Help on Why I want to be a Doctor (Controversial)

[rambosmith912]

Hi Everybody,

This is a throwaway account because this topic is a little sensitive. I have an interview coming up and I have been going through the standard preparation for it. The only question that I have been hesitant on is why I wanted to become a doctor. My reason was that 8 years ago in the 8th grade, due to crappy things going on and not thinking clearly, I attempted suicide. It is something I regret ever having done, and I have moved on with a much more positive outlook on life. However, it was the time that I spent in the hospital following my attempt and the ways that the doctor helped me that inspired me to go into medicine. My experience is also why I volunteer at a Suicide prevention hotline as well. I am not the best writer, so I avoided talking about it on my personal statement, however, I feel that I can convey the emotion of how the event shaped my desire to go into medicine and the positive things that I have done since then in the interview. So should I be honest about what inspired me to go into medicine, especially since the incident was over 8 years ago, or should I state my reasons in more vague terms?
Thank you for any advice

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[Cornfed101]

Unfortunately, mental health problems still carry a stigma. Don't mention that you attempted suicide, but don't be vague in your reasons for "why medicine?' You need to just pick a follow-up experience for why you are pursuing medicine. That shouldn't be hard to do if you have been getting clinical exposure and medicine is really your passion.

 

[Bonne Nuit]

I'm so happy you're in a better place now OP, and congratulations on your interview. I agree with the others - directly discussing your suicide attempt is just too personal for a medical school interview.

You might instead say something like "I went through a period of health problems in childhood, which I fortunately overcame by the time I was in high school. The kindness with which my doctors treated me afforded my family and me great comfort during a scary time in our lives. It was this compassion that inspired me to pursue medicine" etc. Focus on how the physicians behaved towards you/your family, not your specific diagnosis. It's unlikely the interviewers will pry into your health history if you keep it vague.

If you're asked to discuss your current suicide prevention outreach work, you can talk about your commitment to helping others in crisis, and how rewarding it is for you, then reflect on how this has prepared you for medicine. No need to tie this to your past.

Best of luck!

 

[LizzyM]

Why do you want to be a doctor?
Do you want to help people who are sick feel better?
Do you want to be a hero to people who are sick?
Do you want to figure out what is wrong and try to fix it?
Do you want to have a career that combines an interest in science with a practical application?


Dig deep into why after what you've been through you want a career in medicine. Your own health history doesn't need to be the starting point. You aren't going to be a doctor to treat yourself so why do you want to be one? Really dig into what motivates you and why you'd get up in the morning (or the middle of the night) to do this work.

 

[Moko]

Do not mention this. If my school learned an applicant had previously attempted suicide, there is no chance of that student getting accepted. I would have serious reservations about accepting anyone with severe mental health disorders. I am glad that you have made significant strides in your recovery, but unfortunately, this is not information that should ever be volunteered in the application (unless required to do so).

The times that I have seen mental health disorders being leveraged positively were in those with mild forms, strong academics, no personal impairments (academic, social, etc), and significant commitment to others suffering from similar diseases. More often than not though, it ends up hurting applicants, so the decision to discuss one's mental health should be done very thoughtfully and with restraint and tact. Just my thoughts

 

[OrthoTraumaMD]

I'm so happy you're in a better place now OP, and congratulations on your interview. I agree with the others - directly discussing your suicide attempt is just too personal for a medical school interview.

You might instead say something like "I went through a period of health problems in childhood, which I fortunately overcame by the time I was in high school. The kindness with which my doctors treated me afforded my family and me great comfort during a scary time in our lives. It was this compassion that inspired me to pursue medicine" etc. Focus on how the physicians behaved towards you/your family, not your specific diagnosis. It's unlikely the interviewers will pry into your health history if you keep it vague.

If you're asked to discuss your current suicide prevention outreach work, you can talk about your commitment to helping others in crisis, and how rewarding it is for you, then reflect on how this has prepared you for medicine. No need to tie this to your past.

Best of luck!

This is a great way of putting it.
As someone who has a long acquaintance with mental health issues— do NOT mention your suicide attempt. The school, like it or not, will see it as a liability.

 

[DNAJB6]

Medical school admissions committees will use this information against you. I recall reading an article a couple of years ago about a medical student who was told point blank that if she had revealed issues with depression the school would not write her a favorable recommendation for residency. In the future, medical schools and residency directors will absolutely hold it against you no matter how unfair it may be. Instead of answering from your perspective, reframe it from the perspective of someone else. Mention being ill as a child and seeing another child who had attempted suicide in the ER. Alternatively write as if it was about a close relative. Use that fictitious individual as a surrogate for you. I usually advocate complete honesty, but in this case, I encourage you to lie your butt off if necessary. You don't owe them anything.

This thread also brings up an interesting topic. It amuses me that doctors and medical professionals often lament that patients are not open with their medical providers and speak negatively of stigma, yet some of these professionals are among the first to stigmatize and ostracize others (not targeted at anyone in this thread). There is little wonder why so many are loath to discuss mental health issues with their providers and why there is such a mental health crisis in this country. Using distant medical issues that are likely no longer relevant to effectively punish (whether that is the intent or not) someone only leads to further stigma, isolation, and can lead to mental health issues in itself.

To be clear I understand not admitting someone with active mental health issues as medical school is grueling, and the statistics for medical student depression are sobering. On the other hand assuming someone with issues in the distant past, particularly if the issues were acute and due to limited circumstances not likely to be repeated (e.g. abuse, illness, isolated event), is a liability is unfair and doesn't make much sense. Anyone who has ever struggled with extreme depression and recovered can tell you that these experiences can make you stronger and far stronger than the general population. You learn to handle stress and anxiety at levels that others can't fathom. You learn your breaking point, and you learn how to healthfully deal and cope with issues. These skills that are useful with medicine.

Finally what ever happened to wanting doctors that can represent/relate to the general population including those who truly are underrepresented in society/medicine? The average physician is from an upper middle class to upper class family based on statistics (read as an individual who likely had a cushy childhood - I don't want to generalize and stereotype as I would be guilty of the same error that I accuse admission committees of making). I think physicians (and by extension those who ultimately obtain faculty appointments and decide the fate of future prospective physicians) need to consider the possibility that not everyone lived a picture perfect childhood and was as fortunate as he/she/they were. Depression shouldn't automatically be treated as being a character flaw or treated as disqualifying an individual from any vocational path.

 

[Goro]

Medical school admissions committees will use this information against you. I recall reading an article a couple of years ago about a medical student who was told point blank that if she had revealed issues with depression the school would not write her a favorable recommendation for residency. In the future, medical schools and residency directors will absolutely hold it against you no matter how unfair it may be. Instead of answering from your perspective, reframe it from the perspective of someone else. Mention being ill as a child and seeing another child who had attempted suicide in the ER. Alternatively write as if it was about a close relative. Use that fictitious individual as a surrogate for you. I usually advocate complete honesty, but in this case, I encourage you to lie your butt off if necessary. You don't owe them anything.

This thread also brings up an interesting topic. It amuses me that doctors and medical professionals often lament that patients are not open with their medical providers and speak negatively of stigma, yet some of these professionals are among the first to stigmatize and ostracize others (not targeted at anyone in this thread). There is little wonder why so many are loath to discuss mental health issues with their providers and why there is such a mental health crisis in this country. Using distant medical issues that are likely no longer relevant to effectively punish (whether that is the intent or not) someone only leads to further stigma, isolation, and can lead to mental health issues in itself.

To be clear I understand not admitting someone with active mental health issues as medical school is grueling, and the statistics for medical student depression are sobering. On the other hand assuming someone with issues in the distant past, particularly if the issues were acute and due to limited circumstances not likely to be repeated (e.g. abuse, illness, isolated event), is a liability is unfair and doesn't make much sense. Anyone who has ever struggled with extreme depression and recovered can tell you that these experiences can make you stronger and far stronger than the general population. You learn to handle stress and anxiety at levels that others can't fathom. You learn your breaking point, and you learn how to healthfully deal and cope with issues. These skills that are useful with medicine.

Finally what ever happened to wanting doctors that can represent/relate to the general population including those who truly are underrepresented in society/medicine? The average physician is from an upper middle class to upper class family based on statistics (read as an individual who likely had a cushy childhood - I don't want to generalize and stereotype as I would be guilty of the same error that I accuse admission committees of making). I think physicians (and by extension those who ultimately obtain faculty appointments and decide the fate of future prospective physicians) need to consider the possibility that not everyone lived a picture perfect childhood and was as fortunate as he/she/they were. Depression shouldn't automatically be treated as being a character flaw or treated as disqualifying an individual from any vocational path.

Medical students need to survive medical school and residency in order to become those doctors.

Again, we Adcoms speak from hard and bitter experience as to what metal health issues do to medical students.

 

[FlowRate]

I can't give your true answer for you, but I'd imagine that doing work with the suicide hotline could be leveraged as an answer. You need a way to clarify why you want to be a physician and not a psychologist, though. Maybe you have seen other people have a good experience with meds that you can reference? Or are you actually interested in doing something other than psychiatry?

 

[DNAJB6]

Medical students need to survive medical school and residency in order to become those doctors.

Again, we Adcoms speak from hard and bitter experience as to what metal health issues do to medical students.

Would you take the position that anyone who has ever experienced depression is mentally flawed and/or not fit for medical school and residency?

P.S. I'm not trying to argue the point - as adcoms you and Moko obviously know what happens behind closed doors. I am merely trying to understand the logic. I think that many of the people that you all accept every year (and perhaps even some of your best students/residents) have dealt with depression in the past.

The idea that people need to hide who they are and certain aspects of their lives reminds me of the closeted experience that many LGBT students experienced through the 1980s and 1990s.

 

[Moko]

It amuses me that doctors and medical professionals often lament that patients are not open with their medical providers and speak negatively of stigma, yet some of these professionals are among the first to stigmatize and ostracize others ... Using distant medical issues that are likely no longer relevant to effectively punish (whether that is the intent or not) someone ... To be clear I understand not admitting someone with active mental health issues as medical school is grueling, and the statistics for medical student depression are sobering. On the other hand assuming someone with issues in the distant past, particularly if the issues were acute and due to limited circumstances not likely to be repeated (e.g. abuse, illness, isolated event), is a liability is unfair and doesn't make much sense. Anyone who has ever struggled with extreme depression and recovered can tell you that these experiences can make you stronger and far stronger than the general population. You learn to handle stress and anxiety at levels that others can't fathom. You learn your breaking point, and you learn how to healthfully deal and cope with issues. These skills that are useful with medicine ... Finally what ever happened to wanting doctors that can represent/relate to the general population including those who truly are underrepresented in society/medicine? ... Depression shouldn't automatically be treated as being a character flaw or treated as disqualifying an individual from any vocational path.

My thoughts (as someone who has dealt with depression myself, and have many colleagues who have done so as well):
- Our primary goal in admissions is to select for students who will succeed through not just medical school, but also residency +/- fellowship, and beyond to become excellent physicians. When there is a limited number of seats, every applicant is scrutinized.
- In most cases, depression is not associated with an isolated non-recurring event. Depression is also not something that simply 'stays away'.
- While depression is highly treatable over time, it is also prone to recur with new stressors. Given the stresses associated with medical school, residency, and medical practice, it's not surprising that many people have exacerbations of their previously-controlled mental health disorders (whether it be a recurrence or first occurrence). Those of us who have gone through this process have seen first-hand the effects that mental health disorders can have on ourselves and/or our colleagues. In fact, one of my colleagues died from suicide during my medical training, and the demands imposed on them likely contributed to their death (I will defer discussion of my views on medical training).
- Depression is not treated as a binary variable. There are a significant differences between mild depression, remote non-severe depression associated with a truly isolated and stressful event, and severe depression cumulating in a suicide attempt. I have routinely advocated for otherwise-qualified applicants in the first two situations for the reasons that you mentioned. My school offers acceptances to these applicants (some in spite of, and some because of their experiences). For those in the last situation, I/my school would consider to be an absolute deal breaker for admissions.
- Someone who has had severe depression and had previously attempted suicide is at particularly high risk for severe recurrences during training. I cannot in good conscience recommend admission for a student who is at high risk for failure (defined not just from an academic standpoint, but also their physical and mental well-being), even if the number needed to harm is 20.
- The stigma against mental health disorders is very much real and it is regrettable; however, I do not view the above practice as being an example of demonizing those with mental health disorders.
- I would argue that depression is actually very well represented within the medical community. As an aside, the goal of admissions is not to mirror every aspect of the general population - otherwise, a significant percentage of each class would have substance use disorders, criminal histories, etc.
- To be clear, having severe depression is not a character flaw; but it may reflect baseline mood dysregulation and/or genetic vulnerabilities that may predispose them to recurrence with new stressors.
- It all comes back to my first point: can I confidently say that a particular applicant will flourish through medical training and one day become an excellent physician? I cannot confidently say 'yes' to this for those with a history of severe depression, even though many of these applicants probably would go through this process perfectly fine.

 

[Goro]

Would you take the position that anyone who has ever experienced depression is mentally flawed and/or not fit for medical school and residency?

P.S. I'm not trying to argue the point - as adcoms you and Moko obviously know what happens behind closed doors. I am merely trying to understand the logic. I think that many of the people that you all accept every year (and perhaps even some of your best students/residents) have dealt with depression in the past.

The idea that people need to hide who they are and certain aspects of their lives reminds me of the closeted experience that many LGBT students experienced through the 1980s and 1990s.

Flawed? Gawd no. I've suffered from depression myself. Been on SSRIs about 3x over the past 20 years.

Stop projecting...you're taking this personally.

A long stretch of a academic excellence will allay Adcom's concerns about mental health issues. But writing about suicide attempts or bipolar disorder automatically makes us VERY cautious. Again, we've seen firsthand the results of relapses in medical students. Hell, we've seen it even in healthy student break under the pressure of medical school.

There may be some concern about judgement issues as well. Is it really necessary to share certain info with us, even if it's a reason why you wish to be a doctor? Medicine IS a conservative profession.

Comparing hiding one mental health history to LBGT being closeted is a false equivalence. Homophobia is different from being gun shy over relapses. This isn't the argument from authority, it's the argument from hard and bitter experience.

 

[DNAJB6]

Flawed? Gawd no. I've suffered from depression myself. Been on SSRIs about 3x over the past 20 years.

Stop projecting...you're taking this personally.

I'm not trying to project, and I am sorry if it came off that way. I have never attempted suicide, but have noticed a recurring theme over time about posts involving depression, eating disorders, suicide, and the like for prospective medical students. I have always wondered about the topic and finally decided to post some questions on the topic. I truly appreciate you ( @Goro ) and @Moko engaging with me. It means a lot to have adcoms that are willing to have serious discussions about difficult issues in medicine and admissions. We are all lucky to have the two of you posting.

A long stretch of a academic excellence will allay Adcom's concerns about mental health issues. But writing about suicide attempts or bipolar disorder automatically makes us VERY cautious. Again, we've seen firsthand the results of relapses in medical students. Hell, we've seen it even in healthy student break under the pressure of medical school.

There may be some concern about judgement issues as well. Is it really necessary to share certain info with us, even if it's a reason why you wish to be a doctor? Medicine IS a conservative profession.

This makes a lot of sense to me. I had interpreted some of the posts that I have read in the past as a per se or categorical bar to admission based on any scintilla of depression or related issues. Based on comments from you and Moko it appears not to necessarily be true but appears to be a holistic approach while understandably being conservative. Obviously you don't want to make someone ill and push him or her over the edge. That wouldn't be good for anyone. I hadn't thought about the judgment angle, but that makes a lot of sense to me.