PDs will have to deal...

GladifImakeit said:

I've given it some thought and....

I'm just going to be straight up and say... I was depressed. No dishonesty, no obfuscation. If anyone has a problem with my medical history, they'll just have to get over it. I'll make a good doctor someday. I go to a good school with a good board score and if I don't match it's THEIR loss not mine. So there, take that!

Here's what my app is gonna say - something along these lines, anyway -
I was diagnosed with depression in medical school. I was treated and my symptoms have resolved. I am capable of meeting all the expectations of residency.

What do you think??? How's that lemonade taste??????

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Not exactly sure why you feel the need to tell them that...

"PDs will have to deal"

You do realize that for them... "dealing" constitutes not ranking you, right? The ability to be a "good doctor" hinges on both personal capability and licensure. Even the most capable doctor is still a bad doctor if he or she is practicing without a license due to not matching

Im only trying to say that the "well they can suck it" attitude really nets you nothing useful. If you have something unattractive in your app, you need to treat it as such and no amount of pep talking can change it. If you feel it is something that will hinder your ability to match then you need to 1) address it and 2) make your app stand out in other ways. That is the reality of the situation.

also, posting something like this at midnight on a saturday..... was it a beer or a whiskey night?

You get good advice all the time. It's not a good idea to open this bag of worms. Just say you did research and Spanish... If you need more explanation, saying "personal problems" is sufficient.

You need to market your best self, not our weakness. If you don't like what's being said then change the conversation.

JackShephard MD said:

You get good advice all the time. It's not a good idea to open this bag of worms. Just say you did research and Spanish... If you need more explanation, saying "personal problems" is sufficient.

You need to market your best self, not our weakness. If you don't like what's being said then change the conversation.

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Indeed.

Don't directly point out your problems unless they are specifically brought up. Don't lie about it if asked, but don't ever bring it up on your own.

Second what everyone else is saying. "Just deal with it" is a naive way of thinking about this. You have everything to lose and nothing to gain.

Just to reiterate some points made above, program directors (rightly or wrongly) will think: "is this person going to take time off in our program? we are already short on man-power."

I wouldn't bring it up. Not sure if I would make something up either (lie). What if they found out? Perhaps asking your counselor would be an idea. Maybe say "personal family issues that have since resolved." Then change the subject!

JackShephard MD said:

You get good advice all the time. It's not a good idea to open this bag of worms. Just say you did research and Spanish... If you need more explanation, saying "personal problems" is sufficient.

You need to market your best self, not our weakness. If you don't like what's being said then change the conversation.

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This, Keep explinations out of your ERAS as much as possible. Don't even call it a "personal problem." Call it a personal/family reasons.

It may come up in your dean's letter, so be prepared to address it if needed.

I think it's pretty ****ing sad statement about our profession if mental illness isn't a valid reason for a leave of absence. If she broke her leg and delayed a year because she couldn't do her required rotations, no one would think twice about disclosing it. I would sue their asses if you are an otherwise qualified candidate and they don't rank you.

Hour30 said:

Just to reiterate some points made above, program directors (rightly or wrongly) will think: "is this person going to take time off in our program? we are already short on man-power."

I wouldn't bring it up. Not sure if I would make something up either (lie). What if they found out? Perhaps asking your counselor would be an idea. Maybe say "personal family issues that have since resolved." Then change the subject!

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Are they allowed to discriminate against someone with rheumatoid arthritis? Oh no, they might have a flare up and have to miss a few days until they're able to walk again. Are they allowed to discriminate against 25-35 year old women who might start popping out babies? Why is mental illness being treated any differently?

ijn said:

Are they allowed to discriminate against someone with rheumatoid arthritis? Oh no, they might have a flare up and have to miss a few days until they're able to walk again. Are they allowed to discriminate against 25-35 year old women who might start popping out babies? Why is mental illness being treated any differently?

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"Allowed to..."

In reality, they don't have to give any reason for not offering you an interview at all or, if you are offered the opportunity to interview, for not ranking you. No one is going around asking programs to define their selection process. Would (and do) some programs choose not to interview or rank applicants for the reasons you noted above? Absolutely. Do not make the error of thinking that there is anything in the process of matching to residency that prevents "discrimination" on the level you suggest.

ijn said:

Are they allowed to discriminate against someone with rheumatoid arthritis? Oh no, they might have a flare up and have to miss a few days until they're able to walk again. Are they allowed to discriminate against 25-35 year old women who might start popping out babies? Why is mental illness being treated any differently?

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LucidSplash said:

"Allowed to..."

In reality, they don't have to give any reason for not offering you an interview at all or, if you are offered the opportunity to interview, for not ranking you. No one is going around asking programs to define their selection process. Would (and do) some programs choose not to interview or rank applicants for the reasons you noted above? Absolutely. Do not make the error of thinking that there is anything in the process of matching to residency that prevents "discrimination" on the level you suggest.

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Great point. Discrimination is real and won't be spelled out after your rejection. Human beings make decisions based upon prejudices all the time, PDs are no different.

Cool. So telling a neurosurgery PD that you got your tubes tied and hate children should improve your odds.

ijn said:

Cool. So telling a neurosurgery PD that you got your tubes tied and hate children should improve your odds.

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Just trying to tell you how IT IS... honestly most neurosurgery PDs would probably prefer if you did not discuss your personal anatomy at all.

Also? Sometimes these things are actually real considerations... should someone with RA really consider a field where the use of your hands is a prerequisite? Ideally someone with a condition like that would choose a field where they would not be limited by progression of their disease process. That's not "discrimination," that's common sense. Ideally, mental illness would not be a factor... but it depends on the illness. Mild depression on an anti-depressant? Ideally not an issue. History of institutionalization due to psychosis/attempts at self-harm/hyper-manic episodes/history of medication non-compliance or resisting attempts at intervention by healthcare professionals? Very different situations from a PD's point of view.

LucidSplash said:

Do not make the error of thinking that there is anything in the process of matching to residency that prevents "discrimination" on the level you suggest.

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So the NRMP, LCME, or whoever runs this **** never investigates why program X only admits women to 10% of their residency spots while the national average for that specialty is 40%?

TheProwler said:

They could just say "Oh, that's not why we didn't rank you."

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Also? You have almost no way of knowing if a program ranks you or not. You MIGHT be able to infer it in a very select situation (ie classmate ranks program dead last and matches, you rank program first and don't match) but in 99.9% you have no way of knowing.

Also? "Not a good fit" is considered a reasonable explanation for not ranking someone.

Also? A lawsuit, if it wasn't thrown out, would take years to come to fruition (likely would not end in any result you desire). Would not change the situation of you not matching at a given (or any) institution, at all. Years and money down the drain.

ijn said:

So the NRMP, LCME, or whoever runs this **** never investigates why program X only admits women to 10% of their residency spots while the national average for that specialty is 40%?

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Google and see if you can find such a situation... ie many "old school" ortho programs are probably a good example. (Definitely not trying to hate on my ortho colleagues, there are MANY programs that have a lot of wonderful female ortho residents... but there are such places in ortho and other specialties that exist).

It is not the job of the ACGME to police these things unless a specific complaint is lodged against a residency... and any such complaint would be extremely difficult to prove on the part of the complainant.

LucidSplash said:

It is not the job of the ACGME to police these things unless a specific complaint is lodged against a residency... and any such complaint would be extremely difficult to prove on the part of the complainant.

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Also please note I am talking about complaints lodged by someone secondary to not matching. The ACGME would be more likely to investigate complaints of discrimination based on gender, etc, if lodged by an actual resident in that program. Still, significant solid evidence would need to exist for anything to come of it. PDs DO worry about this sort of thing. My program actually treats women very well (ie no differently than the men... except that our female attendings take us out to dinner once a month, leading to "complaints" from the men about not being allowed to attend "Lady Surgeons' Club"). But my PD? Seems to be constantly worrying that we feel disenfranchised, freaks out if he thinks there's a perception that we're being treated unfairly, when there's nothing like that afoot, always telling the women to "come talk to him if you have ANY problems" (which we would if we did but we don't). I feel bad for the guy sometimes, it seems to stress him out so much.

ijn said:

So the NRMP, LCME, or whoever runs this **** never investigates why program X only admits women to 10% of their residency spots while the national average for that specialty is 40%?

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It's pretty clear you have no real world experience.

The "against the rules discrimination" happens ALL the time. We're not talking about man vs woman right now, as easy thing to track. How do they track the things you mention below: arthritis, 25-35 y/o who want babies, mental illness? You can track females but not females that want babies.

I'm not saying women who want babies are discriminated against, but they could be in certain specialties without anyone ever knowing. Interview days are long and there is lots of time to gather information, even at informal social events.

ijn said:

Are they allowed to discriminate against someone with rheumatoid arthritis? Oh no, they might have a flare up and have to miss a few days until they're able to walk again. Are they allowed to discriminate against 25-35 year old women who might start popping out babies? Why is mental illness being treated any differently?

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ijn said:

Cool. So telling a neurosurgery PD that you got your tubes tied and hate children should improve your odds.

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You think a woman who talks about a passion for starting a family and having kids is going to land that Nsurg residency? PDs are only going to follow the rules when it suits them. This is why we have arguments about following/breaking duty hours always. People will break the rules if they see it will benefit them, especially if it can't be policed very well.

When there are 50 capable individuals lined up for a position, little things can sway your decision.

ijn said:

Cool. So telling a neurosurgery PD that you got your tubes tied and hate children should improve your odds.

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It's more likely to improve your odds than telling a neurosurgery PD that you have rheumatoid arthritis.

Our profession is so full of ****. We waste all this time in medical school on touchy feely behavioral science BS and then when the **** hits the fan come residency time, PDs discriminate against people who have mental conditions that they have due to no fault of their own or the fact they were diagnosed with congenital uterus syndrome. I think PDs need more of their time dedicated to small group discussion on flowers and puppies.

ijn said:

Our profession is so full of ****. We waste all this time in medical school on touchy feely behavioral science BS and then when the **** hits the fan come residency time, PDs discriminate against people who have mental conditions that they have due to no fault of their own or the fact they were diagnosed with congenital uterus syndrome. I think PDs need more of their time dedicated to small group discussion on flowers and puppies.

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Welcome to the real world.

academics!=real world (i.e. work... even in academics)

ijn said:

Our profession is so full of ****. We waste all this time in medical school on touchy feely behavioral science BS and then when the **** hits the fan come residency time, PDs discriminate against people who have mental conditions that they have due to no fault of their own or the fact they were diagnosed with congenital uterus syndrome. I think PDs need more of their time dedicated to small group discussion on flowers and puppies.

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In the end, residency spots are jobs, they just happen to be jobs that also train you. If I'm a retail manager and I'm interviewing girl X and girl Y and they're both similar except girl X has had to take leaves of absences in the past due to depression, should I pick girl X? If girl X had depression years ago, is on medication and has it well controlled then they might not give a crap, but either way the retail manager is just looking for the best person who can fill the job, and as far as I know they don't have to give their reasons for why they picked that person.

It doesn't matter who's fault it is that someone has a mental illness, from the perspective of the employer what matters is who'll do the best job. In the case of the OP, it sounds like her problem would currently have negiglible if any impact on her work, so a smart PD will ignore that part of her application. Same as if someone had broken their leg and couldn't work for a few months; any smart PD would just ignore that. But if it would hurt his workforce (since if that resident has to take significant time off, its their coworkers that have to pickup all of that slack), then a responsible PD has to take it into consideration.

You're making the mistake of thinking inequity means injustice. It doesn't.

PDs won't have to deal with anything, they just won't rank you...

ijn said:

Our profession is so full of ****. We waste all this time in medical school on touchy feely behavioral science BS and then when the **** hits the fan come residency time, PDs discriminate against people who have mental conditions that they have due to no fault of their own or the fact they were diagnosed with congenital uterus syndrome. I think PDs need more of their time dedicated to small group discussion on flowers and puppies.

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In the end, PDs want people they can depend on. I guess you can call that discriminating. But it is what it is. It happens in every profession. Name one profession where a person with depression who is going to miss tons of work is going to be picked over somebody of equal qualifications but no depression?

GladifImakeit said:

Former depression. Not depressed anymore.

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Here. I'll fix it for you.

In the end, PDs want people they can depend on. I guess you can call that discriminating. But it is what it is. It happens in every profession. Name one profession where a person with a history of depression necessitating lots of time off is going to be picked over somebody of equal qualifications but no history of depression and lots of time off? Anybody??

GladifImakeit said:

So what is your suggestion? That I kill myself? Just give up because of one mistake?

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I think the general overall suggestion is to be as vague as possible in your application and not divulge your diagnosis (ie say you took time off to deal with family problems or something tangentially related).

.

GladifImakeit said:

So what is your suggestion? That I kill myself? Just give up because of one mistake?

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My suggestion is to not mention it. If people ask you about it and you can't avoid it and don't want to lie, figure out a better response than "just deal with it."

You obviously don't need to kill yourself, that response just oozes immaturity. And don't take it out on the medical profession, as I believe all are "guilty" of the discrimination you are so upset about.

GladifImakeit said:

Know what else oozes immaturity? **** you. I didn't say anything about being discriminated against *******. My whole post was about dealing with a bad situation in the most adaptive way. But you know what? **** you and **** all of SDN stupid ****ing website.

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These discussion don't help. I know you feel like you're being attacked but your actions are inappropriate regardless of what other people do.

I think it's best to end the conversation, agreed?

Go take some time away from the site, you need a breather.

Can everyone else avoid attacking GladifImakeit, please.

People were offering you good advice - I recommend heeding it. There really wasn't any snarkiness is your direction.

GladifImakeit said:

So what is your suggestion? That I kill myself? Just give up because of one mistake?

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Have you heard about "black and white thinking"? It's strongly associated with depression.

There are many things you can say, including personal/health reasons. Then, if anyone asks for details, you can give details as you choose. Usually a good strategy is to turn this into a powerful lesson learned. If you can tell a story about how this helped you learn compassion for your patents, how you learned how to ask for help, how you learned how to change your life strategy in some way, even if it was just how to be more social and less socially isolated, those are all good things. If you can turn adversity into learning and growth experiences, that may help a lot.

Good luck!

GladifImakeit said:

Know what else oozes immaturity? **** you. I didn't say anything about being discriminated against *******. My whole post was about dealing with a bad situation in the most adaptive way. But you know what? **** you and **** all of SDN stupid ****ing website.

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Deep breaths. You realize there's an easy way to not get so worked up...stop coming to SDN. Hell even put it as a blocked site on your firewall if it's so tempting to you.

GladifImakeit said:

Know what else oozes immaturity? **** you. I didn't say anything about being discriminated against *******. My whole post was about dealing with a bad situation in the most adaptive way. But you know what? **** you and **** all of SDN stupid ****ing website.

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You're right, you didn't say anything about discrimination. That was someone else I thought was you (I was quickly responding on a phone). My mistake.

Seriously though, just chill. People are just trying to give you advice. Don't ask for advice if you aren't willing to hear different points of view.

Why should you have to be vague? I would definitely be up front about your depression. If a PD decides not to rank because of it then you probably wouldn't want to match there anyway. If you have to be vague and actively avoid revealing things about yourself then you are probably setting yourself up to be in a negative environment. I think the OP's approach is a great way to sort out the douchebaggy programs.

protogypsy said:

Why should you have to be vague? I would definitely be up front about your depression. If a PD decides not to rank because of it then you probably wouldn't want to match there anyway. If you have to be vague and actively avoid revealing things about yourself then you are probably setting yourself up to be in a negative environment. I think the OP's approach is a great way to sort out the douchebaggy programs.

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The OP was banned, slick.