Going to med school with a service dog?

[hopefullydoc117]

Not sure about service dogs but have some knowledge regarding ADA, accomodations, and long shifts in M3 and M4. Some folks have it in their letter of accommodation (LOA) that they need a 12-hour break in between shifts. I've also seen folks who have break times incorporated in their LOA, for example, 30 minutes of break after 6 hours of work. Usually, because of the ADA and your university's disability office guiding this, clerkship directors and admin are pretty understanding of it. And, since the disability office guides this, they have a list of reasonable accommodations or might reach out to other colleagues to navigate it.

Now realistically, it might affect perception and grades on a day-to-day level. Obviously not fair, and ableism exists in all fields including medicine. But, just being honest. A lot also depends on team dynamics. And, the onus still falls on the student to have to ask to leave if the day is running super long. You will need to get very comfortable saying "I need X, because of my accommodations" because teams change frequently. I have some invisible chronic conditions, and I often find it hard to ask for things that I am technically granted in my LOA. Also, for example, certain fields like surgery were pretty easily out of question for me due to the physical demands.

Oh forgot to add, I've heard of proposed solutions by admin that an 8-week rotation (with only 1 day off) could be extended to 10 (and so forth) weeks if a student needs 2 days off every week.

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[JDWannabe]

I'm so thankful for you! Yes my goal is to do family medicine. I love the way you foster a community with your patients. Yes, I think when I write about my adversary essay I'll tackle how I've managed my disability through the years. It's certainly been a struggle but I have a wonderful care team that has made me appreciate medicine and the way providers can positively influence a patient's life.
I'm sorry to hear you had a tough time in residency. You're super amazing and I look up to you!

You keep writing adversary instead of adversity. I feel as if this may be an elaborate trolling event here.

 

[candbgirl]

You keep writing adversary instead of adversity. I feel as if this may be an elaborate trolling event here.

I’ve thought this too. Especially since OPs dad is a physician and a brother is a M4. Surely OP should be getting advice and support from two of the people that know him best and know thoroughly what’s involved in attending med school successfully and moving on to residency and starting a professional career.

 

[TragicalDrFaust]

Just something I think needs to be said - I have a mental illness and I made it through OMS-1 and 2 ok. Starting OMS-3 soon. I often had multiple jobs at a time before med school so I don’t anticipate it being difficult to adjust to the rotation schedule. Certainly most students who drop out are struggling with mental or physical health issues. But there are at least some of us who are doing fine and the health issues don’t come up because we never have to document them as the reason for multiple failures or taking a LOA.

Realistically my symptoms affect my ability to perform in school and I’m a below average student. But I pass my classes and have no concerns about finishing med school and beginning my career.

 

[Browns99]

Yeah I've heard crazy stuff from my brother about his rotations. But I'm not sure what the other option is in that I can't obviously work hours longer than 12 or it triggers an episode and I'll probably have to be hospitalized. I really hope I can though, since that would be equivalent to asking a walking-impaired person to go a stretch without their cane. For a day or two it's probably doable but in the long run ultimately unsustainable. Do you happen to know if your friend's schoo has disability accomodations?

Not trying to be cruel, but did you think this through....If you can't work hours longer than 12, you are going to have a lot of problems getting through residency. Please seek counseling and be aware of what is in store moving forward. Having a disability is not going to give you a pass on meeting standards required to become a physician. Sure, accommodations should be readily available to you, but only within reason, you have to meet the standard in order to be able to provide adequate care as a doctor.

 

[meow1985]

Not trying to be cruel, but did you think this through....If you can't work hours longer than 12, you are going to have a lot of problems getting through residency. Please seek counseling and be aware of what is in store moving forward. Having a disability is not going to give you a pass on meeting standards required to become a physician. Sure, accommodations should be readily available to you, but only within reason, you have to meet the standard in order to be able to provide adequate care as a doctor.

This is me hijacking the thread a bit to soapbox, but honestly, it’s the “standards” that are the problem in medicine, not that some people cannot meet them. This is not about just about having a disability. No one should be required to work shifts longer than 16 hours, ever, and even 12 is pushing it. Pilots and nurses are not allows to do that, because of liability and error risk after being awake for too long. It’s a grave failure on the medical field’s part that this does not apply to doctors who carry extensive responsibility. Trust me, hardly anyone is providing “adequate care” when exhausted, so patients are only harmed by this. There is nothing to be learned or gained by the person doing the long shift either, except maybe how to manage distress.

If I were a residency director I would not demand or even allow people to work those kinds of shifts. There is a beautiful thing called night float, where people take turns working nights for a week, and more residencies should use it.

In my residency, we unfortunately had 24 hour call but sometimes people split them—one person did day and the other night. It was not common but the admin did not care as long as someone was there to do the work.

 

[orthodoc64]

Hey guys! Hope everyone is doing well.
Question is what it says on the tin. I have an invisible disability I was hospitalized for a couple years ago and since then we got my service dog. She's amazing and professionally trained of course, and she's integral to my functioning. She's really saved my life a couple of times.
My question is how do I apply for med school and all that with a servie dog? I'm really nervous about being discriminated against, even though I know it's illegal under the ADA, it's never stopped people before from disrespecting us or anything like that.
How would interviews and accomodations work?
Thanks guys so much! Please be kind :')

Many medical school clinical rotations will take place in areas where service dogs cannot be(surgery). The best plan would be to talk with individual medical schools to see what they have for accommodations.

 

[OchemOficionado]

Many medical school clinical rotations will take place in areas where service dogs cannot be(surgery). The best plan would be to talk with individual medical schools to see what they have for accommodations.

Surgery is one rotation. What are the many rotations that take place in areas service dogs can't be?

(EDIT: found some answers on the post I linked below ("SICU, med storage rooms, immunocompromised patient's room, pt is uncomfortable with having a dog in the room") These aren’t specific to another rotation though so what rotations were you thinking of?

Also, OP of that thread said service dogs are allowed in the OR if "gowned", but goes on to say they wouldn't make their dog do that. Another poster said dogs are allowed in their hospitals SICU/ICU so I guess it's institution dependent.

OP, you may have seen this but here is a AMA thread from a med student a few years ago with a service dog.

 

[THEBACKANDFORTH]

I'm a new psychiatry resident. I have a sleep disorder that made med school more difficult, and I do see it as a disability, but I never sought accommodation because of stigma of having accommodations that made me appear different than my classmates. I powered through (not saying this is right) and had some miserable days.

I'm sympathetic to your situation and believe a service dog might be possible at some institutions, but difficult and highly unusual regardless. It's a matter of fact that you will face a lot more stigma if this service dog is primarily for mental health and not a more medical condition--like seizures or impaired vision. I would recommend you seek out a free consultation with a disabilities lawyer to get better information on what is required--I do not believe that most people in this thread truly know what they are talking about from a legal perspective (including me).

I also think (opinion) you will have luck at more liberal institutions away from the east coast or the south. Also I want to re-iterate that if you can't do more than a 12 hour shift you might have very real difficulties in med school. There were some people in my class who really came in with a victim mindset regarding their mental health issues, and they inevitably failed out. Mental health and health issues making life more difficult are very real, people are differently abled, but it is ultimately up to you to power through the obstacles in your path. Good luck whatever you decide.

 

[meow1985]

This is me hijacking the thread a bit to soapbox, but honestly, it’s the “standards” that are the problem in medicine, not that some people cannot meet them. This is not about just about having a disability. No one should be required to work shifts longer than 16 hours, ever, and even 12 is pushing it. Pilots and nurses are not allows to do that, because of liability and error risk after being awake for too long. It’s a grave failure on the medical field’s part that this does not apply to doctors who carry extensive responsibility. Trust me, hardly anyone is providing “adequate care” when exhausted, so patients are only harmed by this. There is nothing to be learned or gained by the person doing the long shift either, except maybe how to manage distress.

If I were a residency director I would not demand or even allow people to work those kinds of shifts. There is a beautiful thing called night float, where people take turns working nights for a week, and more residencies should use it.

In my residency, we unfortunately had 24 hour call but sometimes people split them—one person did day and the other night. It was not common but the admin did not care as long as someone was there to do the work.

Also, the only remotely rational explanation I’ve ever gotten for why doctors need to work long shifts is because handoffs are where balls get dropped, so reducing shift changes reduces room for error due to inadequate knowledge of a case. But working to the point of being half brain dead is hardly good for error risk also.

The other explanation I’ve heard is “well, when you are an attending you will be expected to take call and cover nights.” But first of all, far from every attending is required to be work a clinic day and then go galloping from patient to patient in the hospital all night (hello, residency call system). They may get the occasional phone call or page, and more importantly they get a CHOICE. Plenty of attendings do not take call. Second of all, if we eliminated long shifts as a concept or came up with better call coverage systems maybe we would not have to train residents for that scenario. Ok, thread hijacking done.

Tl;dr working long shifts has nothing whatsoever to do with capacity to provide adequate care, quite the opposite.

 

[Browns99]

Also, the only remotely rational explanation I’ve ever gotten for why doctors need to work long shifts is because handoffs are where balls get dropped, so reducing shift changes reduces room for error due to inadequate knowledge of a case. But working to the point of being half brain dead is hardly good for error risk also.

The other explanation I’ve heard is “well, when you are an attending you will be expected to take call and cover nights.” But first of all, far from every attending is required to be work a clinic day and then go galloping from patient to patient in the hospital all night (hello, residency call system). They may get the occasional phone call or page, and more importantly they get a CHOICE. Plenty of attendings do not take call. Second of all, if we eliminated long shifts as a concept or came up with better call coverage systems maybe we would not have to train residents for that scenario. Ok, thread hijacking done.

Tl;dr working long shifts has nothing whatsoever to do with capacity to provide adequate care, quite the opposite.

You're missing the point completely......The issue is not about long hours per se and I agree with you, however it is what is required in today's medicine and as such, the OP if not a troll, will be in for a difficult ride if he/she can't do it, that's what my point was.

And you are equating standards with long hours....no, the point of mentioning of standards is that, because you have a disability does not mean that you should be given a pass, whether it's not having to put the required time in training or anything else that would affect your ability to adequately learn how to treat patients, then you cannot become a physician, period.

This post should not digress in what should or should not be, i.e., resident working too many hours, etc., and that is what your response was.

 

[StressedBiClown]

Other than your inability to work more than 12 hours (which is alarming since you said you'd to be hospitalized - that's a whole other conversation that I'm not equipped to take on), the only difference I see between you needing a service dog and me needing medication is I can take my meds in the privacy of a bathroom or my home where no one can see me take them. Of course, having a dog around takes up "space" like my pill bottles do not, but if your dog is properly trained as a service animal I don't see how that would be a problem. I guess I just don't understand why it would be any different than a student needing a wheelchair on occasion, other than the obvious things like bringing a live animal into the OR or similar. I'm surprised at some the responses since mental health is such an important thing and maintaining it during med school is crucial to success, and you already know what you need as far as care. I assume you are also probably followed regularly, which is more than I can say for most of the folks I attend classes with. I do wish you the best in your journey regardless of what you choose to do. We certainly need more folks in medicine who have personal, daily experiences with disabilities.

 

[voxveritatisetlucis]

Of course, having a dog around takes up "space" like my pill bottles do not, but if your dog is properly trained as a service animal I don't see how that would be a problem. I guess I just don't understand why it would be any different than a student needing a wheelchair on occasion, other than the obvious things like bringing a live

Don’t hospitals forbid cologne/perfume because it’s an allergant/asthma catalyst. Presumably dog hair would be even worse than these for patients with respiratory conditions

 

[StressedBiClown]

Don’t hospitals forbid cologne/perfume because it’s an allergant/asthma catalyst. Presumably dog hair would be even worse than these for patients with respiratory conditions

This goes along with my "other than the obvious things like bringing a live animal into the OR or similar."

 

[OchemOficionado]

Don’t hospitals forbid cologne/perfume because it’s an allergant/asthma catalyst. Presumably dog hair would be even worse than these for patients with respiratory conditions

Easy to avoid those rooms if dog hair is truly a concern. I'm sure in the same way that hospital therapy dogs avoid similar areas.