Quoted: career choice for heavy sleeper

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Laity I've been giving a lot of thought to the career path I should follow. I'd love to be a physician--it has been my dream since I was a little boy, however I am having some issues that might preclude me from achieving this goal.

I've always been a heavier sleeper, but I started sleeping with the lights on a couple of years ago because it made me a lighter sleeper. Over time, this has made me an even heavier sleeper than I was before. I am unable to wake up to my alarm and routinely turn it off in my sleep or sleep straight through several alarms that I set for myself. Additionally, I seem to have developed parasomnias as a result. I seem to exhibit something along the lines of confusional arousal when someone attempts to wake me and don't wake up. Typically I open my eyes, say mean things and can get a bit violent sometimes. This is not at all part of my personality and I never remember anything about these events when I wake up.

I feel as if I've practically become a slave to sleep, and say and do things in my sleep that scare me because I can't control them. It's as if I have an alter ego who is not me, and that is frightening. I also basically pass out every night when I am even slightly tired. I can't control it. I legitimately pass out.

These issues have been going on for a couple of years now and is becoming a bigger issue.

My question here is: with this issue, should I even attempt to go into becoming an MD or should I seriously reconsider my career path?

I know that certain specialties dint allow for much sleeping time, especially if you want to be involved with your family (and I do), and during residency/fellowship the hours put in can be brutal. I've tried to talk to my aunt about this who is a physician and she tells me not to worry about it because I can always go into a specialty like dermatology where there aren't that many emergencies, but that doesn't make me feel better.

I'm not looking for a diagnosis, though if you think it would be helpful for me to see a sleep specialist, please let me know. I'm just telling the full story so I can have someone comment on my situation.

I still have time to change my life plan and go into something else with more predictable working hours. Pharmacy looks moderately appealing to me, as does going into research.

Do you think that my sleep issues warrant a long brainstorming session regarding whether I am fit to become a physician?

Should I do a long self-reflection to see whether this is the only career that will make me happy and if it's not the case, explore careers that are still demanding but that I'm less likely to be unfit for due to my sleep issues?

I feel like this is something that would hold me back a lot. Have you seen other people experience these issues? How did they deal with it?

Anytime one has a health condition that might affect a career choice, seeing a physician about it is a good idea. Otherwise, assuming no obvious cure, we'll see what others have to say. Remember, SDN is not for giving medical advice.

Your dilemma is whether to go into something which is a lifelong dream or something which is, at best, "moderately appealing". For most people, employment takes up a huge proportion of their lives, and doing something they don't like or are unsuited to is the cause of a lot of misery for a lot of people. What job can you see yourself being content with for 40 hours a week, 48 weeks of the year and up to 40 years?

For just about any job or career I can think of, you will at some point need to be able to set an alarm and get out of bed at a particular time of day. If that's a problem, it's a problem for more jobs/careers than being a doctor.

If your sleep problems amount to a disability which can't be alleviated by treatment, and the disability would make shiftwork and overnight call a problem, you could look into whether there are laws on disability and education/employment which would require reasonable adjustments to be made for you.

I honestly don't see how someone with a condition as described above could make it through residency, provided effective treatment isn't found.

Being a doctor wouldn't be an issue. There are 9-5 with no call options in medicine. But getting through residence? What is he has to assist in surgery late in the evening, if he falls "unconscious"? What if he's the senior covering the floor when a patient goes into a crisis, and he doesn't wake to the pager?
I can actually see him getting through med school under some kind of disability provision, but in residency he's an employee responsible for patients' lives. There's only so much leeway that can be given, and complete abdication of patient responsibilities after x and before y o'clock is unlikely to be allowed.

I think you need to see a physician and be evaluated. If there is a treatable cause to your problem, then you can plan accordingly and see how your condition changes with treatment.

Aside from that, if you are such a heavy sleeper that you cannot be aroused, that would be a major problem for many specialties, especially when on call or when chronically late for work. I would also expect that if this was constantly an issue for a resident, a PD would insist on a medical evaluation in order for the resident to keep their position. As the above poster suggests, if you have severe issues with sleep, it may be hard to maintain any job. The bottom line is: see a physician now and figure out what's going on BEFORE you burn bridges.

Go see a sleep specialist and find out what the heck is wrong with you before you make important career decisions. Disagree with shopsteward about the "reasonable accommodations" thing - technically that may be the law, but if you can't handle some sleep deprivation, the chances of you making it through medical training are crappy. However, you really don't know what's going on with you or whether it's correctable. Go see a sleep medicine doctor.