Neurodivergence in medicine: strengths, challenges and workforce implications in Aotearoa New Zealand

Neurodivergence is increasingly recognised within healthcare workforces internationally yet remains largely absent from workforce policy and planning in Aotearoa New Zealand. This viewpoint argues that neurodivergence is not a challenge to be accommodated but a dimension of diversity with implications for workforce sustainability.

This viewpoint uses lived experience to motivate and illustrate an argument informed by a narrative review of international evidence on neurodivergence in medical education, clinical practice and workforce design. Policy frameworks are considered alongside current workforce pressures.

Neurodivergent clinicians may contribute strengths in pattern recognition, lateral thinking and adaptability. However, standardised assessment frameworks, "masking" demands, disclosure risks and neurotypically designed workplaces create barriers to entry, progression and retention. Frameworks do not currently address cognitive diversity, representing both an equity gap and a missed opportunity during acute workforce shortages. This article introduces "cognitive infrastructure"-the design of systems, workflows and environments to support cognitive diversity-as a framing concept for workforce sustainability.

International evidence supports neurodiversity-informed approaches to workforce design. While local evidence remains limited, the New Zealand medical workforce shortages are sufficiently acute that incorporating neurodiversity and cognitive infrastructure into workforce planning, education design and leadership development represents a proportionate and evidence-aligned response.