How honest should I be about my year off during interviews?

[MyNameIsMoose]

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Got what I needed here and offline. Thank you!!

 

[DisorderedDoc417]

Just a word of advice. While I suspect many do this, DON'T state your intention of entering a field to diagnose yourself. While it may feel incredibly deep and insightful, it is creating the premise of a personal flaw as the core ideology for your advancing into a career. Like any career, you would be better served by highlighting your strengths and attributes, and addressing weaknesses as those come up. One in four suffer a major depressive episode, so it is unlikely they will see you as a unicorn and more likely that they see you as a risk for a recurrent episode. Go see a psychiatrist and move on with your life (from that standpoint). If you find that you still would like to be a psychiatrist, great! Pursue it by following these general rules in clinicals: 1) Show up early, 2) Stay late, 3)Be the resident expert on all of your patients, 4)strive to learn as much as you can. These will carry you far. Furthermore, I would try to find something you genuinely enjoy... Psychiatry is only a lifestyle specialty if you like psychiatry. You need to discover if this is the case for you. I really like psychiatry and even I hate it some days. Your attendings have seen thousands of people (patients) present and so when they assess a patient and find that hospitalization was probably not necessary or that they are a low suicide/violence risk but were hospitalized for the 7th time this year because the ER doc is afraid of people who mention chronic suicidal thoughts, it can breed cynicism. I would challenge you to ask these folks why they ended up in psychiatry and not take their reactions at face-value. Cheers!

 

[FlowRate]

There's faculty at our institution who, as part of a spiel they give everyone, recommends avoiding psychiatry if it's primarily to understand oneself or one's family. That is in itself not enough to sustain an interest in the field and also lends to over-identification with patients.

In any case, I would never present your story in interviews the way you did here. Even your writing sounds depressed and the brutal reality is that no one wants to take an actively/intermittently depressed resident.

 

[hamstergang]

Got what I needed here and offline. Thank you!!

I find this highly annoying. You've created a thread in a public forum and then killed it so that no one else can really make use of it or comment on it. If you're not comfortable to share your story, then don't. But to share and then take it away, that just clutters this forum.

 

[DisorderedDoc417]

Please delete this post.

 

[whopper]

There's faculty at our institution who, as part of a spiel they give everyone, recommends avoiding psychiatry if it's primarily to understand oneself or one's family. That is in itself not enough to sustain an interest in the field and also lends to over-identification with patients.

I disagree with the notion that having a mental health issue yourself shouldn't be used as an inspiration to pursue psychiatry. Why not? Over-identification? Yeah well what about doctors that lack empathy? If you suffer from a health issue it could make you more empathic to that patient's needs.

But it doesn't matter what I think. What matters is what the interview and admissions people think. So many of the criteria used by these people are BS with evidenced-based data showing so yet they cling to it.

Realistically I can see someone holding your mental health issues against you despite that it goes against the ethics of our profession (while never admitting it), others might celebrate it. The success of using it will also depend on how you present it. If, for example, one were to talk about how it was a struggle but now it's been under control for years, and you've done some incredible accomplishments in part because of the iron will you developed in fighting for your own mental health then yes it might help out. On the other hand if you talk about your psychotic break that just happened last night.....

It might be the safer thing not to bring up your mental health, but someone might have a story so impressive concerning their mental health it could be very convincing that they need to take you as a candidate. It's going to be a crapshoot, and a risky one if you divulge your mental health issues...and again I don't agree with this either and see this as prejudice on a level hypocritical with our professional ethics.

 

[FlowRate]

I disagree with the notion that having a mental health issue yourself shouldn't be used as an inspiration to pursue psychiatry. Why not?

It might be the safer thing not to bring up your mental health, but someone might have a story so impressive concerning their mental health it could be very convincing that they need to take you as a candidate. It's going to be a crapshoot, and a risky one if you divulge your mental health issues...and again I don't agree with this either and see this as prejudice on a level hypocritical with our professional ethics.

To reiterate, that faculty's opinion (with which I agree) is that a personal/family history of mental illness as a primary or sole motivation is not enough to sustain a career in psychiatry and that there should be other, more compelling reasons in addition. Personal/family mental illness is an extremely common experience, given the prevalence of mental illness; I'm not saying people should actively avoid psychiatry for that reason.

As for the second point, I honestly can't imagine a personal story of mental illness that would make me more likely to want someone. I'd be interested to hear if you have an example in mind.

 

[SeniorWrangler]

My answer to these questions is always the same:
1) If you think doctors don't have a negative reaction to other doctors getting sick, then you don't know many doctors. We are supposed to be above all that somehow. No, it doesn't make any sense but it is real.
2) Any negative information you provide which isn't required is just giving people looking at your application a reason to reject you. If you're applying to a desirable program that gets 200 applications for 10 slots, then this is a bad idea.

 

[whopper]

I honestly can't imagine a personal story of mental illness that would make me more likely to want someone.

So many people I've seen relate to a patient better cause they've been through the same.

One example-I know a psychiatrist with Bipolar Disorder who does a great job. Her having the disorder made her more sensitive to understanding what patients go through and the stigma of admitting you have mental health problem. Her entire training she struggled whether to admit she had the disorder or not and when she did tell people others held it against her despite that she had it under control and was able to get the work done.

I also knew someone with Dyslexia that was able to score extremely well in high school, go to an Ivy League, and was academically very successful but only after great difficulty in understanding this problem. That's someone where I'd genuinely believe them if they told me they had an interest in researching this disorder.

Holding someone's mental health problems against them in a setting such as a job or other area that requires responsibilities while that person has their symptoms under good control and is still able to get the job done goes against the APA's professional ethics and if associated with a job goes against the law.

But reiterating what's been said by others including myself-you're taking a big risk with your mental health problems being used against you during the admissions process despite that this is illegal and unethical.

It's not a good situation and again I don't agree with the prejudice.

 

[WingedOx]

It's not a good situation and again I don't agree with the prejudice.

It's a tough call, really. I think in truth everyone wants to avoid the prejudice and stereotyping, but at the same time, we want you to be able to perform at what's a demanding job... After seeing one of our residents go manic during a night float block, I have to admit that I'm more risk-averse than is probably fair on this issue, and it really does suck for everyone involved, especially when I think about where I was personally during med school and my own glaring red flags during application season.

 

[FlowRate]

Her having the disorder made her more sensitive to understanding what patients go through

That's the over-identification point; it's dangerous to assume that your experience with XYZ disorder is the same as a patient's experience with XYZ. I agree that having some sort of illness experience can help you understand the patient role, but I don't think I need to experience schizophrenia to be good at taking care of people with schizophrenia.

 

[WingedOx]

Plus, there's all kinds of countertransferences that can develop out of ones own experiences, especially when one has achieved recovery/remission of their own issues and they're not positive or empathetic toward the patient, particularly if one gets frustrated in the patient for not achieving the same ends. (I catch myself doing this with patients with a particular set of behaviors)

 

[Trismegistus4]

I find this highly annoying. You've created a thread in a public forum and then killed it so that no one else can really make use of it or comment on it. If you're not comfortable to share your story, then don't. But to share and then take it away, that just clutters this forum.

I second this. Another vBulletin forum I sometimes post on actually has an "edit window" so that after a certain number of minutes past, the poster can no longer edit the post, and I think it works well. I wish SDN would adopt that feature. It drives me crazy to come into a thread like this and find that the OP no longer exists.

 

[WingedOx]

I second this. Another vBulletin forum I sometimes post on actually has an "edit window" so that after a certain number of minutes past, the poster can no longer edit the post, and I think it works well. I wish SDN would adopt that feature. It drives me crazy to come into a thread like this and find that the OP no longer exists.

Of course on the other hand, I'll occasionally come across a thread from 6 years ago containing an opinion I no longer have and find it convenient to quietly delete what I wrote.

 

[michaelrack]

I second this. Another vBulletin forum I sometimes post on actually has an "edit window" so that after a certain number of minutes past, the poster can no longer edit the post, and I think it works well. I wish SDN would adopt that feature. It drives me crazy to come into a thread like this and find that the OP no longer exists.

agree. When I post something inappropriate, I will usually realize it within a few seconds to minutes (and will ponder the fact that I am not anonymous), and quickly delete it.

 

[UVAResident1]

That's the over-identification point; it's dangerous to assume that your experience with XYZ disorder is the same as a patient's experience with XYZ. I agree that having some sort of illness experience can help you understand the patient role, but I don't think I need to experience schizophrenia to be good at taking care of people with schizophrenia.

Isn't using schizophrenia as an example a bit of a straw man? Diseases that are likely to cause consistent chronic cognitive dysfunction of course aren't compatible with a cognitively demanding job. A single of episode of depression or anxiety under an exceptional stressor is hardly comparable.

It is true that equating your experience with a patient's is a mistake but if one has insight into that, empathy can still be a useful tool. I imagine that this issue is something that a universal rule doesn't apply to and that should be assessed on a case by case basis. I think the mention of dyslexia above is a good example.

 

[FlowRate]

Isn't using schizophrenia as an example a bit of a straw man? Diseases that are likely to cause consistent chronic cognitive dysfunction of course aren't compatible with a cognitively demanding job. A single of episode of depression or anxiety under an exceptional stressor is hardly comparable.

It is true that equating your experience with a patient's is a mistake but if one has insight into that, empathy can still be a useful tool. I imagine that this issue is something that a universal rule doesn't apply to and that should be assessed on a case by case basis. I think the mention of dyslexia above is a good example.

The other person used BPAD as an example. I similarly don't think I need to experience frank mania to treat bipolar or rejection sensitivity and poor boundaries to treat borderline.