Afraid of pursuing psychiatric treatment while in Medical School

[wotuvasax]

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PLEASE DO NOT QUOTE

First off, the main point of the thread is to just hear whether you guys think this should be a legitimate fear or if I should just let it go.

So basically, I was diagnosed a couple years ago with OCD. It has been mild for a while, so I decided to forego treatment as I generally just didn't have the time and energy to actually go for treatment, and my obsessions were nothing above mildly annoying. As of recently, because of the stress of the application cycle and issues at home, my obsessions have gotten worse, and I decided to schedule an appointment with an OCD center to be assessed for treatment.

So here are my fears: 1. My school or doctors on rotations might find out about my treatment. The OCD center is affiliated with the main psychiatric hospital the medical school that I am enrolling in is affiliated with. I feel like me seeking treatment could affect how people view me during rotations, or even how PD's view me during residency applications. If I do not tell anyone that I am seeking treatment, there is no way my medical school or residencies could find out right?

2. It may affect my medical licensure in the future. I have read over a few licensure applications and as far as I can tell, if my OCD is under control, I do not have to disclose it, but I want to hear if you guys think this may be a problem as well.

3. I am scared of being judged by my psychiatrist because I am a medical student seeking treatment for a chronic and scary mental health disease. I have yet to meet my psychiatrist, but this is by far one of my biggest fears, because I don't want to be viewed as the doctor who "needs to be on meds" in order to function. I also just have this recurring fear that one day my psychiatrist's patient notes will be used against me in a malpractice case or something.

At the end of the day, I understand getting treatment now will most likely help me in the long run, especially since my stress during medical school will likely make my symptoms worse, but I can't shake the feeling that there will be some sort of negative for seeking this treatment.

I really hope someone else has gone through something like this and can hopefully also give their opinion on these things. Just hearing about another medical student's experience with getting help from outpatient psychiatrists would be nice. Thanks again, and let me know if you guys need me to clarify anything.

 

[NITRAS]

Most of medical school, most of residency, and the first few years of being staff were way more stressful than applying to med school.

I’m not a mental heath professional, but you need to get your head on straight otherwise medicine is not the career for you.

 

[SouthernGent]

Medical school is a crucible that can will bring out anything you don't have under control. Take care of yourself before starting and during school.

 

[wotuvasax]

Most of medical school, most of residency, and the first few years of being staff were way more stressful than applying to med school.

I’m not a mental heath professional, but you need to get your head on straight otherwise medicine is not the career for you.

Medical school is a crucible that can will bring out anything you don't have under control. Take care of yourself before starting and during school.

I thought as much...thanks for the replies! Any feedback on the other concerns I had?

 

[ciestar]

My bipolar II WAS under control before I started med school. Once it started, I was having huge problems.

You won’t make it through without a LOA or worse at the rate you’re currently going. Yeah, the stigma sucks, but you need to take care of yourself in order to care for others. Ive been in treatment since high school. It is what it is.

 

[wotuvasax]

My bipolar II WAS under control before I started med school. Once it started, I was having huge problems.

You won’t make it through without a LOA or worse at the rate you’re currently going. Yeah, the stigma sucks, but you need to take care of yourself in order to care for others. Ive been in treatment since high school. It is what it is.

This is really great to hear, thanks for the reply! Honestly going through the past few months has been scary and I'm glad I'm not alone. Any idea if we HAVE to tell any programs/residencies/rotation sites that we are receiving treatment, or do they generally not ask unless it is a problem?

 

[wotuvasax]

It’s illegal for residences to ask you

Did not know this, but this is also very comforting to know, thanks!

 

[ciestar]

This is really great to hear, thanks for the reply! Honestly going through the past few months has been scary and I'm glad I'm not alone. Any idea if we HAVE to tell any programs/residencies/rotation sites that we are receiving treatment, or do they generally not ask unless it is a problem?

Nobody knows. HIPAA makes this illegal. Only volunteer what you want people to know.

You are far from alone!

 

[ciestar]

Fun fact: some states openly ask illegal mental health questions on their state licensing paperwork.

Yeah I knew that and I believe Florida is one of them?

 

[mehc012]

This was a HUGE concern for me.
Ultimately, I completed my psych rotation and realized that I was way off the bell curve, and that probably needed addressing no matter what the consequences.
I'm very glad that I did so, though I'm still leery about future licensing concerns. I'll keep you posted, but it can't be THAT big of an issue, or else we wouldn't have any physicians at this point.

 

[965978]

HIPAA is extremely strict when it comes to psychiatric patient confidentiality. Hypothetically speaking, you are looking at a multi-million dollar lawsuit if word were to get out that you are undergoing psychiatric treatment and you can prove that it’s harmed your career. No one wants to risk this. So don’t worry.

 

[wotuvasax]

This was a HUGE concern for me.
Ultimately, I completed my psych rotation and realized that I was way off the bell curve, and that probably needed addressing no matter what the consequences.
I'm very glad that I did so, though I'm still leery about future licensing concerns. I'll keep you posted, but it can't be THAT big of an issue, or else we wouldn't have any physicians at this point.

Definitely do!

Nobody knows. HIPAA makes this illegal. Only volunteer what you want people to know.

You are far from alone!

Thanks for all the support and advice, I really appreciate it 🙂

 

[DarkHorizon]

This is a sensitive topic. Most credentialing and state licensing applications ask you if you have been treated for any psychiatric illnesses that may hinder your performance as a physician.

In addition, I personally know of a physician that got reported by his psychiatrist to the state board and the hospital after seeking treatment. According to his psychiatrist, he was a danger to his patients and unfit to practice medicine. He had to go through hell to get reinstated and still can’t get credentialed at many places due to this.

I’m not advocating not seeking care for mental health, I am just letting you know that it’s possible that you may have to disclose it, or worse, some overeager mental health professiOnal may feel that it’s their duty to report you if they feel you’re not fit enough. I think it sucks. We ought to have more compassion for our fellow physicians

 

[wotuvasax]

This is a sensitive topic. Most credentialing and state licensing applications ask you if you have been treated for any psychiatric illnesses that may hinder your performance as a physician.

In addition, I personally know of a physician that got reported by his psychiatrist to the state board and the hospital after seeking treatment. According to his psychiatrist, he was a danger to his patients and unfit to practice medicine. He had to go through hell to get reinstated and still can’t get credentialed at many places due to this.

I’m not advocating not seeking care for mental health, I am just letting you know that it’s possible that you may have to disclose it, or worse, some overeager mental health professiOnal may feel that it’s their duty to report you if they feel you’re not fit enough. I think it sucks. We ought to have more compassion for our fellow physicians

Wow, didn't realize this. Do you think it would be a good idea to discuss this with my psychiatrist to see if this could potentially impact my career in the future? Just to be clear, my obsessions don't involve hurting anyone, and even if they did...its not like people with OCD actually want to act on their intrusive thoughts. Hoping for the best though.

 

[Espadaleader]

I would try to see a private practice Psychiatrist

 

[wotuvasax]

I would try to see a private practice Psychiatrist

As opposed to the OCD center? Why is that?

 

[Mass Effect]

Fun fact: some states openly ask illegal mental health questions on their state licensing paperwork.

Yes and many of us are trying to change that. There has been some success in getting the wording to conform to what is legal -- "have you been diagnosed with a psychiatric illness that currently impacts your ability to provide care?" We still have a long way to go, but we're getting there.

This is a sensitive topic. Most credentialing and state licensing applications ask you if you have been treated for any psychiatric illnesses that may hinder your performance as a physician.

In addition, I personally know of a physician that got reported by his psychiatrist to the state board and the hospital after seeking treatment. According to his psychiatrist, he was a danger to his patients and unfit to practice medicine. He had to go through hell to get reinstated and still can’t get credentialed at many places due to this.

I’m not advocating not seeking care for mental health, I am just letting you know that it’s possible that you may have to disclose it, or worse, some overeager mental health professiOnal may feel that it’s their duty to report you if they feel you’re not fit enough. I think it sucks. We ought to have more compassion for our fellow physicians

This is a problem, but let's not use scare tactics. For a psychiatrist to have done what your friend's psychiatrist did, your friend likely was severely impaired (as in schizophrenia with acute paranoia that someone was trying to harm him or something). Every psychiatrist I've known (and I, myself, am a psychiatrist) understands the sensitive nuances of medical professionals seeking psychiatric treatment and I can't see a psychiatrist calling the medical board, thereby compromising HIPAA and the doctor/patient relationship, unless someone was truly impaired and at risk of hurting patients.

OP, this will likely not happen to you, especially if you get your OCD under control now. Don't let state licensing apps keep you from doing it. Remember, the only thing worse than having to answer "yes" to the question "Do you have a psych diagnosis?" is having to answer "yes" to the question "Were you forced to seek treatment for a psych diagnosis?" because it implies you don't have the insight to know when you're impaired. Many people get by with untreated OCD, but why suffer when you don't have to and why worse it getting worse?

 

[wotuvasax]

Yes and many of us are trying to change that. There has been some success in getting the wording to conform to what is legal -- "have you been diagnosed with a psychiatric illness that currently impacts your ability to provide care?" We still have a long way to go, but we're getting there.



This is a problem, but let's not use scare tactics. For a psychiatrist to have done what your friend's psychiatrist did, your friend likely was severely impaired (as in schizophrenia with acute paranoia that someone was trying to harm him or something). Every psychiatrist I've known (and I, myself, am a psychiatrist) understands the sensitive nuances of medical professionals seeking psychiatric treatment and I can't see a psychiatrist calling the medical board, thereby compromising HIPAA and the doctor/patient relationship, unless someone was truly impaired and at risk of hurting patients.

OP, this will likely not happen to you, especially if you get your OCD under control now. Don't let state licensing apps keep you from doing it. Remember, the only thing worse than having to answer "yes" to the question "Do you have a psych diagnosis?" is having to answer "yes" to the question "Were you forced to seek treatment for a psych diagnosis?" because it implies you don't have the insight to know when you're impaired. Many people get by with untreated OCD, but why suffer when you don't have to and why worse it getting worse?

Thank you for the reassurance. Do you think I am carrying any risk by receiving outpatient treatment at the OCD center rather than at another place, like a private practice physician? The center has psychologists and psychiatrists that are aimed to specifically tackle OCD and related disorders, so I thought that would be the best option, and to be quite honest, finding a private practice psychiatrist not affiliated with my medical school is extremely difficult. Thanks for all the info!

 

[Mass Effect]

Thank you for the reassurance. Do you think I am carrying any risk by receiving outpatient treatment at the OCD center rather than at another place, like a private practice physician? The center has psychologists and psychiatrists that are aimed to specifically tackle OCD and related disorders, so I thought that would be the best option, and to be quite honest, finding a private practice psychiatrist not affiliated with my medical school is extremely difficult. Thanks for all the info!

I think you should get the best care you can. You're not a med student yet, so it doesn't really matter who sees you. The issue is that you may come across these people later in training if you're attending med school in the same place. Some people feel awkward about that, understandably so, but frankly, I think good care (the OCD center in this case) trumps the small possibility of future awkwardness.

 

[wotuvasax]

I think you should get the best care you can. You're not a med student yet, so it doesn't really matter who sees you. The issue is that you may come across these people later in training if you're attending med school in the same place. Some people feel awkward about that, understandably so, but frankly, I think good care (the OCD center in this case) trumps the small possibility of future awkwardness.

Maybe I worded it wrong in my original post, but I am definitely going to be going to medical school this upcoming fall at the medical school affiliated with the hospital system I am seeking psychiatric care from. You are right about the potential future awkwardness, but I think you are also right that I should still try and receive the best care possible. Thanks for all the advice!

 

[Goro]

PLEASE DO NOT QUOTE

Medical school is a furnace, and I've seen it break even healthy students. The #1 reason my school loses students to withdrawal, dismissal or LOA is to unresolved mental health issues.

If you had blood in your urine, would you ignore it?

This is NOT giving medical advice, but get help now and do not embark upon this path until your mental health issues are fully under control.

 

[wotuvasax]

Medical school is a furnace, and I've seen it break even healthy students. The #1 reason my school loses students to withdrawal, dismissal or LOA is to unresolved mental health issues.

If you had blood in your urine, would you ignore it?

This is NOT giving medical advice, but get help now and do not embark upon this path until your mental health issues are fully under control.

Yup, that is why I'm taking the initiative to get myself assessed and pursue treatment as necessary. I still have a few months before school starts to get a treatment plan and actual treatment started, and of course will be keeping my psychiatrist in the loop as I continue into school. I am taking this extremely seriously and definitely want my head on straight before I get into this gauntlet. Thanks again!

 

[anon6134]

The above is great advice and I think you need to take steps now to get the ball rolling on treatment.

Right now is when you should be finding a therapist that you trust and like and will continue with through med school. This person should be accessible location wise from where you're attending school. It is all well and great to get your head on straight right now, but doing this leg work now will make it easier a year from now when you are knee deep and really need the help

 

[Tenk]

I have OCD. Lots of doctors do. It all depends on what your obsessions and compulsions are. Regarding your concerns:

1) won’t happen, hipaa
2) it won’t. They only ask about conditions that will prohibit you from performing as a physician.
3) psychiatrists are probably the only specialists who don’t judge. Also, hipaa.

This would be looked at as nothing by most physicians because most physicians have some form of OCD. Just go get treatment if you want. It won’t affect anything.

 

[wotuvasax]

The above is great advice and I think you need to take steps now to get the ball rolling on treatment.

Right now is when you should be finding a therapist that you trust and like and will continue with through med school. This person should be accessible location wise from where you're attending school. It is all well and great to get your head on straight right now, but doing this leg work now will make it easier a year from now when you are knee deep and really need the help

Thanks for the advice! The treatment center is a 20 minute drive from my school, so pretty accessible!

I have OCD. Lots of doctors do. It all depends on what your obsessions and compulsions are. Regarding your concerns:

1) won’t happen, hipaa
2) it won’t. They only ask about conditions that will prohibit you from performing as a physician.
3) psychiatrists are probably the only specialists who don’t judge. Also, hipaa.

This would be looked at as nothing by most physicians because most physicians have some form of OCD. Just go get treatment if you want. It won’t affect anything.

Great hearing this. Thank you for the advice, it certainly helps.

 

[DarkHorizon]

Yes and many of us are trying to change that. There has been some success in getting the wording to conform to what is legal -- "have you been diagnosed with a psychiatric illness that currently impacts your ability to provide care?" We still have a long way to go, but we're getting there.



This is a problem, but let's not use scare tactics. For a psychiatrist to have done what your friend's psychiatrist did, your friend likely was severely impaired (as in schizophrenia with acute paranoia that someone was trying to harm him or something). Every psychiatrist I've known (and I, myself, am a psychiatrist) understands the sensitive nuances of medical professionals seeking psychiatric treatment and I can't see a psychiatrist calling the medical board, thereby compromising HIPAA and the doctor/patient relationship, unless someone was truly impaired and at risk of hurting patients.

OP, this will likely not happen to you, especially if you get your OCD under control now. Don't let state licensing apps keep you from doing it. Remember, the only thing worse than having to answer "yes" to the question "Do you have a psych diagnosis?" is having to answer "yes" to the question "Were you forced to seek treatment for a psych diagnosis?" because it implies you don't have the insight to know when you're impaired. Many people get by with untreated OCD, but why suffer when you don't have to and why worse it getting worse?

Not trying to scare but presenting the other side. I even said I’m not advocating not seeking psychiatric help. I am just stating the vicious nature of medicine. Do you agree that state license applications ask if you have ever been treated for mental health issues? If you answer yes and explain, it’ll likely result in a hearing in front of the board, possible evaluation from an appointed psychiatrist. Might not be the case for everyone, but it’s a possibility. Do you agree that this may have ramifications for jobs and hospital privileges?

 

[AMEHigh]

I have OCD. Lots of doctors do. It all depends on what your obsessions and compulsions are. Regarding your concerns:

1) won’t happen, hipaa
2) it won’t. They only ask about conditions that will prohibit you from performing as a physician.
3) psychiatrists are probably the only specialists who don’t judge. Also, hipaa.

This would be looked at as nothing by most physicians because most physicians have some form of OCD. Just go get treatment if you want. It won’t affect anything.

Where are you getting the stat that most physicians have OCD? I’m genuinely curious because I’ve never heard that before.

Anyway, OP yes please get your treatment plan in order now. You don’t have to disclose to anyone at this point unless you want to. Yes some state medical licenses do ask about medical history and it’s best that you tell the truth and having your symptoms under control is your best option.

 

[Yakuzadoc]

Dont let these people discourage you and make you afraid of medical school. I started with panic disorder and general anxiety disorder. I matched and graduated and both are pretty much gone thanks to CBT.

 

[Tenk]

Where are you getting the stat that most physicians have OCD? I’m genuinely curious because I’ve never heard that before.

Anyway, OP yes please get your treatment plan in order now. You don’t have to disclose to anyone at this point unless you want to. Yes some state medical licenses do ask about medical history and it’s best that you tell the truth and having your symptoms under control is your best option.

Personal experience. Good luck finding any legit study regarding physicians and mental health other than suicide. I am also including OCPD in that statement. You have to also understand that everything psych related is a spectrum. When you compare physicians to the general population, many physicians will be more type A and have obsessions, probably less with compulsions. For most these traits probably help physicians function better (can monitor minute details and make sure things are not missed) so they aren’t viewed as a hinderence. The only thing I found annoying was my obsession with locks but I’ve largely overcome that on my own.

 

[Mass Effect]

1) won’t happen, hipaa
2) it won’t. They only ask about conditions that will prohibit you from performing as a physician.
3) psychiatrists are probably the only specialists who don’t judge. Also, hipaa.

This is not the case for all states. Some states ask about history.

Do you agree that state license applications ask if you have ever been treated for mental health issues? If you answer yes and explain, it’ll likely result in a hearing in front of the board, possible evaluation from an appointed psychiatrist. Might not be the case for everyone, but it’s a possibility. Do you agree that this may have ramifications for jobs and hospital privileges?

No, I don't agree with that because it's misleading. A handful ask if you have ever been treated for mental health issues. Some ask if you have a diagnosis that could impair your work.

Personal experience. Good luck finding any legit study regarding physicians and mental health other than suicide. I am also including OCPD in that statement. You have to also understand that everything psych related is a spectrum. When you compare physicians to the general population, many physicians will be more type A and have obsessions, probably less with compulsions. For most these traits probably help physicians function better (can monitor minute details and make sure things are not missed) so they aren’t viewed as a hinderence. The only thing I found annoying was my obsession with locks but I’ve largely overcome that on my own.

Just curious, what field of medicine do you practice? OCD and OCPD are not nearly the same thing. One is Axis I and one is Axis II. They're not on a spectrum. They're flat out different disorders.

 

[wotuvasax]

This is not the case for all states. Some states ask about history.



No, I don't agree with that because it's misleading. A handful ask if you have ever been treated for mental health issues. Some ask if you have a diagnosis that could impair your work.



Just curious, what field of medicine do you practice? OCD and OCPD are not nearly the same thing. One is Axis I and one is Axis II. They're not on a spectrum. They're flat out different disorders.

Medical Licensure Questions About Mental Illness and Compliance with the Americans With Disabilities Act

Substantial numbers of medical students and physicians live with some form of mental illness. Over the years, many medical licensure boards have asked physician medical licensure applicants with Doctor of Medicine (MD) degrees intrusive questions about whether they have any psychiatric history...

jaapl.org

Found a really good paper (article) above on it. Glad to see some states at least abide by the ADA guidelines. Most don't though.

 

[AMEHigh]

Personal experience. Good luck finding any legit study regarding physicians and mental health other than suicide. I am also including OCPD in that statement. You have to also understand that everything psych related is a spectrum. When you compare physicians to the general population, many physicians will be more type A and have obsessions, probably less with compulsions. For most these traits probably help physicians function better (can monitor minute details and make sure things are not missed) so they aren’t viewed as a hinderence. The only thing I found annoying was my obsession with locks but I’ve largely overcome that on my own.

Are you a psychiatrist?
OCD and OCPD are very 2 different and distinct disorders, that just so happen to have similar names, correct?
Type A personality doesn’t equal OCD an anxiety disorder or OCPD a personality disorder. Or have I been mislead all these years?
Sorry to derail the thread I just hate when people say "oh I really like things in order, I’m so OCD." No, that is not necessarily OCD. I think using medical terms correctly is important.

 

[wotuvasax]

This is not the case for all states. Some states ask about history.



No, I don't agree with that because it's misleading. A handful ask if you have ever been treated for mental health issues. Some ask if you have a diagnosis that could impair your work.



Just curious, what field of medicine do you practice? OCD and OCPD are not nearly the same thing. One is Axis I and one is Axis II. They're not on a spectrum. They're flat out different disorders.

Are you a psychiatrist?
OCD and OCPD are very 2 different and distinct disorders, that just so happen to have similar names, correct?
Type A personality doesn’t equal OCD an anxiety disorder or OCPD a personality disorder. Or have I been mislead all these years?
Sorry to derail the thread I just hate when people say "oh I really like things in order, I’m so OCD." No, that is not necessarily OCD. I think using medical terms correctly is important.

Question for both of you, and frankly anyone else reading this. In the paper I linked just above this, it states that residency directors may have a requirement to report any history of psychiatric treatment of the applicant to state licensure boards (most likely depending on state). There is no way that the residency/program director would know of any psychiatric treatment of mine unless I volunteered this information correct? Based on previous answers, I am venturing to guess the answer is no, but I just wanted to double check what you guys thought.

 

[differentiating]

Echoing everyone else in that you should undergo treatment if you need it. I had my anxiety mostly under control through coping mechanisms in undergrad, but it got out of control in med school, and I finally decided to get help after underperforming on step 2 due to severe anxiety-induced insomnia. I didn't mention any of this in my residency apps, and have only revealed my medications to employee health as part of my screening/drug testing. That being said, I also feel pretty confident about answering "no" to any questions about having a condition that'd impair my ability to practice as a physician, as even when my anxiety was untreated it didn't impact my clinical abilities.

I also know multiple people in my class who've sought mental health treatment at various points - our school actually dedicates a day every year to talking about mental health issues in medicine and profiling students & physicians who've dealt with them during training, which I found reassuring.

 

[Tenk]

Are you a psychiatrist?
OCD and OCPD are very 2 different and distinct disorders, that just so happen to have similar names, correct?
Type A personality doesn’t equal OCD an anxiety disorder or OCPD a personality disorder. Or have I been mislead all these years?
Sorry to derail the thread I just hate when people say "oh I really like things in order, I’m so OCD." No, that is not necessarily OCD. I think using medical terms correctly is important.

I work in the ED so I get to see all the crazies. You missed my point. Technically to the DSM V, OCD and OCPD are two distinct entities but they are by no means mutually exclusive and a lot of people with OCD will have many OCPD traits just given the very nature of what they are. The main difference between the two is that one causes anxiety (OCD) while the other doesnt have to necessarily. What I was trying to explain is that a lot of the traits you see in people with OCD and OCPD are common traits that are not only seen in physicians but are viewed as strong points. Let’s take hand washing. A very common concern for many patients with OCD. Physicians are encouraged to wash their hands all the time. While it may cause anxiety to the person, everyone else is going to perceive them as being a good physician. That’s all that matters in this case, how others perceive the OP, not how they perceive themselves. They are afraid they will get kicked out of school/license problems and I’m trying to explain that while a disorder such as schizophrenia or bipolar disorder may definitely be viewed at as negative and one that may have problems down the road, disorders like OCD are absolutely not viewed in the same light so seeking treatment is a non issue.

To put this another way let's make two examples: Tim and Larry. Tim is a first year medical student who is obsessed with getting good grades in pre-clinical. Grades cause Tim anxiety. It causes him stress to think he might fail and flunk out or not match his top choice in residency. To combat this, he studies 4+ hours a day (his compulsion). It relieves his anxiety. Lots of medical students are like Tim. Now let's take Larry. Larry is a third year medical student who constantly thinks about stabbing patients in the eye with a pen. It causes him anxiety. To combat this he clicks his pen 10+ times to make sure it is retracted, then places it in his pocket and zips the pocket shut. Clearly, Larry is much further down the rabbit hole on the OCD spectrum than Tim. Society may also applaud Tim for studying so hard but would never applaud Larry for wanting to stab someone in the eye. Do you see the difference and why I can actually safely say a lot of medical students have these traits/disorders? The real question is: do they need treatment?

 

[Tenk]

This is not the case for all states. Some states ask about history.



No, I don't agree with that because it's misleading. A handful ask if you have ever been treated for mental health issues. Some ask if you have a diagnosis that could impair your work.



Just curious, what field of medicine do you practice? OCD and OCPD are not nearly the same thing. One is Axis I and one is Axis II. They're not on a spectrum. They're flat out different disorders.

That’s usually for hospitalizations or major disorders. Leave it blank. If someone magically comments on your OCD (hint: they won’t) you just say: oh I had mild OCD, I didn’t even consider that a problem. Shrug your shoulders. Move on.

 

[Tenk]

Question for both of you, and frankly anyone else reading this. In the paper I linked just above this, it states that residency directors may have a requirement to report any history of psychiatric treatment of the applicant to state licensure boards (most likely depending on state). There is no way that the residency/program director would know of any psychiatric treatment of mine unless I volunteered this information correct? Based on previous answers, I am venturing to guess the answer is no, but I just wanted to double check what you guys thought.

Correct. This is not applicable to you. This would be a resident who had a major melt down during residency or some BIG event that was so drastic the PD thought they may be unfit to practice. It would have to be something on the lines of a psychotic break or a major breech of professionalism (like snorting five lines of coke and missing a shift to go fight a bouncer at a strip club) to have this occur. In your case you would have to tell them to begin with and I’m pretty sure 999/1000 PDs would support you, not hinder you for this.

 

[Mass Effect]

Are you a psychiatrist?
OCD and OCPD are very 2 different and distinct disorders, that just so happen to have similar names, correct?
Type A personality doesn’t equal OCD an anxiety disorder or OCPD a personality disorder. Or have I been mislead all these years?
Sorry to derail the thread I just hate when people say "oh I really like things in order, I’m so OCD." No, that is not necessarily OCD. I think using medical terms correctly is important.

No worries for a derail. It's warranted when @Tenk is spreading misinformation with no regard for medical accuracy. You shouldn't portray yourself as a doctor on here and give advice with incorrect information. Thanks for calling him out.

Question for both of you, and frankly anyone else reading this. In the paper I linked just above this, it states that residency directors may have a requirement to report any history of psychiatric treatment of the applicant to state licensure boards (most likely depending on state). There is no way that the residency/program director would know of any psychiatric treatment of mine unless I volunteered this information correct? Based on previous answers, I am venturing to guess the answer is no, but I just wanted to double check what you guys thought.

That is correct that your PD has no way of knowing and PD don't generally ask. That said, if you're ever asked on a formal document, consult an attorney before you answer "no." These documents stick around and if it ever comes out that you weren't being truthful, you may be in a lot of trouble with your program and the medical board. OCD will never prevent you from being a physician.

I get to see all the crazies.

This right here diminishes any credibility you may have had (and in my view, you didn't really have any when you said OCD and OCPD were on a spectrum of the same disorder).

You missed my point. Technically to the DSM V, OCD and OCPD are two distinct entities but they are by no means mutually exclusive and a lot of people with OCD will have many OCPD traits just given the very nature of what they are. The main difference between the two is that one causes anxiety (OCD) while the other doesnt have to necessarily

Stop. Just. Stop. OCD doesn't CAUSE anxiety. OCD symptoms are the RESULT of anxiety. The above is like me saying nausea causes appendicitis. You don't know what you're talking about.

What I was trying to explain is that a lot of the traits you see in people with OCD and OCPD are common traits that are not only seen in physicians but are viewed as strong points. Let’s take hand washing. A very common concern for many patients with OCD. Physicians are encouraged to wash their hands all the time. While it may cause anxiety to the person, everyone else is going to perceive them as being a good physician.

What?

To put this another way let's make two examples: Tim and Larry. Tim is a first year medical student who is obsessed with getting good grades in pre-clinical. Grades cause Tim anxiety. It causes him stress to think he might fail and flunk out or not match his top choice in residency. To combat this, he studies 4+ hours a day (his compulsion). It relieves his anxiety. Lots of medical students are like Tim. Now let's take Larry. Larry is a third year medical student who constantly thinks about stabbing patients in the eye with a pen. It causes him anxiety. To combat this he clicks his pen 10+ times to make sure it is retracted, then places it in his pocket and zips the pocket shut. Clearly, Larry is much further down the rabbit hole on the OCD spectrum than Tim. Society may also applaud Tim for studying so hard but would never applaud Larry for wanting to stab someone in the eye. Do you see the difference and why I can actually safely say a lot of medical students have these traits/disorders?

No, because you are 100% wrong. They are not the same disorder. They are not on a spectrum. Turn off Dr. Oz and stop spreading wrong information.

 

[AMEHigh]

Question for both of you, and frankly anyone else reading this. In the paper I linked just above this, it states that residency directors may have a requirement to report any history of psychiatric treatment of the applicant to state licensure boards (most likely depending on state). There is no way that the residency/program director would know of any psychiatric treatment of mine unless I volunteered this information correct? Based on previous answers, I am venturing to guess the answer is no, but I just wanted to double check what you guys thought.

Unless your diagnosis is affecting your work and you’re put on a performance plan for example, then no your program doesn’t need to know your medical history/problems.

 

[flapjack3d]

Haven't read the other responses but if you're in med school, NOW is the time to take a little break from school and work on yourself. Your school will probably be very understanding. As long as you do a little research and get a publication or two, it will only be seen as a plus for residency apps. I know multiple people that are taking a year for these reasons and my school was totally fine with it.

 

[Mass Effect]

Haven't read the other responses but if you're in med school, NOW is the time to take a little break from school and work on yourself. Your school will probably be very understanding. As long as you do a little research and get a publication or two, it will only be seen as a plus for residency apps. I know multiple people that are taking a year for these reasons and my school was totally fine with it.

It really does pay to read the thread before replying.

 

[hamstergang]

When you compare physicians to the general population, many physicians will be more type A and have obsessions, probably less with compulsions. For most these traits probably help physicians function better (can monitor minute details and make sure things are not missed) so they aren’t viewed as a hinderence.

If there's no hinderence then there's no psychiatric diagnosis. We don't need to pathologize behaviors which aren't causing problems, and the DSM explicitly states as such.

 

[Tenk]

No worries for a derail. It's warranted when @Tenk is spreading misinformation with no regard for medical accuracy. You shouldn't portray yourself as a doctor on here and give advice with incorrect information. Thanks for calling him out.



That is correct that your PD has no way of knowing and PD don't generally ask. That said, if you're ever asked on a formal document, consult an attorney before you answer "no." These documents stick around and if it ever comes out that you weren't being truthful, you may be in a lot of trouble with your program and the medical board. OCD will never prevent you from being a physician.



This right here diminishes any credibility you may have had (and in my view, you didn't really have any when you said OCD and OCPD were on a spectrum of the same disorder).



Stop. Just. Stop. OCD doesn't CAUSE anxiety. OCD symptoms are the RESULT of anxiety. The above is like me saying nausea causes appendicitis. You don't know what you're talking about.



What?



No, because you are 100% wrong. They are not the same disorder. They are not on a spectrum. Turn off Dr. Oz and stop spreading wrong information.

This will be the last time I respond to you because you are being hostile and rude.

1. I never said OCD and OCPD are on the same spectrum. I said they share some common traits and can be found in the same person hence they are not mutually exclusive. I said psych diseases are all on a spectrum which meant their own spectrum, not one spectrum. This is why I’ve met schizophrenics who have jobs and schizophrenics who can’t even have a conversation. You interpreted what I said wrong. Go reread my posts I never stated what you said.

2. You are wrong. Open the DSM V:

Obsessions are defined in the DSM-5 by (1) and (2) as follows: [3]

Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance as intrusive and inappropriate, and that cause marked anxiety and distress.

Literally uses the word cause in the definition. Dunno how you missed that but happy to educate you.

3. I’m not 100% wrong but you’re 100% hostile. I’m sorry you didn’t understand my posts. Take care.

 

[Tenk]

If there's no hinderence then there's no psychiatric diagnosis. We don't need to pathologize behaviors which aren't causing problems, and the DSM explicitly states as such.

Nowhere in the DSM V definition of OCD does the word hinderence appear. It’s not a criteria for OCD. It just has to cause anxiety/distress. That doesn’t mean it hinders the individual. Plenty of high functioning individuals have OCD.

 

[Mass Effect]

This will be the last time I respond to you because you are being hostile and rude.

Yeah, that happens when someone spreads misinformation and calls psychiatric patients "crazies."

1. I never said OCD and OCPD are on the same spectrum. I said they share some common traits and can be found in the same person hence they are not mutually exclusive. I said psych diseases are all on a spectrum which meant their own spectrum, not one spectrum. This is why I’ve met schizophrenics who have jobs and schizophrenics who can’t even have a conversation. You interpreted what I said wrong. Go reread my posts I never stated what you said.

No one argued they were mutually exclusive. Of course someone people can have both, but this is uncommon (15 - 20%). Some people can have anxiety and antisocial personality. That doesn't make them the same thing or make it appropriate to make a blanket statement about them being present in most med student and justify that statement by saying the symptoms are similar. They're two different things.

2. You are wrong. Open the DSM V:

Obsessions are defined in the DSM-5 by (1) and (2) as follows: [3]

Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance as intrusive and inappropriate, and that cause marked anxiety and distress.

Literally uses the word cause in the definition. Dunno how you missed that but happy to educate you.

Speaking of hostile and rude...

I actually think you miscommunicated this in your reference about strong points of physicians and handwashing. The thoughts cause anxiety (which is why they engage in the behavior) and a symptom of the anxiety is the compulsions (i.e. handwashing).

 

[Mass Effect]

Nowhere in the DSM V definition of OCD does the word hinderence appear. It’s not a criteria for OCD. It just has to cause anxiety/distress. That doesn’t mean it hinders the individual. Plenty of high functioning individuals have OCD

Criteria B of OCD from DSM V:
"The obsessions or compulsions are time-consuming (e.g. take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."

Sounds like hindrance to me.

 

[ArteryStudyPainting]

I know my school's resources like tx, etc. is closely guarded and whoever you see for tx, they can never precept you as your their pt. Nor can they make it apparent as to why. Basically, some schools try to keep everything separate.

I'd call and ask, or see your health and wellness councilor. They can give you the legalities, steps, etc.

 

[siliso]

OCD is not a high stigma, high risk type condition where I’d really worry about being able to get a license or a residency. If you have to answer some unethical question about it, saying you are adequately treated and it hasn’t impacted your competence should be enough. If everyone who took SSRIs or saw a therapist couldn’t be a doctor, there’d be no psychiatrists at all and great shortage in many other fields. Better to get treatment so your problem does not impair your performance in future. BETTER TO GET TREATMENT ANYWAY - a friend of mine from med school avoided treatment for bipolar due to same fears and died by suicide. Do not let hypotheticals and possible futures deter you from getting medically necessary care, no matter what. You cross the bridge when you come to it.

I was treated for panic disorder in med school and felt no compunction at answering the licensing board question “do you have a condition that if untreated would impair your ability to practice competently” - no. Because it never did impair me occupationally, before or after treatment. My performance in work and classes was always more than adequate. I had physical and mental discomfort that bore treating, but not impairment. If I wanted to be truly scrupulous I would have to answer Yes not for the panic disorder but for myopia - if I couldn’t have glasses or contacts, ie was untreated, I would be impaired diagnostically. But that is stupid and it’s a stupid question anyway.