Bipolar I and med school

[Package Guy]

I was recently diagnosed with bipolar I disorder in June 2022. I was pre-med in undergrad (BA Biochemistry) and have a pre-med postbacc under my belt (MS in Biomedical Science). I am not the typical pre-med; non-traditional student 31 YO. I check ALL of the boxes except MCAT (two <50% attempts). Got the grades, research, volunteering, patient care experience, everything. Didn't do a typical postabacc either, it was at an academic med center/med school and we took the MS 1 curriculum for our coursework (gross anatomy, systems physiology, neuroanatomy, medical genetics, bioethics, case based learning, clinical pharmacology).

Is it possible to get through the rigors of medical school and residency with a bipolar I diagnosis? Assuming I can get in. Assuming I smash the MCAT on the third attempt.

Right now I am controlled under medications (3). I have bipolar I with psychotic features so I have criminal history from my manic episodes that may need to be addressed from an admissions perspective. I understand that arrest records never go away. I have experts I can defer to on this at my graduate school or on the SDN confidential admissions forums. All charges have been dismissed (4 misdemeanors), except two current felony indictments that are being litigated presently. I am pretty sure felony convictions would keep you from getting a medical license and DEA license. Is that true?

My outpatient psychiatrist (MD) says it isn't possible to do med school because the stress can cause you to go manic or sleep deprivation doing overnight shifts or call. I don't know enough of the science to know definitely. I also don't understand how much overnight shifts or call you have to do as a med student. As a resident, I understand that it is specialty dependent. I am sure some people have done it. One of the psychiatrists at an in-patient unit I was in said it was possible to do.

Do I give up on the dream of becoming a physician and move onto something else or is it possible to do?

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[Sushirolls]

Sleep disruption is real.
Medical school is a wall that hits some/most people and not as easy as prior education. I recall being exhausted doing 15 hour days, and waking at 3-4AM before a morning to test to cram even more. Several years of 'suck.'
Medical school depends on rotation and school, but surgery rotations you will be exhausted and burning the candle at both ends.
Residency intern year will be bad most everything. Except perhaps pathology residency.

Sleep disruptions are real, and their impact on people without known mental health diagnoses are notable - but a legit Bipolar I, poses a heck of an uphill battle.

Let's say you proceed, you venture forward, and bam, mania/involuntary/consequences pops up in med school? or Residency? and either lead to dropping out? can you handle that debt burden?

What is it about physician/medical school do you want? Truly what is it?

*The only thing worse than working med 40+ hours is being a parent... no catch up days. Or active duty military in thick of battle, being awake days.

 

[TexasPhysician]

Felonies can make it hard to get and maintain a license. Many medical boards may also require you to report bipolar disorder that could theoretically impair your ability to practice medicine. Insight into knowing you are manic and ceasing medical care is generally not good.

 

[comp1]

You're asking about generalities from people who know absolutely none of your specifics, but you already have a clinician who actually knows you. Rely on your own medical providers and if you want a second opinion from a different provider, get it. Of course some people with bipolar disorder have completed med school and residency. Some people with practically anything have. The question is about you, not some mythical average person with bipolar disorder. In terms of medical licensure, that's a legal issue. It depends on the state in question and the specific crimes accused/convicted of. Drug related crimes make it much, much harder in general, but it's state specific.

 

[Crayola227]

It's technically not impossible, but severity is key. How many episodes have you had? What were the triggers?

Bipolar 2, and bipolar 1 without any psychotic episodes, history of being well controlled on meds and history of somewhat mild episodes, would be easier. If your main challenges are depression you cope well with, and mild hypomania would be one thing. That bipolar 1 diagnosis means your up was mania, not hypomania (which by definition means no psychosis, often people can cope with milder forms of hypomania, retain insight, seek elevated care).

But it sounds like this is all much newer for you, and your issues are not mild depressions or mild hypomania.

Also what meds you are on plays a big role. It's easier to do all nighters on say lithium or aripiprazole than it is say quetiapine, depending on your sedation side effects. Quetiapine can cause word finding issues that can make presentations, writing notes, and overall medical communication challenging. But that's pretty minor. The point is that side effects are real and play a role. Needing to "calibrate" meds while training is difficult.

The bigger issue is, will medical training challenges lead you to need to decrease or d/c meds to try to keep up? This pressure, doing so, and wild decompensation is a pretty common theme for many with bipolar especially in medicine or other challenging careers where sleep, sedation or other side effects is an issue.

Even on meds, stress/lack of sleep can lead to decompensation. Even with a history of "how things work for you," things can always change and past performance is no perfect predictor of the future of your illness.

I'll be real with you. The fact that when you decompensate you decompensate to the level of psychosis/loss of touch with reality, and to the level of multiple crimes/legal issues/even felonies...

This is your life. Nothing is more important than your life. Nothing. There is no job in the world besides if you went to battle in a draft where your job is more important. If you don't protect your life, what your job is, is irrelevant. I have a lot to say about the sacredness and importance of medicine as a calling and not a job. But -

End of the day, there are MANY occupations where you can find meaning, fulfillment, a touch of prestige/respect, make a decent living. And many of them will be safer for you.

Others have brought up debt and also risk to others, which are also very important things to consider in the risk/cost to you if things go sideways.

Frankly, you got lucky. Episodes like these are a complete loss of control. Meds and other management are aimed at preventing that from happening again. But do not mistake that for control, and do not think, oh hey, if I go off the rails/start to go off the rails again, we'll just crank up the antipsychotics again and I'll come back. That's generally the case but there are no guarantees. And even if that would be the case, people get themselves killed in all manner of ways from bipolar 1. It really is one of the more deadly psych diagnoses, heck, it's one of the top killers of people who are otherwise physically pretty healthy. You can't keep yourself from getting yourself killed during an episode.

I'll give you a bad analogy. Recently came down with asthma. Was pretty busy, had a couple attacks, and went on my way. Couldn't get seen by a doctor for 3 months. Thought, OK, get an inhaler then. Then had another attack, and it didn't go away right away when I removed myself from the trigger. Realized, wtf am I actually doing??? You know, by definition I literally have zero control of these airways and what they are doing. They could just seize up and I can't just "breathe" them open, and then I'll die. So I had to go to a lot of trouble but I got an inhaler that night.

I think if training changed substantially it might be different. You could pursue med school and they may be able to accommodate you, to that end, it would help you to be open about the diagnosis although obviously there are downsides to that. But that won’t necessarily be the case for training. I know of one IM program that once upon a time had zero 24 hour shifts guaranteed during intern year/rest of residency, that's it. Still have nightfloat and have a month of having to switch to nights. Which is probably less dangerous/could be done than programs with weekly 36 hour shifts etc.

So you would need to be prepared to work with an MD and ZERO residency training, meaning NO medical license. Don't underestimate the suckitude of that, especially in light of debt. That really limits your options, and frankly if you're not going to work with patients then why bother, unless you just really really want that for research or other health careers.

This just isn't a good bet, and it's not worth your life. Please don't be under any illusions that the stakes are any lower than that.

When you are younger and less experienced and more idealistic, you think your life should only unfold one way, and even when the chips stack against you... you think there's only one way to be happy, one job for you, etc etc. But it's a job. You wouldn't risk your life to pump gas, frankly there's no reason to do it to get an MD.

ETA: the above poster is correct, but I think we can still offer perspectives on the general risks, and insight into what challenges training poses overall.

 

[FlowRate]

Well, assuming this thread will probably get locked/closed/moved, but sounds like you have some very compelling reasons to choose PA school over med school.

 

[Crayola227]

Yeah should say this is not medical advice for the OP. I'm just mouthing off about what I know of others with bipolar illness that went into medicine, general issues with bipolar, and my perspective, my personal opinion about the risks inherent for any hypothetical person with bipolar or going into medicine. This is not meant to be specific advice and I'm just taking the hypothetical person who has BPAD 1, psychosis, on meds, who committed crimes during an episode. And frankly without many of those specifics what I have to say is my opinion for a lot of folks with chronic mental illness especially potential for acute decompensation that could be expected to be quite severe.

 

[splik]

I know quite a few bipolar friends who are physicians and also treated many physicians with bipolar disorder. Sometimes people have their first manic episode in med school or residency, so in some ways, it may be a good thing to be already diagnosed and treated. The idea that people cannot get through medschool if they have bipolar or another serious mental illness is ableist nonsense and it is unfortunate that psychiatrists still have this stigma. This is not to say that med school does not have the risk of destabilizing your moods. I have treated bipolar physicians and med students who have attempted suicide or been hospitalized. It was almost never the stress of medicine though sometimes lack of sleep from long hours was a trigger for a first manic episode.

Also, you always check "no" to any questions about mental illness on licensing applications. It is none of their business and they aren't allowed to ask (unless you are truly impaired - which is a different issue altogether). I am a consultant for our state medical board and nothing good ever comes from self-reporting. They will assume you are impaired if you check "yes" and you won't get a full license. If, at a later date, they do find out you have bipolar (which usually means something has happened), you can point them to the APA and AMA's position statements on this and they will usually STFU because they know their questions are illegal.

 

[Package Guy]

Well, assuming this thread will probably get locked/closed/moved, but sounds like you have some very compelling reasons to choose PA school over med school.

I have the grades, theoretically I could do PA, physical therapy (DPT), or dental school. None of those have residency or call as far as I know. I took a job after grad school doing clinical research. I could be happy doing that and move up the ranks to managerial level roles or work in a startup. I have also looked at doing medical sales/medical device (without 24/7 call). Or I could do something completely different. I could be happy, I am just having a hard time with the sunk cost of pursuing med school for so long and doing a very competitive masters.

It's technically not impossible, but severity is key. How many episodes have you had? What were the triggers?

I had one hypomanic episode in December 2021. Mild and no law breaking. My insight was still there somewhat. I had my first manic episode in April 2022 that resulted in the 4 misdemeanor arrests. Last summer (July 2023) I decompensated due to heat exhaustion and stress as I was working at the airport in the summer heat. We also were switching meds and I was on a short acting antipsychotic geodon W/O an adjunct (lamotrigine). I was an idiot and went off the lamotrigine when the physician wanted me on it with the antipsychotic too. The geodon F'ed me up because it made me more susceptible to heat illness, NMS, etc. I wasn't 100% sure BPAD I was the correct diagnosis after the first manic episode so I flirted several times by going off meds temporarily. The second episode confirmed the dx indefinitely.

Even on meds, stress/lack of sleep can lead to decompensation. Even with a history of "how things work for you," things can always change and past performance is no perfect predictor of the future of your illness.

I'll be real with you. The fact that when you decompensate you decompensate to the level of psychosis/loss of touch with reality, and to the level of multiple crimes/legal issues/even felonies...

This is your life. Nothing is more important than your life. Nothing. There is no job in the world besides if you went to battle in a draft where your job is more important. If you don't protect your life, what your job is, is irrelevant. I have a lot to say about the sacredness and importance of medicine as a calling and not a job. But -

End of the day, there are MANY occupations where you can find meaning, fulfillment, a touch of prestige/respect, make a decent living. And many of them will be safer for you.

Others have brought up debt and also risk to others, which are also very important things to consider in the risk/cost to you if things go sideways.

Frankly, you got lucky. Episodes like these are a complete loss of control. Meds and other management are aimed at preventing that from happening again. But do not mistake that for control, and do not think, oh hey, if I go off the rails/start to go off the rails again, we'll just crank up the antipsychotics again and I'll come back. That's generally the case but there are no guarantees. And even if that would be the case, people get themselves killed in all manner of ways from bipolar 1. It really is one of the more deadly psych diagnoses, heck, it's one of the top killers of people who are otherwise physically pretty healthy. You can't keep yourself from getting yourself killed during an episode.

I think I am still coming to terms with all of this. What the diagnosis means and what changes I have to make in my life. It isn't a death sentence but it can be if I decompensate again. Last episode I eloped from the hospital twice and thank God I was found by the cops both times. I could have been hit by a car or found dead somewhere in a ditch on the side of the road. I could have been shot by police during any of the arrests. In jail I "assaulted" (swung) at a guard. Really crummy stuff. I think I need to rebuild my life and come out of this before I think about going back to any sort of school, but medicine as a calling just nags at me. Haunts me really. I think I would have made a really good doctor. If this is the final nail in the coffin for medical school at least I tried. That's why I wanted to post and get the opinion of subject matter experts on my dx. I love medicine. I feel like I am losing a part of myself that I won't ever be able to get back.

But I could do other things. Unfortunately this ended my marriage so I had a divorce to deal with last year. I have three kids. I am beginning to date again and look for stable employment. Those two things alone will probably scratch the itch that I have as far as finding fulfillment. Started lifting weights again and am exercising more. Finding someone that won't bail on me just because I have bipolar will be important. Ex-wife flaked out and was a coward and wouldn't help or sympathize. Right now as I come out of all of this it is all still very surreal. I have medical debt to deal with as I had a suspected NSTEMI hospitalization at the end of my last manic episode (actually was demand ischemia on review by my cardiologist).

Again, finding the right woman in my life and finding a great job will probably allow me to move on from medicine however difficult it may be. But it is a big void to fill. It seems like a chasm right now. Everything went wrong all at once.

 

[Celexa]

I know quite a few bipolar friends who are physicians and also treated many physicians with bipolar disorder. Sometimes people have their first manic episode in med school or residency, so in some ways, it may be a good thing to be already diagnosed and treated. The idea that people cannot get through medschool if they have bipolar or another serious mental illness is ableist nonsense and it is unfortunate that psychiatrists still have this stigma. This is not to say that med school does not have the risk of destabilizing your moods. I have treated bipolar physicians and med students who have attempted suicide or been hospitalized. It was almost never the stress of medicine though sometimes lack of sleep from long hours was a trigger for a first manic episode.

Also, you always check "no" to any questions about mental illness on licensing applications. It is none of their business and they aren't allowed to ask (unless you are truly impaired - which is a different issue altogether). I am a consultant for our state medical board and nothing good ever comes from self-reporting. They will assume you are impaired if you check "yes" and you won't get a full license. If, at a later date, they do find out you have bipolar (which usually means something has happened), you can point them to the APA and AMA's position statements on this and they will usually STFU because they know their questions are illegal.

I'm not sure it's fair to assume the OPs psychiatrist is gives the same advice to everyone with bipolar disorder. I worked in a bipolar specialty clinic in residency with a very experienced attending. Our patients ran the gamut from SMI to extremely high functioning--including physicians. There are a LOT of points working against going to medical school being a good idea for the OP besides just that he has bipolar disorder in what he shared here and the psychiatrist is likely privy to more.

 

[Stagg737]

I'm not sure it's fair to assume the OPs psychiatrist is gives the same advice to everyone with bipolar disorder. I worked in a bipolar specialty clinic in residency with a very experienced attending. Our patients ran the gamut from SMI to extremely high functioning--including physicians. There are a LOT of points working against going to medical school being a good idea for the OP besides just that he has bipolar disorder in what he shared here and the psychiatrist is likely privy to more.

Agree with this. Not all bipolar patients experience the same levels of severity or frequency of symptoms. I’ve treated at least 4 medical students who had a manic episode in med school (3 of them first break). They ranged in severity from probably didn’t require inpatient admission to lucky to be alive/not spending 20+ years in prison with the latter being expelled from med school during their 3rd year (for good reason). In all cases, the “stress of medicine” was some form of contributing factor (whether direct or just leading to significant sleep disturbance).

It’s certainly possible to become a physician if one has bipolar disorder, but it does add a potentially very dangerous risk to a process that already sucks a lot for most people. Having (potential) felony charges is going to be a huge hurdle, possibly insurmountable.

To the OP, is it specifically treating patients that makes you want to be a physician or are there other aspects of the science that you really enjoy? There are tons of areas of research that are far less taxing and have far more reasonable physical requirements/demands that could be potential paths. There are a lot of areas of research where you could interact directly with patients as well. You could definitely leverage that master’s experience to pursue some of these roles. I also did a masters before med school and several of my classmates did that instead of med school.

 

[Package Guy]

It’s certainly possible to become a physician if one has bipolar disorder, but it does add a potentially very dangerous risk to a process that already sucks a lot for most people. Having (potential) felony charges is going to be a huge hurdle, possibly insurmountable.

Heard this last week from a close friend who is an ED attending physician; that med school is hard for most people who are healthy at baseline. Even if everything goes right in the process it is hard. I have hurdles that other people don't have. I think a felony conviction will be the final nail in the coffin for med school. Don't think it will happen but I am preparing for the worst. My lawyer thinks we have a good case and the worst I will get is a deferred prosecution agreement, pled down to misdemeanor charges and/or probation.

To the OP, is it specifically treating patients that makes you want to be a physician or are there other aspects of the science that you really enjoy? There are tons of areas of research that are far less taxing and have far more reasonable physical requirements/demands that could be potential paths. There are a lot of areas of research where you could interact directly with patients as well. You could definitely leverage that master’s experience to pursue some of these roles. I also did a masters before med school and several of my classmates did that instead of med school.

I really enjoy treating patients. I have patient care experience in outpatient physical therapy as a physical therapy aide. At that time the scope of practice was wider and we could massage and perform modalities at will. I really enjoy the medical sciences. Not sure I want to teach. Never done it. I really enjoyed my research job because I was tasked with study startup from inception. We were developing protocols from research proposals, testing ideas, working with statisticians (epidemiologists), and doing feasibility reviews. Kind of like paralegal work, I was drafting and writing documents for the MDs and PhDs. I am really high in openness and I am really creative. I might be too creative for medicine with all the rules to follow and legalities. I don't think I want a PhD. I don't think that in-depth. I am neurodivergent and high functioning autistic (IQ +115). There are great opportunities in research and even direct patient interaction in research but again I need to get the legal issues squared away before those can become a possibility for me too.

Meds sales also has roles where patient interaction occurs more often. But I checked with an expert and he said med sales won't take me until my records are expunged (3 years minimum). Might be the same for research once I get down to interviewing for roles.

 

[Package Guy]

Let's say you proceed, you venture forward, and bam, mania/involuntary/consequences pops up in med school? or Residency? and either lead to dropping out? can you handle that debt burden?

I come from an affluent family so I can deal somewhat with some debt burden. But I have to choose my battles carefully. I already have consumer debt and medical debt around 70K and job prospects aren't great with my criminal background.

What is it about physician/medical school do you want? Truly what is it?

I had a parent with T1D and had multiple organ transplants, dialysis, the whole nine yards. I think being a physician is the greatest job in the world. I saw it first hand. They gave my mom extra years of life. Of course there were unsung heroes in the background, nurses, case workers, etc. but I got to see everything the physicians did and it piqued my interest. I thought it was the coolest thing. It has felt like a calling for me. Can't explain it.

 

[mistafab]

Just throwing in there that PhD clinical psychologists see many similar patients to us - albeit without using medications.

That training does not require night call generally, nor day/night flipping. Another plus is integration of research into the clinical work, with potential for straight clinicianship, vs more academic roles.

If I had bipolar I and enjoyed research / had a background, I would deeply consider that - especially given the lack of needing debt to complete those funded programs.

 

[Celexa]

Just throwing in there that PhD clinical psychologists see many similar patients to us - albeit without using medications.

That training does not require night call generally, nor day/night flipping. Another plus is integration of research into the clinical work, with potential for straight clinicianship, vs more academic roles.

If I had bipolar I and enjoyed research / had a background, I would deeply consider that - especially given the lack of needing debt to complete those funded programs.

This is an excellent point. The OP mentioned a PT background; rehab psychology could be a great fit for him.

 

[Package Guy]

Just throwing in there that PhD clinical psychologists see many similar patients to us - albeit without using medications.

That training does not require night call generally, nor day/night flipping. Another plus is integration of research into the clinical work, with potential for straight clinicianship, vs more academic roles.

If I had bipolar I and enjoyed research / had a background, I would deeply consider that - especially given the lack of needing debt to complete those funded programs.

I am looking at the option to do clinical psychology as well as the others mentioned above. I just don't know if clinical psychology will be exciting enough for me. In an ideal world I could probably be a good psychiatrist, not a great one. Lots of sitting. I wanted to do general surgery residency when I was looking at med school before bipolar set in. I like to work with my hands and on my feet. PT is boring to me but I could do it if I had no other options. I just don't like the pay, which is low for a doctorate. I could go to dental school assuming my criminal cases get dismissed (and they overlook it) and that I can crush the DAT. I had major maxillofacial surgery (LeForte III osteotomy & genioplasty) a few years ago and it was interesting to me. Could help me scratch the itch of wanting to do general surgery without the call.

I just don't know if oral and maxillofacial surgery residencies have call or not. Seems to me most procedures/surgeries are daytime in the office or hospital for cosmetic cases. I am sure there are some trauma reconstruction cases though. I will check the dental forum to see and check with friends who are dentists.

 

[claypigeon]

It’s more likely someone makes it through med school with a bipolar 1 background than they get in with two failed MCAT scores. Add the criminal background and you have some many cards stacked against future you practicing as a physician. Sorry to say that as not doing great on a pass fail test or having a criminal background for something out of your control at the time which you now have control over shouldn’t cut one off from being a physician.

 

[Celexa]

I just don't know if oral and maxillofacial surgery residencies have call or not. Seems to me most procedures/surgeries are daytime in the office or hospital for cosmetic cases. I am sure there are some trauma reconstruction cases though. I will check the dental forum to see and check with friends who are dentists.

They have call. The structure of the programs can vary but I know of one where they have call while they are on medical school clerkships . So even worse than normal medical school!

 

[mistafab]

I am looking at the option to do clinical psychology as well as the others mentioned above. I just don't know if clinical psychology will be exciting enough for me. In an ideal world I could probably be a good psychiatrist, not a great one. Lots of sitting. I wanted to do general surgery residency when I was looking at med school before bipolar set in. I like to work with my hands and on my feet. PT is boring to me but I could do it if I had no other options. I just don't like the pay, which is low for a doctorate. I could go to dental school assuming my criminal cases get dismissed (and they overlook it) and that I can crush the DAT. I had major maxillofacial surgery (LeForte III osteotomy & genioplasty) a few years ago and it was interesting to me. Could help me scratch the itch of wanting to do general surgery without the call.

I just don't know if oral and maxillofacial surgery residencies have call or not. Seems to me most procedures/surgeries are daytime in the office or hospital for cosmetic cases. I am sure there are some trauma reconstruction cases though. I will check the dental forum to see and check with friends who are dentists.

OMFS is extremely grueling. It’s a surgical specialty, all of which have immense call and workload - in addition to dental training. I would take all surgical specialties off the table.

To be honest I would just toss away MD as an option. Too high risk that even if you get in, you’ll be unable to complete or practice. If bp1 had instead hit during MD school it might be different. However, if you haven’t started yet I recommend against medicine in general.

Best of luck. There are plenty of great jobs out there that ROI excellently and let you use your hands. You’ll find something great for you.

 

[whopper]

Adding to all of the above, if you admit you have Bipolar Disorder, and applications will ask you if you have a mental illness, you are supposed to answer honestly.

Despite that programs aren't supposed to discrminate against you for a controlled health problem, many of them will. You'll never be able to prove it unless they admit it to your face, and they won't.

While in medschool, your stress will be pushed to the limit, and you will have your circadian rhythm severely pushed which are both major factors for relapse even if you're on a treatment regimen that works in usual situations. Medical school-the stress of failing out with extreme debt, working over 100 hours a week, and sometimes not sleeping at all for over 24 hours a few times a week are chronic realities. Not just a temporary thing that will go on for a few weeks.

 

[Dantes]

Unfortunately regardless of medical history, if you end up with a felony conviction that's going to be a non-starter for admission.

 

[shoomer]

Going to echo what others above have said in terms of pursuing medical school is probably not worth it. Even for the average person, I'm hesitant to recommend med school and provide cautious guidance. But bipolar with severe mania (psychosis, felony charges) poses a very high risk if decompensation were to occur and your concerns about the ramifications of a felony conviction are well-founded.

You could maybe get accepted into a med school, maybe survive the grind of pre-clinicals, maybe pass step 1+2, maybe do well on rotations, then still not get into any residency program. Or you might even do that but then not get licensing approval.

You have other possible career choices that are of interest to you, so I would pursue those instead. This romanticized view of medicine as a "calling" falsely puts it on a pedestal, when it's far from the only profession that helps people and is interesting.

 

[Splenda88]

You have other possible career choices that are of interest to you, so I would pursue those instead. This romanticized view of medicine as a "calling" falsely puts it on a pedestal, when it's far from the only profession that helps people and is interesting.

Blame those TV dramas.

Blame the public who somehow think we are different.

I would advise OP to stay away from medicine in no uncertain terms.

 

[annoyedpsychiatrist]

Some people with bipolar disorder may be able to successfully make it through medical school. Your situation is very high risk. You have kids, significant life stress, private debt and very significant past episodes. Med school will likely severely exacerbate that stress. Also the felony charges could complicate things. Im sure youre a very intelligent person and have the intellectual capability but dont put a price on your mental health, I promise you its not worth it. Be very objective with yourself in regards to what you want to do, and what is least likely to be a breaking point for you.

 

[Crayola227]

Some people with bipolar disorder may be able to successfully make it through medical school. Your situation is very high risk. You have kids, significant life stress, private debt and very significant past episodes. Med school will likely severely exacerbate that stress. Also the felony charges could complicate things. Im sure youre a very intelligent person and have the intellectual capability but dont put a price on your mental health, I promise you its not worth it. Be very objective with yourself in regards to what you want to do, and what is least likely to be a breaking point for you.

Yeah somehow I missed the part about kids. I didn't have my one daughter until after med school/training. Imho that puts an entirely different pricetag/risk on pursuing a career in medicine. That's not to say people with kids shouldn't go through training. I'm saying it raises the stakes on what further severe bipolar episodes can do. I don't even drive the way I used to now having a child. I know we talk all the time about people with psychosis and violence and stereotypes, so this is not what I am getting at. But even if you don't put them directly in danger, there is always the hardship episodes put on children, and what it is to lose a parent.

 

[annoyedpsychiatrist]

Yeah somehow I missed the part about kids. I didn't have my one daughter until after med school/training. Imho that puts an entirely different pricetag/risk on pursuing a career in medicine. That's not to say people with kids shouldn't go through training. I'm saying it raises the stakes on what further severe bipolar episodes can do. I don't even drive the way I used to now having a child. I know we talk all the time about people with psychosis and violence and stereotypes, so this is not what I am getting at. But even if you don't put them directly in danger, there is always the hardship episodes put on children, and what it is to lose a parent.

for sure. I can only imagine the stress that many parents have with wanting to be the ideal parent and the fear of failure. Medical school already causes insecurity and doubt, coupled with the stress of trying to be a good parent, manage financial concerns, etc. When I started medical school I really had no obligations such as kids, family, pets, etc and even then I was still stressed at many points and experienced self doubt. Tbh I dont think I would have made it to where I am today if I had to juggle extra stress that others have to deal with, while doing med school

 

[Merovinge]

Yeah somehow I missed the part about kids. I didn't have my one daughter until after med school/training. Imho that puts an entirely different pricetag/risk on pursuing a career in medicine. That's not to say people with kids shouldn't go through training. I'm saying it raises the stakes on what further severe bipolar episodes can do. I don't even drive the way I used to now having a child. I know we talk all the time about people with psychosis and violence and stereotypes, so this is not what I am getting at. But even if you don't put them directly in danger, there is always the hardship episodes put on children, and what it is to lose a parent.

I (foolishly) bought a 2 door convertible my first year as an attending (in cash before anyone gets on that) and using it to transport my daughter around in eco mode all the time is a far cry from what I was expecting when I made the purchase. She does fit fairly well with the front seat forward but I think it's time for a sedan soon...

 

[FlowRate]

I (foolishly) bought a 2 door convertible my first year as an attending (in cash before anyone gets on that) and using it to transport my daughter around in eco mode all the time is a far cry from what I was expecting when I made the purchase. She does fit fairly well with the front seat forward but I think it's time for a sedan soon...

New M5 touring?? (I wish I had the income to be able to justify buying something like that new--or even lightly used--to myself.)

 

[Merovinge]

View attachment 380877

New M5 touring?? (I wish I had the income to be able to justify buying something like that new--or even lightly used--to myself.)

Think I'm going EV moving forward, hard to go back to combustion after feeling the power of EVs.

 

[FlowRate]

Think I'm going EV moving forward, hard to go back to combustion after feeling the power of EVs.

Fair enough. I think PHEV's are the sustainable wave of the future, at least until we get a new battery technology that's not reliant on highly constrained resources like lithium, but EV's certainly sound like fun, especially in the acceleration department.

 

[mistafab]

Forget EVs.


I’m going classic for an attending car. Something from 1955-1978. Ballpark 30k. Candy paint. New engine. Daily driver.

 

[Crayola227]

I (foolishly) bought a 2 door convertible my first year as an attending (in cash before anyone gets on that) and using it to transport my daughter around in eco mode all the time is a far cry from what I was expecting when I made the purchase. She does fit fairly well with the front seat forward but I think it's time for a sedan soon...

Lol yes I was more thinking about how I drive much more cautiously than before, and I hate to use stereotypes but I shouldn't be surprised that many men are struck by how fatherhood affects their choice of car 🤣

All around kids change how you drive 😅

 

[RespectTheChemistry]

I find myself wishing for a hybrid or electric with idling in the pick-up line waiting for the kids to be released. It wastes gas just sitting there. (I don't have a kid this old, but I used to do after-school care and picked him up from school.)

 

[whopper]

IMHO EVs are still in the phase where just a few years from now the one you got will be a POC compared to the one's in the near future. E.g. I got a Prius an was going to get the first one that could operate completely on battery mode. The range was something like 10 miles. Then just a year or two later it went up to something like 100 miles. I held off on getting the ones that could operate on full-battery.

EVs are getting there, but still have some time before I'm willing to buy one.

 

[comp1]

I want a PHEV. I hate gas stations, but I need to drive more than 250 miles at a time a couple of times a year and adding an extra hour to charge on that drive is horrible.

 

[Candidate2017]

I'll be real with you. The fact that when you decompensate you decompensate to the level of psychosis/loss of touch with reality, and to the level of multiple crimes/legal issues/even felonies...

Mania/psychosis resulting in arrests, assault, felonies, hospital elopement, divorce, cardiac issues. Plus "autism"...

Anecdotally, I only know of one physician with bipolar. But who knows if that diagnosis is accurate. As far as I know, all of my patients with bipolar have lower occupational functioning than prior to their diagnosis. As with any chronic med condition, even if treated, relapses are generally the norm.

Well, assuming this thread will probably get locked/closed/moved, but sounds like you have some very compelling reasons to choose PA school over med school.

All fields that involve direct patient treatment require licensing, so I assume the same issues would pop up.

p.s. I notice this thread is moving toward cars, a favorite tangential topic here. Now there needs to be a post about pay, midlevels, etc.

 

[clausewitz2]

There are many car threads as it stands, let's try and keep discussion to things more germane to OP's question.

 

[FlowRate]

All fields that involve direct patient treatment require licensing, so I assume the same issues would pop up.

p.s. I notice this thread is moving toward cars, a favorite tangential topic here. Now there needs to be a post about pay, midlevels, etc.

Those same issues might, but having to do residency or taking on med-school level of debt and time commitment would not. My impression is that even their clinical rotations are likely less intense (did a good number of overnights as a med student.)

 

[tr]

Fair enough. I think PHEV's are the sustainable wave of the future, at least until we get a new battery technology that's not reliant on highly constrained resources like lithium

Not to worry. The world's largest lithium seam was recently discovered in the PNW.

The U.S. may have the largest known lithium deposit in the world

McDermitt Caldera straddles the border of Oregon and Nevada. It may be the site of a new "white gold" rush.

bigthink.com

Good news for battery users and sufferers of bipolar disorder alike.

 

[tr]

I want a PHEV. I hate gas stations, but I need to drive more than 250 miles at a time a couple of times a year and adding an extra hour to charge on that drive is horrible.

My 2018 Tesla Model 3 still gets 300 miles on a full charge. And wouldn't you stop for a meal at least once in a 5h drive?

 

[Celexa]

My 2018 Tesla Model 3 still gets 300 miles on a full charge. And wouldn't you stop for a meal at least once in a 5h drive?

Lol I can't speak for the person you're responding too but my personal limit for solo drives in a single day is 10 hours and 'stopping for a meal' consists of McDonald's drive through, eating in the parking lot, running in to use the restroom and immediately getting back on the road. Can't yet do that on full electric.

 

[tr]

Lol I can't speak for the person you're responding too but my personal limit for solo drives in a single day is 10 hours and 'stopping for a meal' consists of McDonald's drive through, eating in the parking lot, running in to use the restroom and immediately getting back on the road. Can't yet do that on full electric.

Gee, that sounds nauseating.

Anyway, technically you could pull that off if you stop at a Supercharger (15 minutes to add 200 miles, 24-38 min to full if starting from completely depleted - I doubt you could get your food, finish eating, and also use the restroom in less time), but there could be an availability issue with those depending on where you are driving.

 

[Celexa]

Gee, that sounds nauseating.

Anyway, technically you could pull that off if you stop at a Supercharger (15 minutes to add 200 miles, 24-38 min to full if starting from completely depleted - I doubt you could get your food, finish eating, and also use the restroom in less time), but there could be an availability issue with those depending on where you are driving.

It's not pleasant but often better than the alternatives, especially when driving through large stretches of the middle of nowhere. We had a 20 min lunch period in middle school (including getting to the cafeteria, buying food if necessary, eating, and getting back to class) which left me with a lifelong habit of being able to finish nearly any meal in <10 mins. I don't spend more than 15 mins off the highway per stop, unless McDonald's has a line

 

[clausewitz2]

Seems like we have pretty well exhausted the OP's question given the return to cars.