Blind leading the blind

[Chevalier]

I'm a 4th year med student (6 year program) currently on my IM rotation (which I dislike). I'm in the process of finding out what specialty I wish to continue and recently I've been drawn into psych.

I've had such inclination since before entering med school (I considered studying psychology too) however the main reason that I've taken interest in psych is because I was diagnosed last year with bipolar NOS and since then I've read a lot about psych disorders (even tho my psych rotation is next year).

However, I'm afraid of following psych because I feel it will be like the "blind leading the blind" and it somehow feels immoral how I wish to help the mentally ill when i'm ill myself (might affect my clinical judgement)

I just need advice on what to do. I know that I still have 2+ years to decide and at the end it's my call if I want to do psych or not, but it's nice to have some insight from others.

My other options have nothing to do with psych (heme/onc, rad-onc or path)

Also, this is my first post here

After I finished writing this I noticed there was a similar thread but it was about emotional issues and nothing was actually concluded.

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[F0nzie]

Let's be real we're all SMI here. Welcome!

 

[milesed]

If you choose Psyc you should learn about transference/ counter-transference in you residency and how to deal with it. We all have a history of connection to SMI through friends, family, neighbors or our own personal stuff. It can be a good tool instead of a hindrance if properly addressed and used.

 

[kaserm]

Do not worry, unless you are interested in psychoanalysis you will not have to go through didactic analysis, so you are fine. Actually, when a person becomes a psychiatrist, his mental illness becomes just a small" eccentricity"( in fact, with " high profile" psychiatrists eccentricity is some kind of aristocratic spice, and if they do not have it as personality trait they fake it, because " genius borders on insanity").

One of the reasons my family vehemently opposed my interest in psychiatry was that they believed " just like other doctors can contract a flu or virus, so can psychiatrist contract a mental illness from his patients" ( they had strong empirical evidence- all the psychiatrists they knew were a bit nuts). In fact, I could swear there was some kind of insanity/ eccentricity competition( NPD comes for free, of course) going on between my psychiatry professors: one of them used to come to classes wearing different colored socks with Disney characters and a ripped tie, another one lived in his university office with his two dogs.

Also, do not worry, you have been diagnosed with what i call " you-do-not-really-have-a-mental-illness-but- since-you-have-made-an-effort-to-come-we-can-not-let-you-go-empty-handed" ( i will lobby to get it accepted in DSM VI).

 

[notdeadyet]

Also, do not worry, you have been diagnosed with what i call " you-do-not-really-have-a-mental-illness-but- since-you-have-made-an-effort-to-come-we-can-not-let-you-go-empty-handed" ( i will lobby to get it accepted in DSM VI).

Other specified unspecified?


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[hamstergang]

However, I'm afraid of following psych because I feel it will be like the "blind leading the blind" and it somehow feels immoral how I wish to help the mentally ill when i'm ill myself (might affect my clinical judgement)

But you won't be 'blind' because you'll be a trained psychiatrist, not just a patient that got his hands on a prescription pad. As long as you stay aware of whatever bias you may be bringing in, I don't see why this would be a problem.

 

[MacDonaldTriad]

I have to weigh in just a little bit. If any specialty should be sensitive to accepting someone with a mental illness, it should be us, but I would argue that it might convey some disadvantage despite all of the hub bub about how this can “help you relate to your patients”. I have no data to say if any one particular person’s mental illness is going to make them 110% effective as a psychiatrist, or equal, or 90% or 20%, but I do know that when it comes to tough objective decisions in a very grey world, having your own experience can go both ways. Of course “having a mental illness” is probably on a whole not a good thing and might be a problem in many specialties. The up and down side in psychiatry is probably more perspective than; for example someone with bipolar disorder going into something that involves a lot of sleep deprivation.

If you were going into other specialties would you mention your personal exposure to their illnesses as your motivation for your interest in that specialty? The answer to this depends upon the degree that those illnesses have negative stigma or are likely to interrupt your ability to perform on the job. Psychiatrists should be above the former, but the latter is a relevant concern. I can tell you that I find out about trainee’s limitations due to medical problems (be them physical or mental) 99% more often after they start than before the match.

I think psychiatry may be a good direction for you and I don’t know enough about you to say for certain, but this choice is yours. If you mention your illness or not during the application process is less relevant than if you do some real self-evaluation as to why you want to be a psychiatrist and do this for the right reasons. I do know that most undergraduate physicians don’t have a clue as to why or how they got to the point of having to pick a specialty. They were just programed to become a physician. Those that were in high school and knew they were going to be plastic surgeons have less credibility than those that are in your place or even completely clueless in my opinion.

Psychiatry is a fairly open and easily accessed specialty, but it isn’t for everyone and there are many very talented physicians who shouldn’t come near it. It takes comfort with ambiguity, and boundaries that make you almost completely without a need for a reinforcing “thanks for helping”. I mean this more from other doctors than from patients. Practicing psychiatry involves absorbing a lot of projected anger and distortion and seeing this as illness. If you have your own problems with hanging on to your center this can be challenging to say the least.
I hope you get into our game, but I want to say to everybody, don’t set your goals on a slam dunk contest if you have a rotator cuff injury.

 

[Psychobabbling]

Just my two cents:

From watching my program talk about applicants, judge their personality based on a 30 minute applicant interview, make fun of people's names, etc. I would be leery to disclose any suggestion of "mental illness." Of course, I'm incredibly biased....

 

[kaserm]

Other specified unspecified?


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