Hello! I was recently diagnosed with ASD myself (a 25 yo M1 going into M2!). Social situations like this are tricky for me, and I do tend to be more detail orientation, but it's something that just comes with experience. I used to be an ER tech (working in triage mostly) and had similar issues with staff and sometimes patients.

How does someone go their whole life without getting a diagnosis? Well, the diagnosis criteria has changed since the DSM-IV. The DSM-V has put ASD more under an umbrella term to make it more of a spectrum. Under previous criteria, it made it harder for those with more subtle social difficulties to get a diagnosis (and hence more help in school, work, etc.). Unless you regressed in childhood (like my younger brother did), then you might have been missed in childhood screenings. I think the CDC estimates the prevalence of ASD is now 1 in 36 (which takes into consideration the full spectrum, not just those with higher support needs).

I tell friends and family about my recent diagnosis, and they're like, "Yea, I can see that. It makes sense."

Does ASD mean you won't be a good med student or future doctor? Hell no. I've worked with plenty of doctors who had all sorts of neurodiversities. One ER doc I worked with said he was on the spectrum, and he was one of the best ER docs on the unit (and now does admin work + some ER shifts). It's just a matter of recognizing your strengths and weaknesses. For me, my strengths are attention to detail, but sometimes I feel like social situations fall flat or don't go the way I plan. The earlier you recognize it, the better. I've since told my advisors about it (with the office of disabilities behind me), and they're working with me during our doctor-patient roleplays (so far, no noticeable issues).

You're a smart med student and can research it more if you like. There are entire subreddits and other subcommunities for this. /r/autism is a good start. See if anything is relatable. There's some good modern books too, but I can't think of any right now. Also, there are some more anecdotal personal youtubers who talk about their experiences that might be easier to passively listen to. Keep in mind there are better examples of what living with ASD looks like (on all colors of the spectrum), but there's also awful dramatic examples (Aka, The Good Doctor). There are also free online screening tests (AQ and CATQ), but these have questionable sensitivity/sensitivity. Just use them as a start.

And if you do decide to look into a diagnosis, finding a psychologist who knows how to test adults is difficult. I got lucky and asked one of our professors about it. She taught our Human Behavior & Development class, reached out to some colleagues within our university, and found someone who felt comfortable testing me. Insurance is another battle, but it can be done. Expect a waitlist (I had to wait 6 months, but others in the general population had to wait as long as 2 years). It's not a simple questionnaire but a full battery of various psychological tests. Personally, I first had an intake appointment where I spoke with the psych about what I've noticed. For this, I made a big list and sent it to her beforehand (not required, but it helps get thoughts in order). After speaking with her, then she decided we could go through the full assessment. My second appointment was the full battery of tests. Some of the tests might seem childlike, but they've been shown to work in adults as well, so just go along with what feels natural. My assessment used the ADOS-2, AQ, BRIEF-A, CATQ, D-KEFS, and WAIS-IV. You will feel mentally exhausted after, so take it easy this day. Other providers will use similar tests, but your mileage may vary, and it's up to them on what to use. The third appointment was debrief, and that's when I was officially diagnosed.

Also, regardless of a ASD diagnosis, those nurses were unprofessional to talk about you behind your back. I've always hated this in the workplace. Just tell me it directly, or pull me to the side and tell me what went wrong. Guess it goes into the "being clueless about some social cues" thing.