Disclosing medical problems: diabetes & SSRI?

[purplecricket]

Hi all,

I'm wondering about everyone's take on disclosing medical information. There are a couple things I'm very concerned about. I've said this before, but I am applying to SMPs this year and I'm sure they are going to ask what happened GPA-wise in undergrad, and what's changed. Problem was I was an undiagnosed diabetic freshman year and also suffered from GAD, so my grades weren't stellar until I got those under control. I started treating diabetes summer after freshman year and started taking SSRIs for the GAD at the end of junior year.

Here's the problem, I don't want to say that I'm a diabetic and am taking SSRIs if it's going to get me booted out automatically. Also, my grandmother told me that I would have problems even becoming licensed as a doctor since I do take SSRIs for my anxiety and I should pursue something else.

Help! Do I disclose or not? And is the SSRI thing true? 🙁

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[Gut Shot]

Hi all,

I'm wondering about everyone's take on disclosing medical information. There are a couple things I'm very concerned about. I've said this before, but I am applying to SMPs this year and I'm sure they are going to ask what happened GPA-wise in undergrad, and what's changed. Problem was I was an undiagnosed diabetic freshman year and also suffered from GAD, so my grades weren't stellar until I got those under control. I started treating diabetes summer after freshman year and started taking SSRIs for the GAD at the end of junior year.

Here's the problem, I don't want to say that I'm a diabetic and am taking SSRIs if it's going to get me booted out automatically. Also, my grandmother told me that I would have problems even becoming licensed as a doctor since I do take SSRIs for my anxiety and I should pursue something else.

Help! Do I disclose or not? And is the SSRI thing true? 🙁

Most (all?) medical schools have so-called technical standards, things you must be capable of doing/achieving in order to complete the curriculum. If you poke around online you can find the technical standards posted for various schools.

If you have some sort of illness or disability that requires accommodation to meet the technical standards (like being deaf and needing sign language interpreters), you will have to disclose a need for accommodation. Something like diabetes requires no accommodation by the school, so you don't have to disclose it. One of my classmates was diabetic and had an insulin pump, which was actually pretty cool.

A medical school could find itself in deep trouble if it gets busted discriminating against those with disabilities. See the Americans with Disabilities Act.

As for the SSRI issue, that's private medical information. I would invite you to visit the various state medical boards (list can be found here) and read some of their individual licensure application forms. The short version is that your GAD is only significant if it impairs your ability to complete your studies and perform your job. Keep it under control and you'll be fine.

If mental dysfunction were grounds for dismissal there wouldn't be anyone left in this field.

 

[Kadava Reviva]

Hi all,

I'm wondering about everyone's take on disclosing medical information. There are a couple things I'm very concerned about. I've said this before, but I am applying to SMPs this year and I'm sure they are going to ask what happened GPA-wise in undergrad, and what's changed. Problem was I was an undiagnosed diabetic freshman year and also suffered from GAD, so my grades weren't stellar until I got those under control. I started treating diabetes summer after freshman year and started taking SSRIs for the GAD at the end of junior year.

Here's the problem, I don't want to say that I'm a diabetic and am taking SSRIs if it's going to get me booted out automatically. Also, my grandmother told me that I would have problems even becoming licensed as a doctor since I do take SSRIs for my anxiety and I should pursue something else.

Help! Do I disclose or not? And is the SSRI thing true? 🙁

You would be surprised at the number of physicians who take SSRIs or other antidepressants. I must say I don't know much about US schools, but in Canada, I don't know of any schools asking for disclosure of such info. If you have a condition which is effectively treated and you are functioning normally, it shouldn't be an issue. Showing you overcame such odds may even help you as, in some schools, one of the subjects they give points for is having dealt with a significant illness. This is usually part of a secret list, so the candidates will be less likely to come up with some BS. Disclosing the info may also help explain a poor performance for a semester or year, providing the rest of your file is consistent. As I already said, I am not too familiar with US schools, but wouldn't be too surprised if similar criteria apply.

 

[MedPR]

Hi all,

I'm wondering about everyone's take on disclosing medical information. There are a couple things I'm very concerned about. I've said this before, but I am applying to SMPs this year and I'm sure they are going to ask what happened GPA-wise in undergrad, and what's changed. Problem was I was an undiagnosed diabetic freshman year and also suffered from GAD, so my grades weren't stellar until I got those under control. I started treating diabetes summer after freshman year and started taking SSRIs for the GAD at the end of junior year.

Here's the problem, I don't want to say that I'm a diabetic and am taking SSRIs if it's going to get me booted out automatically. Also, my grandmother told me that I would have problems even becoming licensed as a doctor since I do take SSRIs for my anxiety and I should pursue something else.

Help! Do I disclose or not? And is the SSRI thing true? 🙁

I've heard that dependence on certain drugs has a bit of stigma in the application process, but I don't know if there's any truth to it. I thought I had ADD for a while, but refused to get medicated for it because of this very reason. Turns out I don't have ADD.. or I somehow managed to control it without medication.

 

[TheMightySmiter]

I believe it is not a good idea to bring up mental health problems in your application. If you use it to explain poor grades, it often ends up sounding like an excuse. It's no problem to bring up your diabetes if it had a significant impact on your motivation to become a doctor.

 

[purplecricket]

Thanks everyone, I agree about not bringing up the GAD issue in the application process, I was just worried I wouldn't actually be able to get a license to practice if I had such an issue. :\ It is under very good control now that I am taking the SSRI for it, to the point where it's barely noticeable. So I wouldn't have to report this unless it's a big hindrance to my everyday life?

The diabetes was really the issue with grades early in undergrad (high BGs leading to sleeping and being groggy ALL the time, always sick, you know what I mean). But it is a big reason why I want to pursue a career in medicine. The good thing is there is a pretty obvious upswing in academic performance after I started controlling the sugars!

 

[mimelim]

Re: Diabetes
If its an important part of your pre-medical school history, then you should include it. It is no different than someone saying, "I broke my leg in HS, met this orthopedic surgeon and wanted to go to medical school to do what he does." If anything it will be more unique.

Re: GAD
If they ask, you have to disclose. Hiding it is not only wrong, but illegal. No matter what you think the significance of these conditions are, it is up to the school to decide. If they ask for that information, you have to give it to them. If they don't ask and you don't think its relevant, I would not mention it.

I can tell you that after applying to medical school and residency, that never once was asked or a part of an application. I was however surprised when I was applying for a state medical license that it did ask me about mental health issues and prescription drug use. It was not clear to me if this would have affected me getting the license, but the question was there. Most likely I would have simply had to fill out more paperwork, but I'm not sure.

 

[Gut Shot]

Thanks everyone, I agree about not bringing up the GAD issue in the application process, I was just worried I wouldn't actually be able to get a license to practice if I had such an issue. :\ It is under very good control now that I am taking the SSRI for it, to the point where it's barely noticeable. So I wouldn't have to report this unless it's a big hindrance to my everyday life?

It's a private issue until it's not private. Meaning unless it causes you to fail out of medical school, get terminated from residency, or become judged unfit to practice (as in following a psychiatric hospitalization or losing your job from gross dereliction of duties), then your condition is between you and your doctor.

 

[Gut Shot]

I was however surprised when I was applying for a state medical license that it did ask me about mental health issues and prescription drug use. It was not clear to me if this would have affected me getting the license, but the question was there. Most likely I would have simply had to fill out more paperwork, but I'm not sure.

Those questions are designed to flag the people with serious mental health and/or drug addiction issues. IIRC, most of the ask things like "Have you ever been hospitalized for psychiatric reasons?" "Do you currently abuse any legal or illegal drugs?" "Are you currently taking any prescription medications that will impair your ability to practice medicine?"

 

[mimelim]

Those questions are designed to flag the people with serious mental health and/or drug addiction issues. IIRC, most of the ask things like "Have you ever been hospitalized for psychiatric reasons?" "Do you currently abuse any legal or illegal drugs?" "Are you currently taking any prescription medications that will impair your ability to practice medicine?"

Thats what I would have thought as well, but no, this was specific and wanted to know if I had ever been diagnosed with ANY psychiatric illnesses or was taking prescription medication to treat any illness. When I read it, I was taken aback. I couldn't believe that they asked. The first thought I had was, this can't be legal, but its the state medical board, so maybe they are allowed to do it.

 

[mechengmed]

Should I disclose that I have epilepsy? My neurologist said that it shouldn't be an issue and one of his patients is a doctor that also has epilepsy.

 

[Gut Shot]

Thats what I would have thought as well, but no, this was specific and wanted to know if I had ever been diagnosed with ANY psychiatric illnesses or was taking prescription medication to treat any illness. When I read it, I was taken aback. I couldn't believe that they asked. The first thought I had was, this can't be legal, but its the state medical board, so maybe they are allowed to do it.

I actually think some of the questions posed by state medical boards could be tossed out in a court of law, but nobody ever challenges them. Who wants to "soften" the process for medical licensure?

The fact remains, tons of people in medicine have been on SSRIs at one point or another, and saying you were treated in college for GAD is about the wimpiest condition I can think of. That alone will prevent absolutely nobody from getting licensed.

 

[mimelim]

I actually think some of the questions posed by state medical boards could be tossed out in a court of law, but nobody ever challenges them. Who wants to "soften" the process for medical licensure?

The fact remains, tons of people in medicine have been on SSRIs at one point or another, and saying you were treated in college for GAD is about the wimpiest condition I can think of. That alone will prevent absolutely nobody from getting licensed.

👍 I agree.

 

[Floersh]

"If mental dysfunction were grounds for dismissal there wouldn't be anyone left in this field."
Heehee, brilliant 😀

 

[pietachok]

Should I disclose that I have epilepsy? My neurologist said that it shouldn't be an issue and one of his patients is a doctor that also has epilepsy.

Are you asking about disclosure during the application process?

If the epilepsy has not played a pivotal role (good or bad) in your path to becoming a physician, I would not mention it at all. If it has played a role, & you want to discuss it to explain your motivation or to explain away an academic history, you need to be careful. If it is truthful, you want to discuss it in a way that makes absolutely clear your epilepsy is well under control & is not expected to prevent you from succeeding in med school or as a physician. If that is not quite true you may not want to open the topic up for discussion at all. If you bring it up, you need to anticipate the questions it will raise, & formulate answers that convince people it's a non-issue or that you have maturely reflected upon how it will limit you. I will tell you that my mother (a teaching physician in well-regarded residency & fellowship programs) keeps her epilepsy secret from anybody who does not need to know.

Things to think about:
-some epilepsy is exacerbated by acute/chronic stress...can you do surgery safely? could you work in a swamped ER? will long hours of studying or work be a problem?

-some epilepsy medications alter mentation or motor skills -- will your performance on exams be hurt by aphasia (a problem if exams are open answer vs multiple choice)? will your communication with patients be compromised or make them uncomfortable (for instance if your affect seems unusual)? are you worried about a tremor affecting your safety in surgical skills, placing lines, other procedures, etc...? how about 15 years from now? have you thought about it in regards to what field you'll pursue?


...once you are admitted or enrolled may be a more appropriate time to bring it up with a Dean/advisor to discuss any concerns with your education or long-term career plans. Once you're a student, you're an investment they'll help succeed, & the scrutiny of the application process will turn to support.

 

[pietachok]

Thanks everyone, I agree about not bringing up the GAD issue in the application process, I was just worried I wouldn't actually be able to get a license to practice if I had such an issue. :\ It is under very good control now that I am taking the SSRI for it, to the point where it's barely noticeable. So I wouldn't have to report this unless it's a big hindrance to my everyday life?

The diabetes was really the issue with grades early in undergrad (high BGs leading to sleeping and being groggy ALL the time, always sick, you know what I mean). But it is a big reason why I want to pursue a career in medicine. The good thing is there is a pretty obvious upswing in academic performance after I started controlling the sugars!

I think you already realize this, but when discussing your DM, make sure you frame it positively. You want to raise as few concerns as possible that this will compromise your ability to succeed in med school or the SMP. Place emphasis on the contrast of how much easier it is to function now that you have a diagnosis & are under treatment. An SMP adcom may not view the DM as quite the asset I think some med schools could (I have a chronic illness & it comes up in *all* of my evaluations as something my instructors believe helps my empathy, etc.). An SMP might be more concerned still with the reputation of their own program & getting people into med school (certainly the case where I did my post Bacc)....although. they may not care about accepting people they don't believe will succeed, I'd get a firm grasp of how they handle students who have an obstacle that hurts them *during* the SMP -- just in case of the worst case scenario -- e.g. you want to know they wont permanently refuse to write you a committee letter if you get an incomplete(s) if you end up in the hospital at a pivotal time like finals week...some of these programs make a lot of $ by maintaining their reputation/success rates by effectively preventing their students with imperfect transcripts from ever applying to med school while affiliated with the SMP either by failing people out of the program on s regular basis or denying committee letters.

 

[jf1987]

Why not go to a psychologist and deal with the underlying issues that are causing your "GAD" ?

 

[purplecricket]

The fact remains, tons of people in medicine have been on SSRIs at one point or another, and saying you were treated in college for GAD is about the wimpiest condition I can think of. That alone will prevent absolutely nobody from getting licensed.

Haha that makes me feel a lot better! 🙂

 

[purplecricket]

Why not go to a psychologist and deal with the underlying issues that are causing your "GAD" ?

I do see a therapist for CBT in conjunction w/ the SSRI, which is probably why I don't even notice it anymore. I understand the need for both.

 

[purplecricket]

I'd get a firm grasp of how they handle students who have an obstacle that hurts them *during* the SMP -- just in case of the worst case scenario -- e.g. you want to know they wont permanently refuse to write you a committee letter if you get an incomplete(s) if you end up in the hospital at a pivotal time like finals week...some of these programs make a lot of $ by maintaining their reputation/success rates by effectively preventing their students with imperfect transcripts from ever applying to med school while affiliated with the SMP either by failing people out of the program on s regular basis or denying committee letters.

WOW, I had no idea that was an issue! Perhaps it would be a good idea not to bring up the diabetes at all? 😱

 

[CPIstan]

Hi all,

I'm wondering about everyone's take on disclosing medical information. There are a couple things I'm very concerned about. I've said this before, but I am applying to SMPs this year and I'm sure they are going to ask what happened GPA-wise in undergrad, and what's changed. Problem was I was an undiagnosed diabetic freshman year and also suffered from GAD, so my grades weren't stellar until I got those under control. I started treating diabetes summer after freshman year and started taking SSRIs for the GAD at the end of junior year.

Here's the problem, I don't want to say that I'm a diabetic and am taking SSRIs if it's going to get me booted out automatically. Also, my grandmother told me that I would have problems even becoming licensed as a doctor since I do take SSRIs for my anxiety and I should pursue something else.

Help! Do I disclose or not? And is the SSRI thing true? 🙁

How'd you get the diabeetus? Are you overweight? Or is it type 1?