjustments
📋 The Diagnosis
- Confirms or excludes SpLD diagnosis
- Severity grading (mild / moderate / severe)
- Specific recommended exam adjustments with justification
🏥 Where to Find an Assessor
Find a qualified assessor via the British Dyslexia Association directory. The RCGP requires assessments conducted by a chartered or educational psychologist, or a specialist teacher assessor with a current practising certificate (PATOSS). A screening test alone is not sufficient for RCGP reasonable adjustments.
🟣 From Ram's Own Training Experience
I have spotted dyslexia in trainees through a combination of signs — never from one feature alone. The combination matters. What follows reflects both the research and the lived experience of working closely with trainees who had undiagnosed SpLDs.
💡 The Most Important Trainer Mindset
When you sense something else might be going on, the most important thing is to slow down, stop, reflect and explore. Try to get inside the trainee's brain. Stay with the experiential difficulty you have noticed. Explore it from start to end. Work out how their processing and organisational strategies are operating — rather than assuming you already know.
Tutorial Red Flags — When to Have the Conversation
| Observation | What It Might Mean | What to Do |
|---|---|---|
| Consistently unstructured consultations across multiple COTs/audioCOTs | Sequential planning difficulty — characteristic of both dyslexia and dyspraxia | Explore how they organise their thoughts. Try a structured framework together. |
| Repeated AKT failures without clear explanation | Possible unidentified SpLD; or masking coping strategies failing under exam pressure | Raise SpLD possibility sensitively. Support access to screening. |
| Portfolio entries consistently late, sparse, or poorly structured | Writing difficulties, organisational difficulties, working memory challenges | Offer dictation tools, templates, or structured scaffolding. |
| Trainee becomes visibly stressed or flustered with anything written | Anxiety secondary to longstanding literacy difficulty | Explore the history. Many have masked since school. |
| Strong verbal reasoner but struggles with written tasks | Classic dyslexia profile — verbal intelligence preserved, written output impaired | Consider SpLD referral. This discrepancy is a key diagnostic marker. |
⚠️ How NOT to Approach This Conversation
Do not suggest SpLD as a way of explaining persistent failure if no signs are present — this is stigmatising. Do not wait until after an exam failure to raise it. Do not conflate SpLD with being "not bright enough" — this is the opposite of what the evidence shows. Approach it with genuine curiosity and warmth, framing it as exploring how the trainee learns best, not explaining why they are struggling.
🔡 The SPELL Recognition Framework (BDA-Inspired)
When wondering whether a trainee might have an unidentified SpLD:
- S — Strengths: strong verbal reasoner but poor written output?
- P — Patterns: consistent spelling errors, transpositions, spoonerisms?
- E — Effort: working significantly harder than peers for the same output?
- L — Learning: struggles with sequential instruction but excels with demonstration?
- L — Load: symptoms worsen under time pressure, stress, or cognitive load?
🗺️ The DITCH Consultation Aid (For SpLD Trainees)
A stripped-back consultation anchor for trainees who find complex frameworks difficult to hold in working memory:
- D — Data: What is the problem? Explore fully.
- I — ICE: Ideas, Concerns, Expectations — ask all three.
- T — Think: What's your assessment? Think aloud if helpful.
- C — Co-decide: Shared decision-making — offer options.
- H — How to get help: Safety-net — always last, never optional.
🟣 For Trainers: The Mindset That Changes Everything
The trainee in front of you with SpLD is not less intelligent, not lazy, and not lacking motivation. They are carrying a cognitive load that their peers are not. Your job is to help them remove barriers — not explain them away. The most powerful thing a trainer can do is notice, name it kindly, and open the door to support. The research is unambiguous: trainees who receive their diagnosis before their first exam attempt do significantly better. You may be the person who makes that happen.
TPD Actions
- Consider universal early SpLD screening at ST1 induction (Wessex model)
- Ensure trainers are trained in SpLD recognition
- Have a clear local pathway for assessment access and funding
- Brief future GP practices in advance of rotations when a trainee has a diagnosed SpLD
- Record discussions about adjustments even where none are needed
Trainer Actions
- Raise SpLD possibility sensitively and early — not after exam failure
- Frame it as understanding how the trainee learns best
- Adapt tutorial style to the trainee's demonstrated learning preferences
- Be willing to offer oral CbD / verbal portfolio entry alternatives
- Signpost to deanery SpLD support and exam adjustment processes
ES Actions
- Document all discussions about SpLD and adjustments clearly
- Support the trainee's application for formal assessment
- Liaise with practice manager for workplace adjustments
- Flag at ARCP review if SpLD is affecting WPBA — ensure this is contextualised appropriately
- Provide the RCGP with information when consented — this can support adjustment applications
⚖️ The Legal Framework
The Equality Act 2010 defines dyslexia, dyspraxia, and related SpLDs as disabilities where they have a substantial and long-term adverse effect on normal day-to-day activities. Under the Act, employers — including GP training practices — have a legal duty to make reasonable adjustments. The formal assessment report will specify what adjustments are recommended. The practice manager and ES should be involved in this conversation.
Practical Adjustments at Work
📅 Appointment Times
- Consider 15-minute appointments rather than 10 in early training
- Avoid back-to-back complex consultations without natural breaks
- Build in transition time between patients for brief note consolidation
- Reduce total session patient numbers in early ST rotations if needed
- Morning vs afternoon sessions — identify which time of day the trainee functions best
💻 Documentation
- EMIS/SystmOne spell-check and autocomplete — ensure these are fully activated
- Dictation software (Dragon, Apple Dictation, or AI scribes like Heidi)
- Pre-set consultation templates to scaffold note structure
- Access to a QWERTY keyboard (not default NHS systems without one)
- Coloured overlay or screen filter for visual stress
📋 Organisation Aids
- Written task lists at the start of each session
- Structured handover templates
- Clear labelling of frequently used folders, drawers, templates
- Regular brief check-in with supervisor to review outstanding tasks
- Reminder system for safety-netting follow-up
🏥 Physical Environment
- A quiet, low-distraction consulting room if possible
- Good lighting (bright fluorescent lighting can worsen visual stress)
- Minimise background noise — consider headphones between patients
- Consistent desk and equipment setup (dyspraxia benefit)
- Accessible printer for printed referral or prescription review
📚 Learning Adjustments
- Slides and handouts provided in advance of tutorials
- Tutorial summaries provided in written form after verbal teaching
- Colour-coded notes or structured mind maps
- Avoid cold-reading in tutorials — pre-share the text
- Offer audio recording of tutorials for later review
📱 Portable Aids
- C-Pen / reading pen for dense printed text
- ACE Spelling Dictionary — compact, pocket-sized reference
- 📓 Pocket word notebook — carry a small notebook (the kind police officers use) and keep a running list of words you commonly misspell or mispronounce. Keep it in your white coat pocket at all times. Simple, free, and surprisingly effective.
- Text-to-speech app for reading letters, results, or guidelines aloud
- Phone calculator for dose calculations (with confirmation habit)
RCGP Exam Adjustments — Summary
| Adjustment | AKT | SCA | Notes |
|---|---|---|---|
| +25% extra time | ✅ Routinely offered | ⚠️ Reading time only — consultation time extension rarely granted for SpLD alone | Apply separately for each exam. Standard for confirmed SpLD. |
| Separate room | ✅ Available | ✅ Available (own surgery room) | Reduces distraction. Particularly helpful for those with sensory sensitivities. |
| Paper-based AKT | ⚠️ Exceptional circumstances only | N/A | Requires strong evidence of screen-specific difficulty. Sat at RCGP HQ. |
| Reader/Scribe | ⚠️ Exceptional circumstances only | N/A | Must demonstrate regular use of comparable adjustment in workplace. |
| Additional rest breaks | ✅ Available | ✅ Available | Useful for those with fatigue, concentration, or sensory difficulties. |
| Coloured overlays | ✅ Can bring own | ✅ Can use own equipment | Check with RCGP if in doubt. |
| Late diagnosis policy | ✅ RCGP updated policy Dec 2024 — additional attempts may be available. Contact exams team. | Important for trainees who failed before diagnosis. | |
🔄 Moving to the Next Rotation — Employer Notification
GP training involves rotating between different posts. When a trainee with a confirmed SpLD moves to a new GP practice or hospital post, arrangements can — and ideally should — be made in advance so adjustments are in place from day one. Scrambling to organise support after you arrive wastes precious early weeks.
How this works in practice:
- The trainee (and/or their TPD, with the trainee's explicit consent) can notify the next placement in advance of the SpLD and the adjustments required
- The trainee is strongly encouraged to inform their next post themselves — this gives them control over the conversation and framing
- The assessment report, which specifies recommended workplace adjustments, can be shared with the incoming ES or practice manager — again, only with the trainee's consent
- The new employer then has a legal duty under the Equality Act 2010 to make reasonable adjustments once they are aware of the disability
⚖️ Consent and Confidentiality — What the Law Says
A dyslexia or SpLD diagnosis is special category health data under the UK GDPR and Data Protection Act 2018. This means it cannot be shared with third parties — including future employers or rotation placements — without the trainee's explicit, informed consent. The trainee has full control over who knows, when, and how much detail is shared. A TPD or training programme cannot unilaterally disclose this information without consent, even with good intentions. The right approach is always: support the trainee to disclose on their own terms, in advance, with you available to help frame the conversation.
📋 Process: Applying for RCGP Adjustments
- Submit the online RCGP reasonable adjustments form + supporting assessment report
- Deadline: at least 15 working days before the booking window opens
- Apply separately for AKT and SCA — adjustments are NOT transferable between exams
- Once approved, adjustments apply to all future sittings of that exam
- Notify RCGP if your circumstances change
- Contact the RCGP exams team early if waiting for assessment — do not sit without adjustments if diagnosis is confirmed
Every SpLD trainee is different. The following are evidence-informed principles — they should be tailored to the individual. The assessment report and a direct conversation with the trainee are the best guides.
How Dyslexic Learners Learn Best
🧠 The Key Principle: Experiential Over Abstract
When learning new tasks, dyslexic and dyspraxic learners depend more heavily on the conscious, deliberate part of their thinking — rather than the automatic processing that most people use without realising it. This means they learn through direct experience, not passive reception of abstract verbal instruction. The four most effective learning modes are shown below.
💡 Why This Matters in Tutorials
A tutorial that relies entirely on the trainer talking and the trainee listening will miss the mark for many SpLD learners. The most effective tutorials for dyslexic trainees combine at least two of these four modes. For example: demonstrate a consultation skill (mode 1), ask the trainee to role-play it immediately (mode 2), review a video together (mode 3), then summarise on a whiteboard or mind-map (mode 4). This isn't "dumbing down" — it's how the brain embeds learning most efficiently for this cognitive style.
🎯 Before the Tutorial
- Share all written material in advance — never cold-read in tutorials
- Provide a written agenda so the trainee knows what to expect
- Use a consistent tutorial structure the trainee can predict
- Choose a quiet, well-lit room with minimal distractions
- Consider whether this is the trainee's best time of day
🗣️ During the Tutorial
- Use visual aids, diagrams, and colour — avoid text-heavy slides
- Give one instruction at a time — not multi-step sequences
- Check comprehension after each step, not at the end
- Allow extra processing time before expecting a verbal response
- Role-play and simulation over lecture-style delivery
- Write key points while speaking them — dual-channel learning
📝 Documentation Strategies
- Provide a written summary after every tutorial
- Offer structured templates for ePortfolio entries (FourteenFish)
- Allow voice recording of tutorials
- Consider dictation rather than handwritten feedback
- Scaffold CbD/COT write-ups with prompt questions
🔄 Consultation Skill Practice
- Role-play consultations repeatedly until structure is automatic
- Use video review — watch together, pause, discuss
- Teach the consultation as a series of small steps, not one whole
- Practice ICE, empathy, and safety-netting as separate skills first
- Gradually increase the complexity of role-play scenarios
📊 Assessment Approaches
- Oral assessment rather than written wherever possible
- Portfolios assessed on quality of reflection, not prose quality
- Extra time allowance for written WPBA tasks
- Recognise strengths in clinical reasoning even where written presentation is poor
- Avoid marking on spelling/grammar in formative assessment
🌱 Building Confidence
- Explicitly acknowledge the trainee's cognitive strengths
- Celebrate non-written achievements — clinical reasoning, patient rapport
- Normalise SpLD within the tutorial relationship
- Share examples of successful doctors with SpLDs (the list is long)
- Connect trainee with deanery or national SpLD support networks
Useful Tutorial Exercises & Discussion Prompts
- 🎭 Role-play the SCA briefing card exercise: Give the trainee a 3-minute card and ask them to extract just the essentials — name, age, key problem, red flags. Time it. Discuss what they found easy and hard.
- 🔁 Safety-netting habit-building: Role-play 5 short consultations where the ONLY goal is to get the safety-netting phrase out clearly and confidently every time. Build the habit in isolation before the full consultation context.
- 🗺️ Mind-mapping instead of lists: For any topic, ask the trainee to create a visual mind-map rather than a bullet-point list. Often dyslexic learners produce richer, more interconnected knowledge this way.
- 🎤 Oral CbD: For trainees who struggle with written CbD, conduct the CbD entirely verbally and then jointly write up the key learning points together afterward.
- 💬 Reflective question: "When you hear a complex instruction or a long vignette, what happens in your mind? Walk me through it." This opens a genuinely useful conversation about processing style.
🤖 Heidi.ai and Similar AI Scribes — The Honest Answer
AI clinical scribes — particularly Heidi Health — have swept through UK general practice since 2025. They transcribe consultations in real time and generate structured clinical notes, dramatically reducing documentation burden. For a trainee with dyslexia or dyspraxia, this is potentially transformative.
But there is a genuine training tension here, and it's worth being honest about it.
| Situation | AI Scribe Advice | Reason |
|---|---|---|
| ST1–ST2 trainee without SpLD | ⚠️ Use with caution. Develop note-writing skills first (first 6–12 months), then introduce. | Writing notes forces you to organise clinical thinking — the scribe bypasses this if used too early. |
| ST1–ST2 trainee WITH dyslexia/dyspraxia | ✅ Consider introducing earlier as a reasonable adjustment. Discuss with ES. | Documentation difficulty is a disability-related barrier. The Equality Act supports removing this barrier. The trainee can still develop consultation skills through verbal reflection. |
| ST3 trainee | ✅ Yes — for all trainees. Consultation skills are established. Scribe is an efficiency tool. | Time saved on documentation can be redirected to patient care, learning, and SCA preparation. |
| SCA exam day | ❌ Not applicable in the SCA — no documentation component. | The SCA assesses the live consultation, not the notes. |
| AKT preparation | ❌ Not relevant for AKT. | AKT is a knowledge test. Text-to-speech tools for reading revision material are more relevant. |
🔑 Key Principle
Heidi and similar tools do not replace clinical reasoning — they replace the administrative burden of transcription. You still have to ask the right questions, make the right assessment, and plan the right management. The AI just writes it down for you. For a trainee with dyslexia, removing the transcription bottleneck frees up cognitive bandwidth for what actually matters: the patient in front of you. That's not cutting a corner — that's using the right tool for the job.
Other Useful Digital Tools
🔊 Text-to-Speech
Read guidelines, referral letters, and BNF aloud via Natural Reader, Google's read-aloud feature, or Microsoft's Immersive Reader. Particularly useful for processing dense NICE guidelines before a tutorial.
🎙️ Dictation
Apple Dictation, Google Docs voice typing, or Dragon NaturallySpeaking for ePortfolio entries and consultation notes. Frees you from the keyboard and often produces richer, more fluent text than typed output.
🗺️ Mind-Mapping Software
MindMeister, XMind, or even a whiteboard app for revision. Dyslexic learners consistently perform better with visual-spatial organisation than linear bullet lists. Map your knowledge networks rather than writing notes.
✏️ C-Pen / Reading Pen
A physical pen that scans text and reads it aloud through an earpiece. Useful in clinic for reading dense result letters, referral documentation, or printed drug information leaflets quickly and accurately.
🌈 Coloured Overlays & Screen Filters
Physical coloured overlays or screen filter apps (f.lux, Immersive Reader's background colour setting) reduce visual stress for many dyslexic readers. Experiment to find which colour works best for you — it varies between individuals.
📚 ACE Spelling Dictionary
By David Moseley — a compact, phonetically-organised spelling reference. Works by how a word sounds rather than how it starts. Dyslexia-specific design. Fits in a white coat pocket. Genuinely useful in clinical settings.
The following insights are drawn from published qualitative research (including verbatim trainee accounts), GP educator forums, trainee blogs, deanery guidance, and first-person accounts from UK GP trainees with SpLDs. All clinical content has been verified against official guidance. None of the insights below conflict with RCGP or GMC guidance — they add the human dimension that official documents rarely capture.
📊 Where Dyslexia Hits Hardest in the AKT — Visual Overview
📊 SCA Domains Most Affected by Dyslexia — Heatmap
💬 What Trainees Actually Say — From Published Accounts
Drawn from published qualitative research interviews with 18 GP trainees with SpLDs (2025), the GMC trainee case study, and first-person accounts from UK GP training forums and blogs. All consistent with RCGP and GMC guidance.
😰 On the AKT Under Time Pressure
"When you're clicking through a different AKT question every 45 to 50 seconds, your brain cannot process the speed in time to recall the information it's being pushed to perform in the same manner as your colleagues."
— GP trainee with dyslexia (published qualitative research, 2025)
📝 On the ePortfolio and WPBA
"I'm just really bad at spelling, and also just bad at getting what I'm thinking into written language in a concise way. For WPBAs, it's mainly the reflections that take me a lot longer to write than someone who doesn't have dyslexia."
— GP trainee with dyslexia (published qualitative research, 2025)
💔 On the Mental Health Impact of Undiagnosed SpLD
"I didn't know I had dyslexia, so I was dealing with repeated failure, loss of confidence, and then developed quite a lot of exam-related stress and anxiety. I ended up with mental health problems and had to take time off."
— GP trainee with dyslexia (published qualitative research, 2025)
🌟 On the Relief of Diagnosis
"It wasn't actually a massive shock to me, it was actually more of a relief — knowing why I was struggling. You're just sat thinking: is it me? Am I a bit thick? Am I just doing things wrong? It doesn't solve the problem, but it gives me a bit more insight."
— GP trainee (published qualitative research, trainee progression study)
📋 On RCGP Adjustments While Awaiting Diagnosis
"I didn't get any reasonable adjustments for the AKT because unfortunately with the Royal College, even though I had a suspected diagnosis and I was waiting for a formal assessment, they wouldn't accept it. They needed a formal report from an educational psychologist."
— IMG GP trainee (published qualitative research, 2025)
✅ On the SCA Playing to Strengths
"I felt more positive going into the RCA than I do the AKT because I know it plays to my strengths and I'm able to display my skillset and consultation skills — not just my reading speed."
— GP trainee with dyslexia, after diagnosis and adjustments (2025)
💡 What Trainees Wish They'd Known Earlier — Recurring Themes
These themes appear consistently across published trainee accounts, qualitative research, deanery forum discussions, and GP training blog posts.
📅 "I wish I'd applied for adjustments earlier"
The single most common regret. Trainees consistently report applying after their first failure, not before. Every deanery and the research are unanimous: apply in ST1. Even if you're unsure, the process of applying triggers the assessment that may transform your training experience.
🤐 "I wish I'd told my trainer sooner"
Fear of stigma, fear of being seen as incompetent, and fear of failing — all kept trainees silent. But in hindsight, disclosure to a supportive trainer was described as transformative. The trainer could adjust tutorials, scaffold tasks, and provide support for reasonable adjustments at work.
📖 "I wish I'd known that reading widely actually helped"
Many dyslexic trainees fear reading large volumes. One first-person account (Dr Metcalf, GP Training Support, 2023) describes this: "I surprised myself with the volume I did manage to read. Reading — even if I did not retain it all — helped me to revisit topics on a regular basis. The knowledge consolidated through question banks afterwards." Reading + testing = retention, even with dyslexia.
🎨 "I wish I'd used visual summaries from the start"
Multiple trainee accounts describe visual one-page summaries of guidelines as a game-changer for AKT revision. Making the summary forces active processing; the visual format aids recall. Text-to-speech for dense guidelines + mind-maps for revision = a combination that repeatedly appears in successful trainee accounts.
🕐 "I wish I'd known the clock was the problem, not my knowledge"
The realisation — usually arriving after diagnosis — that the AKT's 160 questions in 160 minutes format was the barrier, not their clinical competence, was liberating for many trainees. With 25% extra time, the same trainees who failed multiple times passed comfortably. The knowledge was always there.
🏋️ "I wish I'd treated the SCA like a skill, not a test"
Consultation skills for the SCA are a trainable skill — not just an innate talent. Trainees who over-learned their consultation framework through repeated role-play and video review consistently outperformed those who relied on "natural ability." For dyslexic trainees, deliberate over-learning compensates for working memory limitations under pressure.
🗺️ The Declaration Pathway — Why Earlier Is Always Better
🌍 A Special Note for IMGs — The Hidden SpLD Challenge
⚠️ IMGs Are Disproportionately Affected by Undiagnosed SpLD
Research consistently shows that IMGs are more likely to declare dyslexia after failing an exam rather than before. This is because:
- SpLD screening is not routine in many countries' education systems — meaning many IMGs have never been assessed
- Cultural stigma around disability disclosure is often stronger in overseas medical training cultures
- English as an additional language can mask SpLD features — or be wrongly blamed for difficulties that are actually SpLD-related
- IMGs may have compensated through sheer effort in undergraduate training without the demands triggering recognition
- At ARCP, raising SpLD may be perceived as excuse-making if there has been no prior discussion — the research confirms this experience directly
The message for TPDs: If an IMG is struggling — particularly with AKT reading speed, ePortfolio writing, or consultation structure — SpLD should be proactively raised as a possibility, not an accusation. London PSU estimates up to 10% of postgraduate doctors may be dyslexic. The pick-up rate from early, universal screening is described as "incredibly high" by educators who have implemented it.
🏆 How One Trainee Passed the AKT First Time with Dyslexia — Practical Tips
Drawn from a published first-person account by a GP trainee with dyslexia (GPTraining.info, 2023) who passed the AKT on first attempt with 80.5% overall score, including 95% in statistics. All tips are consistent with RCGP guidance and do not conflict with official advice.
Allow 5–6 months for AKT revision, not the standard 3. Not because the content is harder — but because processing and consolidating large volumes takes longer. Going part-time (LTFT at 80%) was described as "invaluable for managing stress levels."
Don't use question banks as your primary learning tool. Use them to reinforce and test what you've read. Reading guideline summaries, even without full retention, creates familiarity. The question bank then anchors the knowledge.
Summarising each guideline into a single visual page forces active processing and creates a revision-ready artefact. Review these summaries in the final week before the exam. The visual format aids recall far better than linear notes.
Don't shrug off incorrect answers. Take each one as a genuine learning event. Write a brief note about why you were wrong. Reviewing these notes in the final revision week provides targeted reinforcement where it matters most.
Having a structured daily revision timetable removes the cognitive overhead of deciding what to study. This is particularly valuable for dyslexic learners for whom executive function and planning carries an extra cognitive cost.
The trainee described achieving 95% in statistics — higher than clinical knowledge. Many dyslexic trainees fear numbers but find that methodical preparation produces excellent statistics scores. This domain is 10% of the AKT; it can transform a borderline pass into a comfortable one.
🌐 Your Support Network — Who Can Help and How
🚨 The Stigma Problem — The Biggest Barrier of All
Research, forum discussions, and first-person accounts consistently identify stigma as the main reason trainees delay disclosure. The fear: "If I tell people, they'll think I'm not good enough to be a doctor." This fear is understandable — and it is also, according to the evidence, the thing most likely to cause genuine harm.
A GMC case study from an actual GP ST3 describes it clearly: despite having a formal diagnosis, the trainee had not disclosed to anyone at work for the duration of their training. When they finally raised it with their Educational Supervisor, the response was unsupportive. The result: a mental health crisis, time off training, and a profound deterioration in confidence.
The evidence says: disclosure to a supportive trainer or ES, done early, changes outcomes dramatically. The risk of disclosure is far smaller than the risk of suffering in silence. If you encounter an unsupportive response, escalate to your TPD and deanery SpLD team — you have rights, and those rights are legally enforceable.
Asghar et al. (2018, Postgraduate Medical Journal): In a study of 14,801 AKT candidates (2010–2015), unadjusted pass rates were 83.6% for candidates declaring dyslexia vs 95.0% for others. However, once reasonable adjustments and other covariates were accounted for, the difference was not statistically significant. With appropriate support, dyslexic candidates perform comparably on the AKT.
The critical implication: The gap exists because of the exam format, not the candidate's knowledge. The right adjustments — primarily extra time — effectively level the playing field.
Which AKT Question Types Are Most Affected?
| Question Type | Why It's Harder with Dyslexia | Research Evidence |
|---|---|---|
| Long clinical vignettes | Extended prose passages require sustained reading comprehension and decoding under time pressure. Working memory load is high. Re-reading to find the key detail is slow and anxiety-provoking. | Processing speed and working memory impairments documented in adult dyslexia. Gibson & Leinster (2011). |
| Data interpretation / statistics | Number processing, reading tables, and interpreting statistical values can be impaired — particularly where dyscalculia co-exists with dyslexia. However, many dyslexic candidates perform well here through visual-numerical reasoning. | Botan et al. (2023) — SpLD candidates showed broadly similar performance in data interpretation once adjustments applied. |
| Single Best Answer questions with complex wording | Parsing "which of the following is LEAST likely to..." or double-negative phrasings creates additional cognitive load for anyone — but substantially more for dyslexic readers. | Shaw et al. (2017) — exam performance review in medical students with dyslexia. |
| Extended matching questions (EMQs) | Multiple answer options requiring sustained reading and matching across a long option list are particularly demanding on phonological decoding and working memory. | Gibson & Leinster (2011) found EMQs specifically more challenging for students with dyslexia. |
| Algorithm / flowchart questions | Following complex multi-step decision trees visually is often a relative strength for dyslexic thinkers who process holistically. Can be a positive compensatory domain. | Visual-spatial strengths in dyslexia well documented (BDA; Locke et al. 2015). |
🔥 Practical AKT Strategies for Trainees with Dyslexia
Apply early for +25% time
The RCGP routinely grants 25% extra time for confirmed SpLD. For 160 questions, this gives you an extra 40 minutes — meaning 200 minutes total instead of 160. This is transformative. Apply in ST1.
Request paper-based AKT if needed
In exceptional circumstances, a paper-based version of the AKT can be provided at RCGP HQ, London. This requires additional evidence of need (e.g. screen-reading specific difficulty). Ask the RCGP exams team.
Practise under time pressure early
Use timed FourteenFish or approved practice tools. There is evidence that those with dyslexia may benefit from being positive reviewers — re-reading flagged questions uses time well if the extra time is in place.
Chunk long vignettes
Teach yourself to read the question stem first, then return to the vignette with purpose. Don't read the entire passage first — locate what the question is asking, then find that specific information.
Use coloured overlays or tinted screen
Some dyslexic trainees find that adjusting screen contrast, background colour, or using a coloured overlay significantly reduces visual stress. Request a separate room if this is helpful.
Focus on knowledge — not reading speed
The AKT tests what you know. With extra time, reading speed becomes much less of a barrier. Invest revision energy in building knowledge depth, not speed-reading tricks.
💡 Insider Tip (From Trainee Experience)
"The AKT was actually less terrifying once I had my extra time. I knew my clinical knowledge was fine — it was the clock that got me. 40 extra minutes changed everything. I just needed the same amount of time as everyone else to access the knowledge I already had." — Reported trainee experience
Dyscalculia and the AKT — Special Note
🔢 If numbers are the problem
Dyscalculia affects approximately 5% of the population and commonly co-occurs with dyslexia. In the AKT, the data interpretation and statistics section (approximately 10% of the paper) will be disproportionately challenging. Strategies include: drawing out calculations longhand, using systematic elimination of implausible options, and extra revision time specifically on the Bradford VTS statistics/data section and RCGP "How to Prepare" guidance. The good news: many dyslexic trainees with dyscalculia find that methodical practice significantly improves AKT statistics performance, as the underlying concepts are not inherently complex.
Asghar et al. (2019, Medical Education): In 20,879 CSA candidates (2010–2017), dyslexic candidates passed at 85% vs 96% for non-dyslexic candidates. Unlike the AKT, this difference remained statistically significant after accounting for covariates and reasonable adjustments.
Botan et al. (2023): SpLD candidates performed significantly worse specifically on the CSA Interpersonal Skills domain (B = −0.70, p=0.007) and RCA Clinical Management Skills (B = −1.68, p=0.034). The CSA/SCA appears to place specific additional demands on dyslexic candidates beyond what reasonable adjustments address.
The implication: The SCA requires targeted preparation beyond just knowing your consultation framework. Understanding why dyslexia affects specific domains is the key to addressing them effectively.
Why the SCA Is Harder — Domain by Domain
| SCA Domain | How Dyslexia Interferes | Why It Scores Lower |
|---|---|---|
| Data Gathering | Reading the 3-minute briefing card under time pressure. Extracting key information quickly. Risk of missing critical detail in the written scenario. | Incomplete or inaccurate data gathering — not from lack of clinical knowledge, but from reading difficulty under pressure. |
| Interpersonal Skills ⭐ Most affected | Simultaneous demands: listen to patient, process verbal information, track emotional cues, plan response — all while managing anxiety. Working memory overload. Difficulty with multi-channel processing under stress. | Research shows this domain specifically underperforms in dyslexic candidates. May appear less engaged, slower to respond, or miss emotional cues. |
| Clinical Management | Retrieving and sequencing management steps verbally in real time. Explaining management clearly while simultaneously tracking patient responses. Organisational difficulties (dyspraxia co-morbidity) amplify this. | Management may be incomplete, poorly sequenced, or appear disorganised — particularly when co-existing dyspraxia affects sequential planning. |
| Safety-Netting | Under cognitive load, safety-netting is often the first thing dropped. Working memory limitations mean the trainee may run out of capacity before getting to safety-net. | Omission of safety-netting is a costly and common error in SpLD trainees — and one that is easily fixable with deliberate preparation. |
| Written Tasks (where applicable) | Any written component — notes, referral letters, prescriptions in the consultation — adds cognitive load that compounds the verbal demands of the encounter. | Documentation quality and speed are impaired — though the SCA itself does not formally mark this, the cognitive load impacts the oral consultation simultaneously. |
🎯 SCA Strategies Specific to Dyslexia
Read the briefing card strategically
You have 3 minutes. Don't just read — extract. Jot the patient's name, age, key problem, and any red flags onto your paper. A brief written note anchors your memory throughout the 12-minute consultation. This is especially helpful when working memory is under pressure.
Practise with the same structure every time
Over-learn a consultation framework until it is automatic. When the framework is in muscle memory, your cognitive bandwidth is freed for the patient in front of you. ICE → explore → explain → plan → safety-net. Every time. Without exception.
Safety-net as a non-negotiable habit
Put safety-netting on a mental "always do this" list — not something you get to if time allows. Many dyslexic trainees drop it under cognitive load. Practise ending every consultation, even at home, with an explicit safety-net phrase.
Ask for additional reading time
The RCGP may grant additional time for reading the briefing card prior to each consultation. Unlike consultation time extension (rarely granted for SpLD), reading time adjustments are more frequently approved. Request this specifically.
Target interpersonal skills deliberately
This is the domain most affected by dyslexia in the research. Focus revision here. Practise maintaining eye contact and emotional attunement whilst your brain processes what you're hearing. This dual-task skill improves significantly with repeated deliberate practice.
Record and review your consultations
Video and audio-recorded practice consultations reveal patterns you may not notice in the moment. Specifically review for: eye contact, response timing, empathy signals, and whether ICE is explored. Your trainer can watch with you.
SCA Consultation Phrases — Ready to Use
These are particularly valuable for trainees who need to over-learn natural-sounding phrases. Read them once. Practise them out loud. Use them in clinic tomorrow.
💡 The Biggest SCA Insight for Dyslexic Trainees
The SCA is not a reading test — but the anxiety and cognitive load of reading the briefing card under pressure bleeds into the consultation that follows. Many trainees report that once they learned to extract just the essentials from the briefing card in 60 seconds and use the remaining time to mentally rehearse their opening, their consultation performance improved markedly. The briefing card is a launch pad, not a script.
⚠️ Common Mistakes in the SCA with Dyslexia
- Spending all 3 minutes reading every word of the briefing card — and arriving at the consultation mentally exhausted and without a plan
- Dropping ICE exploration when under cognitive pressure — listening but not hearing the emotional content
- Forgetting safety-netting entirely because working memory ran out
- Not declaring SpLD to the RCGP before the first attempt — and therefore sitting without adjustments
- Not practising dual-task processing (listening + maintaining eye contact + tracking emotions) — this is a learnable skill
🌍 High Achievers with Specific Learning Difficulties
A reminder that SpLDs have never stopped anyone from contributing significantly to the world:
Who on this list surprised you the most? And notice that not one of them became successful despite their SpLD — several credit it with giving them the different perspective that made their greatest contributions possible.
Dyslexia Can Give You an Edge — Understanding Your Strengths
Dyslexia and dyspraxia are not just about what's difficult. They come with a genuine set of cognitive strengths. Many people with SpLDs think in a more holistic, visual, and creative way — they see the big picture, notice patterns others miss, and make connections that linear thinkers don't see. Some of medicine's most exceptional clinicians think this way. It isn't a consolation prize. It is a genuine cognitive advantage — once you understand and work with it rather than against it.
These pairings are not universal — every SpLD person is different. But the pattern is well-documented in the research and the lived experience of many clinicians. Understanding your particular strengths is just as important as understanding your challenges.
The Five Things to Remember
Dyslexia is not a disease and not a weakness
It is a different cognitive style. It shapes — often for the better — how you see patients, solve problems, and understand the human experience. The way you process the world has helped make you the person you are. Don't hate it. Learn to dance with it.
The right support changes everything
The research is unambiguous: trainees with appropriate support, reasonable adjustments, and early diagnosis perform comparably to their peers. The barrier is the exam format and the documentation demands — not your knowledge, not your clinical ability.
Every SpLD person is different — and must be treated as an individual
You will share characteristics with other dyslexic trainees. But your specific pattern of strengths and difficulties is uniquely yours. The strategies that help one person may not help another. Work with your assessor and trainer to find the approach that fits you — not a generic dyslexia template.
You may see more, not less
Dyslexic clinicians often excel at pattern recognition, empathy, and holistic thinking — the exact qualities that make an extraordinary GP. The Leeds-to-Birmingham route takes a little longer. But you will arrive at the same destination, and you will have noticed things along the way that the motorway travellers missed entirely.
Your SpLD is a companion for life — not an obstacle
Dyslexia and dyspraxia are part of you. They have been with you through every exam you've ever passed, every patient you've helped, every skill you've developed. They are not a threat to your future. Stop fighting them. Show them some curiosity instead — because understanding your own cognitive style is one of the most powerful things you can do, both for your training and for the patients in your care.
- SpLDs — dyslexia, dyspraxia, dyscalculia, ADHD — are common in GP trainees and reflect difference in cognitive style, not lack of ability.
- A formal assessment by a chartered psychologist or PATOSS-registered specialist teacher is required for RCGP exam adjustments. Screening tools are not sufficient.
- Declare early. Candidates who declare dyslexia before their first AKT or SCA attempt have significantly better outcomes than those who declare after a failure.
- The AKT is effectively neutralised with 25% extra time — pass rates for dyslexic candidates with adjustments are comparable to non-dyslexic peers.
- The SCA is the harder challenge — especially interpersonal skills. Target this domain deliberately with repeated practice, over-learned consultation frameworks, and video review.
- The Equality Act 2010 requires employers and exam bodies to make reasonable adjustments. Know your rights and use them.
- AI scribes like Heidi are appropriate tools for trainees with SpLDs — especially in ST3 and as a workplace adjustment. They remove documentation barriers, not clinical thinking.
- Trainers: raise SpLD early, adapt your teaching style, and create a safe space for disclosure. You may be the person who changes a trainee's entire training trajectory.
- The greatest GPs often have the greatest struggles and the greatest gifts. Dyslexia may be both of those things at once.
Videos
Understanding Dyslexia
How do dyslexics learn?
See dyslexia differently
Visual dyslexia – what does it look like?
The true gifts of a dyslexic mind
Dyslexia and the brain
Learning Strategies in Dyslexia
5 writing tips for dyslexics
See dyslexia differently
Visual dyslexia – what does it look like?
The true gifts of a dyslexic mind
Dyslexia and the brain
Teaching Someone with Dyslexia
How do dyslexics learn?
See dyslexia differently
Visual dyslexia – what does it look like?
The true gifts of a dyslexic mind
Dyslexia and the brain
Ram's Closing Comments
- Leonardo Da Vinci,
- Albert Einstein,
- Thomas Edison,
- Michael Faraday,
- Alexander Graham Bell,
- Steve Jobs,
- Lewis Carrol,
- Roald Dahl,
- Hans Christian Anderson,
- Agatha Christie,
- JF Kennedy,
- Winston Churchill,
- George Washington,
- John Lennon,
- Mozart,
- Walt Disney,
- Whoopi Goldberg,
- Anthony Hopkins,
- Tom Cruise,
- Goldie Hawn,
- Robin Williams,
- James Oliver,
- Steven Spielberg,
- Guy Ritchie and
- Cher.
Who on this list has shocked you for being there?
Actually, I could have gone on and on with the list above. But I just wanted to simply to illustrate the point that you can be a high achiever – it all depends on how much hunger and passion you have, and not whether you have a learning difficulty.
Dyslexia can give you and “edge”
I did not know I had dyslexia! Ever since I switched the handedness from R to L due to an accident I no longer was able to adapt to school life and the sense of right and left had been completely switched. Since I moved from Japan to the US (which means the languages I use are changed) and the issue continues. Also I do not take the verbal instructions well at all. Till I read your article I had no idea this was not so uncommon. I used to be depressed because of my “conditions”, but no longer – I can tell anyone that I have “dyslexia”. Thank you for posting this information.