All Branch Topic (ABT) HPSP...autism/add

[anonymous51892]

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I am in the middle of applying for HPSP and am awaiting to hear the boards decision shortly. Military 150% is what I want to do and I don't want to risk losing this opportunity.

I will be going to see a psychiatrist to be tested for Autism and ADD respectively.

In the event I were to be diagnosed with either do I have to report either or could I keep this to myself? Is there any way that the military could find out about these records without me voluntarily releasing it to them?

Thank you for your responses and it is very appreciated. God bless.

 

[notdeadyet]

In the event I were to be diagnosed with either do I have to report either or could I keep this to myself? Is there any way that the military could find out about these records without me voluntarily releasing it to them?

I do fitness for duty evaluations for psychiatric issues frequently.

But when folks pose questions asking whether or not the military could find out about a psychiatric diagnosis if the applicant decides to lie, it makes me very reluctant to discuss the specifics as to what would be a disqualifying diagnosis, what the terms are, and whether or not it is waiverable.

Get an evaluation done, get any applicable diagnoses, get the treatment you need, if any.

You can choose not to. But if you are diagnosed later with a long-standing disqualifying condition, there is a chance the military can find that you had a pre-qualifying condition, boot you out of the military, and have you pay the money they gave you and paid your medical school. And if they do that, it will be on MUCH less favorable terms than if you'd taken out the loans yourself (e.g. many jobs have loan repayment programs that pay a portion of your medical school debt. This would not apply if you owe money to the military directly). If they found out that you actually lied during the commissioning process, or withheld your psychiatric ailments during your time in HPSP or after, there are also consequences. When you commission, you sign a Release of Information form that entitles the military to request any medical or psychiatric records. You don't get to say "no."

Lying is a bad idea. It is the kiss of death in the military and it is the kiss of death in medicine. Having a glaring "s/he lied" on your record early has the potential for long term consequences professionally. Don't do it.

But I'm old school (and just old). You might find another person on the forum that can tell you the best way to go about beating the system.

 

[Cooperd0g]

I have an idea - don't go see a psychiatrist looking for a diagnosis of autism or ADD.

 

[HighPriest]

Yeah, I mean, I don't think either one is fatal. And you presumably have the concentration level to find and comment on this forum and get admitted to a medical school.....so is it worth closing doors to have the diagnosis?

 

[anonymous51892]

I do fitness for duty evaluations for psychiatric issues frequently.

But when folks pose questions asking whether or not the military could find out about a psychiatric diagnosis if the applicant decides to lie, it makes me very reluctant to discuss the specifics as to what would be a disqualifying diagnosis, what the terms are, and whether or not it is waiverable.

Get an evaluation done, get any applicable diagnoses, get the treatment you need, if any.

You can choose not to. But if you are diagnosed later with a long-standing disqualifying condition, there is a chance the military can find that you had a pre-qualifying condition, boot you out of the military, and have you pay the money they gave you and paid your medical school. And if they do that, it will be on MUCH less favorable terms than if you'd taken out the loans yourself (e.g. many jobs have loan repayment programs that pay a portion of your medical school debt. This would not apply if you owe money to the military directly). If they found out that you actually lied during the commissioning process, or withheld your psychiatric ailments during your time in HPSP or after, there are also consequences. When you commission, you sign a Release of Information form that entitles the military to request any medical or psychiatric records. You don't get to say "no."

Lying is a bad idea. It is the kiss of death in the military and it is the kiss of death in medicine. Having a glaring "s/he lied" on your record early has the potential for long term consequences professionally. Don't do it.

But I'm old school (and just old). You might find another person on the forum that can tell you the best way to go about beating the system.

Thank you for responding. Is there a high chance I would be DQ'ed if I received the scholarship and then later went on and got diagnosed shortly after and reported it? For the autism, ive started realizing ive been exhibiting signs of it for all my life, starting at birth; albeit, it is not an extreme case. Im considering not even going in for this since finding an answer won't change anything- it can only hurt me.

As for ADD, I have decent academics but that is from selecting the "right" professors and classes and attending a very underacheiving school (they have a >90% acceptance rate). I have trouble focusing while reading too which worries me since i know i'll have to do a lot of this in medschool. It take me +5-7 minutes to read a page in a novel I am interested in reading (not dense text) because i cant stay focused.

 

[HighPriest]

You'll have to make the call here. I'd still stray away from seeking out a diagnosis of autism. The way you've described it, you want to know just for personal edification. That's fine and all, but it may cause problems in the future. So far as the ADD is concerned, were I in your shoes, if you're doing well enough in school to make the grades conducive to medical school I would delay that appointment until after you're in medical school AND you find that you're having trouble.

 

[anonymous51892]

You'll have to make the call here. I'd still stray away from seeking out a diagnosis of autism. The way you've described it, you want to know just for personal edification. That's fine and all, but it may cause problems in the future. So far as the ADD is concerned, were I in your shoes, if you're doing well enough in school to make the grades conducive to medical school I would delay that appointment until after you're in medical school AND you find that you're having trouble.

I agree about the autism thing, it'd be nice to have closure, but I guess it isn't necessary..:/
As for ADD, it is preferential for me to not find myself in trouble concentrating while in school while also having to worry about possibly getting medicated, possibly failing out, and worrying if I'm going to get the boot or not from HPSP if i report it. If I can get all of that resolved now, it would be much better, and less stressful.

 

[HighPriest]

Yep. That's your call. It may or may not cause issues with the HPSP application. The truth is, however, you don't need HPSP to pay for medical school.

 

[TheEarDoc]

Don't commit a fraudulent enlistment. Just. Don't. Do it.

 

[anonymous51892]

Don't commit a fraudulent enlistment. Just. Don't. Do it.

Is it fraudulent enlistment if i am diagnosed after I receive the scholarship? Again, this is assumming the doctor does think I have ADD.

 

[HighPriest]

It's not a binary thing. If you were wondering if you had marfan's syndrome, and there was some evidence that you might before enlisting but you didn't act on it, then that would be fraudulent. If you had an MI while vacationing in Thailand, but you never told anyone here in the states so that you could apply to HPSP, that would be fraudulent. These things could kill you.

ADD is a spectrum, and is notoriously overtreated (or at the very least arguably overtreated). If you think you have ADD that is bad enough to require treatment, and there is pre-existing evidence of this, then not claiming this would be fraudulent. If you have a mild case that may or may not require treatment, then who cares? More importantly, if there's no documentation existing in any official capacity that you have ADD, then it'll be difficult to prove that you purposefully hid it.

If you have the attention span of a gnat, and everyone knows it, and someone has documented that, and you don't say anything when you apply, then you might get into some trouble.

If you have a mild case of ADD for which you may never need medication, then it doesn't matter. Again, I'm not sure how someone could have bad untreated ADD and still make the grades and have the academic and extracurricular prowess to make it into a medical school. That seems like the work of someone with mild ADD at best. But that may just be me.

I see this as a risk:benefit ratio. How much benefit will you get from treatment:what doors are you closing.

 

[TheEarDoc]

Is it fraudulent enlistment if i am diagnosed after I receive the scholarship? Again, this is assumming the doctor does think I have ADD.

Yes it is. If you think you have it and have symptoms of it and there are notes suggesting it/possible diagnosis and it comes out to be problematic later then it could be considered fraudulent enlistment. Then your least concern will be having to pay uncle Sam back for the money you borrowed and having a dishonorable discharge stamped on your records, but you could also be tried for fraudulent enlistment which is a felony. I know people who have been caught and were charged. One got a hefty fine and a dishonorable. The other just got an administrative discharge with a non re-enlistment code so he can never be in the military.

Now let's take it a step further. You are trying to direct commission as an officer in the military. You are supposed to lead by example. Do the right thing, etc..
Sure you may function fine is a civilian environment, but you are going to be in charge of medical care for other people in possibly some very rough areas. You don't have the right focus and something bad could happen. Others will be depending on you.

 

[anonymous51892]

So from what I am gathering, it is impossible or next to impossible to have ADD, be medicated, and to be a part of HPSP?

 

[Gastrapathy]

So from what I gather, you want to take a performance enhancing drug and avoid consequence.

 

[notdeadyet]

Thank you for responding. Is there a high chance I would be DQ'ed if I received the scholarship and then later went on and got diagnosed shortly after and reported it?

Asked and answered:

But when folks pose questions asking whether or not the military could find out about a psychiatric diagnosis if the applicant decides to lie, it makes me very reluctant to discuss the specifics as to what would be a disqualifying diagnosis, what the terms are, and whether or not it is waiverable....

 

[notdeadyet]

As for ADD, I have decent academics but that is from selecting the "right" professors and classes and attending a very underacheiving school (they have a >90% acceptance rate). I have trouble focusing while reading too which worries me since i know i'll have to do a lot of this in medschool. It take me +5-7 minutes to read a page in a novel I am interested in reading (not dense text) because i cant stay focused.

Just a couple of observations:

1. If you made it as far as medical school with good enough grades and MCAT to make it into a U.S. medical school, you likely do not have ADHD or, if you do, you have a relatively mild case that likely doesn't likely require medication.

2. You are DEFINITELY overestimating the amount of reading you will do in medical school. Medical school is MADE for individuals with attention deficits. Learning is done slide by slide. You study a wide variety of material at a superficial level. It is very flash-card friendly and can be readily learned via modalities recommended to folks with attention issues.

For mild cases of ADHD (such as ones recently considered in individuals that have made it as far as getting into medical school), reaching for stimulants is not the only route. There are non-psychopharmaceutical interventions that can be quite helpful. But you'll have to see a professional.

 

[jabreal00]

I am tired of these threads where medical students ask about HPSP and ADD. If someone is functional enough to get into medical school they do not have ADD. Most US medical schools are still very competitive to get into so the cream of the crop generally are accepted. Every human being has periods of feeling inattentive or boredom. Most times it's underlying depression that masks as "ADD." It's only the select few who have expansive attention span. Everyone needs to find their best way to learn. I couldn't sit through my medical school lectures. I was easily distracted by my laptop or phone. Some students had the concentration of steel and soaked up everything in lecture. Most were somewhere in between. Instead I got the transcribed notes or listened to the recorded lectures in the late afternoon and evenings and did much better that way. I didn't reach for some diagnosis or for stimulant medications. I did relatively well in medical school. Did well in residency and fellowship. I would consider myself highly functioning.

 

[TheEarDoc]

As a GMO, I wrote the letters that got people tossed for fraud. Guessing I did about 20 over my operational time. It's so easy, and next to impossible to fight. It is mandatory processing, which means that no commander could stop the process once I started it. Only the service headquarters can overturn it. General discharge, minimal benefits, give me your uniforms and get off my base.

From what I am seeing in the VA they don't have enough people like you.

I see people all the time with pre-existing conditions that I would bet my left nut showed symptomology well before they hit the recruiter's office and they committed fraudulent enlistment. Then of course on the way out of the separation exam they claim about 30 conditions they never once reported during the military, but hey they know what they can claim and show now evidence for and get a rating for. They also of course claim their pre-existing conditions that they sought treatment for in the military so most end up getting a hefty disability check each month tax free.

The system is so broken it is beyond belief. It makes welfare fraud, SSI fraud look like a minor issue!

 

[bourbon&waffles]

An ADD/ADHD diagnosis is not a problem for military medical students. I had several classmates at USUHS that came in with ADHD diagnosis on methylphenidate and continued on it throughout medical school.

 

[DD214_DOC]

I am tired of these threads where medical students ask about HPSP and ADD. If someone is functional enough to get into medical school they do not have ADD. Most US medical schools are still very competitive to get into so the cream of the crop generally are accepted. Every human being has periods of feeling inattentive or boredom. Most times it's underlying depression that masks as "ADD." It's only the select few who have expansive attention span. Everyone needs to find their best way to learn. I couldn't sit through my medical school lectures. I was easily distracted by my laptop or phone. Some students had the concentration of steel and soaked up everything in lecture. Most were somewhere in between. Instead I got the transcribed notes or listened to the recorded lectures in the late afternoon and evenings and did much better that way. I didn't reach for some diagnosis or for stimulant medications. I did relatively well in medical school. Did well in residency and fellowship. I would consider myself highly functioning.

This is completely false. There is more to ADHD than just hyperactivity or problems with attention. Another huge aspect is executive functions, including management of time, organization, and assigning a value and priority to multiple tasks. Contrary to popular opinion, not everyone is created equal either, and there is a small group of individuals with intellectual abilities on the higher end of the spectrum who can do just fine for most of their educational life until the point where they can no longer breeze through on intellect alone. Medical school is a great example, as the difficulty lies with the amount of material and not its difficulty. Rote memorization is the order of the day, and if someone is significantly impaired in executive functions -- particularly organization and the ability to assign priorities to various tasks -- they can easily fall behind and have considerable difficulty despite high intellectual capacity. "Impairment" is a relative thing, and simply because someone appears to be highly functional when compared to the status quo doesn't necessarily mean they haven't been impaired or held back in some way.

 

[jabreal00]

This is completely false. There is more to ADHD than just hyperactivity or problems with attention. Another huge aspect is executive functions, including management of time, organization, and assigning a value and priority to multiple tasks. Contrary to popular opinion, not everyone is created equal either, and there is a small group of individuals with intellectual abilities on the higher end of the spectrum who can do just fine for most of their educational life until the point where they can no longer breeze through on intellect alone. Medical school is a great example, as the difficulty lies with the amount of material and not its difficulty. Rote memorization is the order of the day, and if someone is significantly impaired in executive functions -- particularly organization and the ability to assign priorities to various tasks -- they can easily fall behind and have considerable difficulty despite high intellectual capacity. "Impairment" is a relative thing, and simply because someone appears to be highly functional when compared to the status quo doesn't necessarily mean they haven't been impaired or held back in some way.

I don't buy it. Stimulant medication should be reserved for those with impairments. Plenty of students seek the diagnosis so they can either get extra time on their tests or they can "concentrate" better. Everyone has the potential to do better with extra time or stimulants.

 

[DD214_DOC]

I don't buy it. Stimulant medication should be reserved for those with impairments. Plenty of students seek the diagnosis so they can either get extra time on their tests or they can "concentrate" better. Everyone has the potential to do better with extra time or stimulants.

They are impaired, it just means that their, "lower functioning" may be your, "average functioning" or even, "high functioning". Reference data collected during certain psychometric tests, such as a WISC and a CPT. Someone can have a significantly above-average level of intellectual ability but perform horribly on the CPT because of attention problems. This is why it's important to LISTEN to what a patient is SAYING, because your perspective or perception of how things should be is irrelevant. Yes, there are people who are full of crap. There's also a bunch of people who aren't, but get overlooked because of those who are.

 

[Gastrapathy]

That is really scary logic. You are saying that the threshold for rxing a performance enhancing drug is that it should enhance performance.

At least these drugs aren't habit forming. Oh wait...
Nuts.

 

[Apollyon]

I am impaired in my ability to bench 400lbs...

What is it for ortho? Step I + max bench >= 650?

 

[asdf123g]

Average Step scores keep increasing, so pushing closer to 700.

Seriously though, what's with the increase in Step scores? My just-shy-of-250 was really great back when I started. Now that's like average for the Navy students coming through our interviews. Craziness.

what specialty are these navy students going in for? Are you at a popular location like SD or something??

 

[j4pac]

Blahaha...I was wonder what has been keeping this thread alive, now I know. 🙂

I can envision a psychiatrist giving a patient a standardized test and titrating he stimulant up to a passing score. If that has become the purpose of stimulants, then let's do this right.

 

[TheEarDoc]

Blahaha...I was wonder what has been keeping this thread alive, now I know. 🙂

I can envision a psychiatrist giving a patient a standardized test and titrating he stimulant up to a passing score. If that has become the purpose of stimulants, then let's do this right.

Yes my fat butt is going to need some phentermine, some anabolics, and heck why not some meth to curb those hunger cravings so I can make tape and join up! After all it's the purpose of stimulants is to overcome my current issues to meet the standard right?

 

[j4pac]

Yes my fat butt is going to need some phentermine, some anabolics, and heck why not some meth to curb those hunger cravings so I can make tape and join up! After all it's the purpose of stimulants is to overcome my current issues to meet the standard right?

During a polysomnogram, the Neurologist should strap on an IV full of Versed...not a C-Pap. Titrate to theta waves. I can guarantee the patient will sleep.

 

[jabreal00]

They are impaired, it just means that their, "lower functioning" may be your, "average functioning" or even, "high functioning". Reference data collected during certain psychometric tests, such as a WISC and a CPT. Someone can have a significantly above-average level of intellectual ability but perform horribly on the CPT because of attention problems. This is why it's important to LISTEN to what a patient is SAYING, because your perspective or perception of how things should be is irrelevant. Yes, there are people who are full of crap. There's also a bunch of people who aren't, but get overlooked because of those who are.

Wow, where do I start with this? Capacity for intelligence and to a lesser extent concentration is all relative once you are comparing very bright students. There are going to be a small percentage of people who are in the 99 percentile with regards to intelligence and concentration. The majority average and a good percentage above average. If someone has done well enough in high school and college to matriculate into a US medical school then they are above average in all regards. Impairment is someone who cannot function outside of a very competitive academic environment (failing grades).

Now if you compare someone who was a star student at their regional university or college to a collection of star students in medical school they may find themselves average or lagging. The same applies for athletics. Many star high school athletes cannot hack it at a D1 programs. Many stud D1 athletes have no chance to make the pros. This is why doping is rampant to get that edge.

I am not in any position given my specialty to write stimulant medications. However prior to subspecialization I would have NEVER written a stimulant to some medical student who all of a sudden has manifested ADD and needs some stimulant to "concentrate" better.

 

[DD214_DOC]

Wow, where do I start with this? Capacity for intelligence and to a lesser extent concentration is all relative once you are comparing very bright students. There are going to be a small percentage of people who are in the 99 percentile with regards to intelligence and concentration. The majority average and a good percentage above average. If someone has done well enough in high school and college to matriculate into a US medical school then they are above average in all regards. Impairment is someone who cannot function outside of a very competitive academic environment (failing grades).

Now if you compare someone who was a star student at their regional university or college to a collection of star students in medical school they may find themselves average or lagging. The same applies for athletics. Many star high school athletes cannot hack it at a D1 programs. Many stud D1 athletes have no chance to make the pros. This is why doping is rampant to get that edge.

I am not in any position given my specialty to write stimulant medications. However prior to subspecialization I would have NEVER written a stimulant to some medical student who all of a sudden has manifested ADD and needs some stimulant to "concentrate" better.

You are missing the point. They do not, "suddenly develop" symptoms of ADHD. The symptoms have always been present but the impairment may not have existed, or did not exist to a degree that brought it to anyone's attention. High school isn't exactly difficult and neither is college, so poor attention or poor organization can be compensated for if someone is bright enough, just as someone of average intellect can compensate for that to a degree with disciplined study habits, tutoring, or other services that may be available. However, as these compensatory abilities are further stressed by increasing demands they can become overwhelmed and result in significant impairment. I have not seen where anyone is in this discussion is advocating that someone who has never had the SYMPTOMS at any point in the past warrants a diagnosis and treatment; the DSM, for those who are strict adherents to descriptive psychiatry, clearly points this out. It does not, however, state that there must have been IMPAIRMENT as a result of these symptoms in the past.

 

[Shikima]

Don't forget, you must not be able to explain these symptoms by other co-occurring diagonses. It's a diagnosis of exclusion.

 

[HighPriest]

I think this is a clear case of Koro.

 

[TheEarDoc]

I think this is a clear case of Koro.

Ah that took me back to my abnormal Psych undergrad days hahhahahaha