Leave of absence help

[Bananainpajamas]

I just finished my second year of medical school and am currently scheduled to take Step 1 in late June. My second year was going swimmingly until I was diagnosed with mono in December and then had a major relapse in February. Round two of mono was miserable- viral meningitis, hepatosplenomegaly, generally stuck in bed with fever, chills, ridiculously severe fatigue for 4-5 wks. Thankfully my school videostreams almost everything and I was able to keep up with all my work and actually ended up with great grades for the semester.

The problem is, it is now mid-may and I am still having mini-relapses everytime I "exert" myself (basically, doing anything other than sitting and studying). Additionally, I have had a few episodes of syncope/near-syncope over the past two months during these times that I have "exerted" myself. I went back to student health and had labs drawn and a cardio work-up because of the syncope. My white count is up and I am worried this is another relapse. They are worried about my ability to physically handle starting clinicals. I am so devastated. I had been so focused all semester on surviving and just getting through each test. My main motivator was that when this hell is over I get to start 3rd year! I at first was convinced that I would be able to get over this in the next 6 weeks. Then I had to go up to school for a training thing for 2 days over a week ago and everything has just gotten worse since.

I had my study schedule set up for Step and have hardly been able to do any of it. I spoke with the dean weeks ago when I my doctor first brought up that I may need time off and he wanted me to take Step as scheduled and start 3rd year on time and just see how I am. I have been sooo stressed out ever since that conversation. I am certain that I have had some mild depression since February and now that has gotten much worse. I just want to lie on couch and cry all day. I get mad so easily and I would love to just punch something but I am too darn tired. Before this whole thing I was super athletic and active and definitely not a sad, angry person.

I know how to solve one problem. Obviously I need to just admit to my doc that I'm suffering from depression and hopefully start getting some treatment. The problem is, I now realize that I need time off, but I am not sure how much I need to take. Also, I'm wondering if I should just take some time (almost) completely off to try to rest without trying to stress myself out by forcing myself to study for Step while I feel terrible. I feel like I am being a whimp, and I should just suck it up and keep going, but I am just not sure about my ability to fight this while doing school anymore. I am not sure what increments of time I am able to take off without having it effect my graduation date. What should I do??

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[link2swim06]

Four thoughts:
1. STEP 1 is coming up fast, postponing it isn't a big deal. This score affects your life for the next 40 years...taking it a few months later does not. Don't make a dumb decision to "please" your dean or just try to stay on the schedule of your peers.

2. You can't get med advice here, so go see a doctor for your depression. Also remember depression meds take a couple of weeks to do anything. So dont expect to go see your doc tomorrow morning and feel great and start full-steam studying by Saturday (in other words a june test date doesnt sound plausible).

3. You have a legit med excuse. Assuming your dean is not your personal doctor, you need YOUR doctor to communicate about your condition to the dean. Then get the accommodations you need...this will not hurt you academically BUT needs to be properly communicated AND confirmed from your doc.

4. Most med schools have tons of padding/filler time in 4th year. I doubt taking off 2-3 months (aka a rotation) couldn't be made up 4th year. Don't you think taking step 1 in September would be more reasonable?

 

[sirenomelia]

Ive always been fascinated by the irony of how we are lectured to be so empathetic, compassionate, etc doctors yet we treat each other like dog$%^&, especially within the training environment, as though we are expected to be untiring senseless robots with any gesture of personal need or lattitude viewed as a weakness or burden to our colleagues.

 

[Bananainpajamas]

Ive always been fascinated by the irony of how we are lectured to be so empathetic, compassionate, etc doctors yet we treat each other like dog$%^&, especially within the training environment, as though we are expected to be untiring senseless robots with any gesture of personal need or lattitude viewed as a weakness or burden to our colleagues.

I completely agree. There is something about medical school that makes you afraid to show any weakness, less you be thrown to the wolves. I have been beating myself up for weeks over my inability to just suck it up and keep going full speed into 3rd year. Unfortunately, my end goal is to be competent & compassionate physician, not angry @$$hole, MD.

 

[DrSnips]

link2swim gave you some solid advice. Especially the part about time to defer 3rd year coursework into 4th year. I have many classmates who have deferred their entire first 6 week rotation into 4th year and will graduate on time. If you think the length of one rotation is not enough time to recuperate then you probably do need to postpone starting 3rd year. Better safe than sorry.

 

[Lil Mick]

Been through that, too. Take some time off before things get worse. If you're out of commission on MS3, you're going to run into more problems than taking time off...