Quoted: Protection of health information

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A concern for discussion

A similar question was asked re: eligibility for residency after being dx'd w/schizophrenia.

I'm applying for programs to start the fall of 2008 so my applications for residency are years away.

I've been treated for anorexia on/off for the past 12 years. I've been doing well & I feel pretty confident that I can start medical school with this behind me.

How much does your medical history follow you? What are the risks of seeking psychological care as a medical student? Will you ever be required to disclose you personal medical/psychiatric history? What about filling out health info for the student health services? I had a nightmare as an undergrad with student health/dean's office 'sharing' my info & trying to coerce me into taking an LOA.

I don't have gaps on my CV as a result of my disorder so I can't think of any reason I would want to disclose this later.

Thanks.

From a residency standpoint, the issue is simply 1) whether any illness impacts your performance in medical school and 2) whether any illness requires any accomodations during residency training. If the answer is no to both, then it should not come up during your residency interview process.

After matching, all residents at our program complete a confidential health assessment by Occ Med. They would want to know about this, but should keep it private from your PD. I think it's important, because the stress of residency can cause flares of illnesses.

Things become more tricky if your treatment requires medications which could possibly impair your judgment/performance. Benzo's are the classic -- should you be able to put a central line in if you are on a chronic benzo? My sense is yes (we let people drive cars on chronic benzos) but I could see some people having a problem with this. This is where occ med is most useful -- they can make an assessment of whether you are competent to be a resident or not (from a medical standpoint) so that I don't need to get involved in your medical history.

posted anonymously for OP

Thanks for replying to my post, I really appreciate it.

My illness didn't impact my performance as an undergrad so it wasn't something that came up throughout my application process.

I'm curious what occupational health can do w/this information, especially if it's a past tense health problem. I'm doing a MD/PhD, so by the time I apply to residency it will have been years since I was symptomatic.

I guess my concern is that I don't want to be supervised by occupational medicine and I don't want to have a past issue impact the rest of my career. Would information from my personal doctors saying I'm competent likely mean that occ health would agree?

I know I can't be the only med student that's ever had therapy (hah) I just really wonder how this handled. I don't want to lie, but I don't want to regret being open about my history either.

Thanks so much for your input.

If it's years in your past, and you're not on any medications that could impair your judgement/ability to be a physician, then it will simply end up on your problem list: History of anorexia >10 years ago, in remission.

The more time between when your problem resolved and when you start your residency, the better. That's not a good reason to do an MD/PhD, but if that's what you've chosen it makes things even easier.

In this case, I really think it's a non issue. This occured in your past. It's resolved. You're not on any "dangerous medications" (and as I mentioned above, it's unclear what those might be). It's not a disease that usually gets worse once addressed. Case closed.

I still wouldn't lie about it on your medical intake. You had anorexia. It's been cured/in remission for years. That's all, no one will really care much more than that.

It's a bit different than the person with schizophrenia. That's an illness that tends to get worse over time, and tends to greatly impact people's ability to do complex work.

Replying to aPD...

Thanks again for your input, I really appreciate it.

I'm doing the MD/PhD because I love being in the lab-- I certainly agree a PhD that I wouldn't enjoy wouldn't be worth it just to put a few more years between me & my past before applying for residency. But yeah, I do think it will make it easier for me to confidently say [to myself & whoever else would be concerned] that my illness is, in fact, entirely in the past.

Thanks.