Chances for entering psychiatry

[remainsteady]

---

Members don't see this ad.

Hello. I live with Bipolar Disorder Type One, and years ago, I had a manic episode during medical school. I critiqued my institution during my episode (this did not violate any school policies. I did not violate any school policies during my manic episode) and my medical school retaliated and dismissed me from medical school. Multiple attorney's believe my school's actions are discriminatory. I would like to become a child and adolescent psychiatrist to become the help I wish I had when I was younger. I think my life experiences would be helpful to patients in this field. I am considering heading to the Caribbean and applying into psychiatry through the carribean. Based on the fact that I have been dismissed for non-academic and professional reasons (my school said I did not meet technical standards), does anyone think I have a shot at entering a psychiatry residency program? Thank you.

 

[Stagg737]

Essentially zero. Being an IMG in psych would already hurt your odds. A Step failure would be an auto-rejection at most programs. Being excused from med school is a kiss of death. To be blunt, someone dismissed from medical school would not be considered where I’m at.

I would say to have any chance you would need to be able to legally show you were wrongfully dismissed and then complete med school, then have a program be willing to take a chance on you. Keep in mind, it is likely you’ll have to disclose why you had to go through this ordeal. However, without getting the dismissal reversed I don’t see any chance of a psych program offering an interview.

 

[remainsteady]

Essentially zero. Being an IMG in psych would already hurt your odds. A Step failure would be an auto-rejection at most programs. Being excused from med school is a kiss of death. To be blunt, someone dismissed from medical school would not be considered where I’m at.

Regardless of the reason?

 

[Stagg737]

Regardless of the reason?

Updated above, but no. We get hundreds of applicants for <10 positions and obvious red flags are the easiest and typically fairest way to narrow down interviews. Psych has gotten more competitive and we typically only accept 1 FMG/IMG per year, all of whom had very solid apps with no red flags. Applicants from our home program (which is quite large) frequently don’t match here.

Like I said, you’d need to be able to show the dismissal was inappropriate, then pass boards and graduate, then have a compelling explanation for everything, and then find a program sympathetic enough to take a chance on you. Is it possible? Sure. Is this actually realistic in psych? Probably not.

 

[littlefred]

Why not apply to nursing school and then become a psych NP?

I think it's your best chance to do what you dream of.

 

[TexasPhysician]

Let’s walk through the obstacles. You can likely get into a for-profit medical school in the Caribbean. Even if you do wonderful there, you have large red flags.

While I don’t recall the exact wording, the standard residency application asks things like:

Were there any delays in completing medical school?
Have you ever had any professional misconduct?
Any academic misconduct?

Even if you won a lawsuit, the time issue could still get you.

Many residency programs filter out these applications and never actually look at them. Omitting past events would be grounds for termination.

Assuming you overcome these hurdles without any mental health set-backs, board licensing could be a problem. It isn’t appropriate to go into detail about your medical history here, but every medical board that I’ve applied too asks something like:

Do you have medical or mental health conditions that could adversely impact your ability to treat patients safely? This could also stop you.

In summary, you are looking at a significant time and financial expenditure that has low odds of paying off. In the absence of already being very wealthy, I’d be considering the next best career path. Anything is possible, but the risks outweigh the rewards here in my opinion.

 

[remainsteady]

Let’s walk through the obstacles. You can likely get into a for-profit medical school in the Caribbean. Even if you do wonderful there, you have large red flags.

While I don’t recall the exact wording, the standard residency application asks things like:

Were there any delays in completing medical school?
Have you ever had any professional misconduct?
Any academic misconduct?

Even if you won a lawsuit, the time issue could still get you.

Many residency programs filter out these applications and never actually look at them. Omitting past events would be grounds for termination.

Assuming you overcome these hurdles without any mental health set-backs, board licensing could be a problem. It isn’t appropriate to go into detail about your medical history here, but every medical board that I’ve applied too asks something like:

Do you have medical or mental health conditions that could adversely impact your ability to treat patients safely? This could also stop you.

In summary, you are looking at a significant time and financial expenditure that has low odds of paying off. In the absence of already being very wealthy, I’d be considering the next best career path. Anything is possible, but the risks outweigh the rewards here in my opinion.

Thank you for this reply and taking the time to reply. I’ve spoken with physicians with bipolar disorder and they’ve advised me to join a physician monitoring group. I have no issue being transparent and being monitored. I understand what you’re saying in your post and I appreciate the advise at the end. It hurts, but thank you

 

[comp1]

You're not a physician yet, so I'm unclear how a physician monitoring program would be of assistance (or even available). The issue is not you having bipolar disorder. Bipolar disorder is very treatable and there are many professionals with it. The issue for you is the medical school dismissal, particularly as it is formally described as being for technical inability. I am quite concerned about you going to the Caribbean. They probably would take your money, but this could risk hundreds of thousands of dollars in debt and still not meet your goal, even assuming you finished. There are hundreds of AMGs each year who fail to match into psych. Your goal of helping people is admirable and is certainly shared by the vast majority of physicians. However, med school, for whatever reason, did not work out for you. I would second the others who have said you might consider an alternative. There are many ways to work in mental health other than as a psychiatrist. A direct entry PMHNP (or PA) is one with much less of a debt risk, but there are also MFT, LCSW, PsyD, etc.

 

[J ROD]

You would likely get into a Caribbean medical school but not get a residency spot. The medical school dismissal from a US MD school is a death blow. One thing that is not mentioned in medicine is if you have medical issues they will do their best to get you out. I have seen folks dismissed from medical school and residency with medical issues. Like sharks in the water waiting on a paper cut. Much easier to become a PA. Still see patients and do what you mentioned. We are all "providers" in the end anyway.

 

[calvinhobbes]

Do not go to the Caribbean for the love of god. So many hurdles. It was an okay option maybe 25 years ago. It became more difficult to obtain a residency spot 10 years ago. Now it’s extremely difficult unless you’re okay with FM and even that’s not guaranteed. Psych is competitive these days. Only consider medical school in the US, either MD or DO. There are more MD schools, more DO schools, not enough residency spots to keep up the pace with all the graduates. You will be making the biggest financial mistake of your life if you graduate a Caribbean medical school and don’t match into residency. Even being a top applicant for residency and graduating from the “best schools” like SGU or Ross isn’t a guarantee for peds psych IM FM OB gas or surgery as it was 15 years ago, because there are so many more US students applying.

 

[remainsteady]

Do not go to the Caribbean for the love of god. So many hurdles. It was an okay option maybe 25 years ago. It became more difficult to obtain a residency spot 10 years ago. Now it’s extremely difficult unless you’re okay with FM and even that’s not guaranteed. Psych is competitive these days. Only consider medical school in the US, either MD or DO. There are more MD schools, more DO schools, not enough residency spots to keep up the pace with all the graduates. You will be making the biggest financial mistake of your life if you graduate a Caribbean medical school and don’t match into residency. Even being a top applicant for residency and graduating from the “best schools” like SGU or Ross isn’t a guarantee for peds psych IM FM OB gas or surgery as it was 15 years ago, because there are so many more US students applying.

Okay. Thank you for your reply.

 

[eforest]

You’re taking on a huge financial risk. I had 250 k in loans. Even with a well paying job this has been extremely stressful. I will not be done paying until I’m 50.

If you get into medical school again- you will incur a large amount of debt- unless you are independently wealthy. If you go off shore there is zero guarantee that you will match and find a job.

Consider getting a degree in psych or social work and serving as a therapist. Consider becoming an NP or PA.

I'm not the crazy one...

This includes the life and times of a bipolar MD. The blog was started when I was in medical school- the previous title was Highs and Lows Bipolar in Medical School. I'm changing the focus of the blog but keeping old posts

bipolarinmedschool.blogspot.com

 

[Merovinge]

Time to decide how dedicated you are to the goal (and make sure you have a good psychiatrist managing your condition) and in order of difficulty:
1) Reapply US/DO schools in the states and come up with a way to answer why you got dismissed
2) PA/NP school
3) Social work/masters level therapist

Option 4) of a totally different career is also entirely reasonable.

Notice there is no option 5 of going to a Caribbean school.

 

[FlowRate]

Why not apply to nursing school and then become a psych NP?

I think it's your best chance to do what you dream of.

Honestly not a bad suggestion for OP, if he or she then went on to work in an inpatient facility with full supervision from a reasonably good psychiatrist for a few years after. I imagine PA schools, being more choosy, would probably also screen out for prior med school dismissal.

 

[remainsteady]

You would likely get into a Caribbean medical school but not get a residency spot. The medical school dismissal from a US MD school is a death blow. One thing that is not mentioned in medicine is if you have medical issues they will do their best to get you out. I have seen folks dismissed from medical school and residency with medical issues. Like sharks in the water waiting on a paper cut. Much easier to become a PA. Still see patients and do what you mentioned. We are all "providers" in the end anyway.

The attorneys that I’ve consulted with have stated the decision to dismiss me is discriminatory because they treated my disability as behavioral issue instead of a medical one and they stated I am a threat to the campus community because of my condition. Honest to God. Is it still a kiss of death when considered me unable to be a doctor because of my condition and dismissed me?

 

[comp1]

Right now you literally only have the opinion of an attorney who works for you. Further, medical conditions CAN prevent someone from practicing medicine. Check the state medical board report of any state each quarter and you'll see dozens of people whose medical licenses were suspended or revoked due to medical conditions. You'll also see them revoked for "behavioral" issues, but it's certainly not like the ADA allows everyone to practice medicine. The technical inability is actually a specific area where the school is allowed to discriminate by statute. Regardless, psychiatry is competitive and no residency applicant board has to explain to anyone why they ranked you where they did.

 

[J ROD]

The attorneys that I’ve consulted with have stated the decision to dismiss me is discriminatory because they treated my disability as behavioral issue instead of a medical one and they stated I am a threat to the campus community because of my condition. Honest to God. Is it still a kiss of death when considered me unable to be a doctor because of my condition and dismissed me?

One thing to believe it or even know it. Harder thing to prove in court. We all have said you are basically going to waste time and money. Unless you go the legal route and can get the dismissal removed and hopefully they would have to allow you to continue.

 

[comp1]

If you could get a court to force them to reinstate you, you might have some chance, although you would still have to explain the lapse in training to residencies and it would remain a significant barrier. It'd be a heck of a lot better than the Caribbean. I do not, of course, actually believe you could get a court to do so. If your attorney is willing to take you on as a contingency, might as well try. If your attorney is asking for money up front, do NOT progress as they also do not believe in your case and are just fleecing you.

 

[Stagg737]

One thing to believe it or even know it. Harder thing to prove in court. We all have said you are basically going to waste time and money. Unless you go the legal route and can get the dismissal removed and hopefully they would have to allow you to continue.

If you can’t complete medical school no residency will consider you in any field. If you can’t get this decision reversed, it’s extremely unlikely any other legitimate school will accept you. Even if they do and you graduate, you’ll have to explain the dismissal which may but most likely will not be seen with sympathy. The situation sucks and is unfair if it’s as you describe, but with how many other great applicants get turned away at each step you would have to be extremely compelling to get multiple people to take a chance on you.

Bottom line is you need to get this decision reversed if you want a shot at becoming a physician. Otherwise it’s likely best to cut your losses and see if there are other paths you can pursue to reach your goals. I agree that I would NOT recommend the Caribbean route, but if you can’t complete medical truly graduate maybe you have a chance at some residency somewhere, but it will almost certainly not be in psychiatry. Best of luck with whatever path you choose.

 

[Celexa]

I agree that your chances of obtaining a residency and so close to zero that the non zero chance is essentially equivalent to being hit twice by lightning and surviving.

Even if you hadn't--i have treated a lot of high functioning bipolar patients. I have treated bipolar physicians. Bipolar 1 is a particularly bad diagnosis to try and get through residency with because even in psych, you will need to deal with significant sleep deprivation and erratic schedules. It is a perfect set up for decompensation. Even well treated, closely monitored bipolar can unravel easily in those circumstances. You would have to offer an explanation for your unusual timeline, which means you would need to be truthful; application committees dislike uncertainty sometimes more than red flags. Do not waste time or money trying to finish medical school.

I disagree slightly with the advice to go the NP route. I think thats a pretty good way to end up constantly reminded about things in the past you cant change. I would look seriously at becoming a therapist, possibly a PhD or psyd. It would still let you work in mental health at a high level of expertise, but outside the direct medical provider hierarchy, and I've never heard of a psychologist having to be in the hospital overnight.

 

[Merovinge]

I agree that your chances of obtaining a residency and so close to zero that the non zero chance is essentially equivalent to being hit twice by lightning and surviving.

Even if you hadn't--i have treated a lot of high functioning bipolar patients. I have treated bipolar physicians. Bipolar 1 is a particularly bad diagnosis to try and get through residency with because even in psych, you will need to deal with significant sleep deprivation and erratic schedules. It is a perfect set up for decompensation. Even well treated, closely monitored bipolar can unravel easily in those circumstances. You would have to offer an explanation for your unusual timeline, which means you would need to be truthful; application committees dislike uncertainty sometimes more than red flags. Do not waste time or money trying to finish medical school.

I disagree slightly with the advice to go the NP route. I think thats a pretty good way to end up constantly reminded about things in the past you cant change. I would look seriously at becoming a therapist, possibly a PhD or psyd. It would still let you work in mental health at a high level of expertise, but outside the direct medical provider hierarchy, and I've never heard of a psychologist having to be in the hospital overnight.

That's a really good point. Someone capable of getting into a US MD school would be cognitively equipped for a PhD program, would definitely depend on the undergrad and previous interest in psychology/research methodology (even clinical psychology requires a heavy amount of schooling in research methodology). I would be weary of all but the best PsyD programs which are often for-profit models designed to pump out doctorate degrees like DNP locations.

 

[clausewitz2]

That's a really good point. Someone capable of getting into a US MD school would be cognitively equipped for a PhD program, would definitely depend on the undergrad and previous interest in psychology/research methodology (even clinical psychology requires a heavy amount of schooling in research methodology). I would be weary of all but the best PsyD programs which are often for-profit models designed to pump out doctorate degrees like DNP locations.

Reputable clinical psychology doctoral programs are not appreciably less selective than US medical schools, as our psychologist colleagues can tell you. This is not a good backup option. The programs that OP would have a very easy time getting into are exactly the ones you'd want to steer clear of.

 

[comp1]

So I adore psychologists and what they do. I'm definitely aware of the massive training variations (I host predoctoral trainees from many different schools), but the adjective reputable is carrying a lot of weight in the comment above. In terms of employment in a mental health career of some sort, the OP is a heck of a lot more likely to be successful through pretty much any route other than the being an IMG MD.

 

[Merovinge]

Reputable clinical psychology doctoral programs are not appreciably less selective than US medical schools, as our psychologist colleagues can tell you. This is not a good backup option. The programs that OP would have a very easy time getting into are exactly the ones you'd want to steer clear of.

That's exactly what I am saying. They are absolutely in a similar tier of selectiveness which is why it would be reasonable for them to go that pathway if there undergrad or interests aligned. It's not a backup, they were accepted already to a US MD school and enrolled.

 

[clausewitz2]

That's exactly what I am saying. They are absolutely in a similar tier of selectiveness which is why it would be reasonable for them to go that pathway if there undergrad or interests aligned. It's not a backup, they were accepted already to a US MD school and enrolled.

I hear you, I'm just pointing out that being accepted to a US MD school does not mean they are competitive for those slots.