Manic episode advice M3

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kinnencan

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I’m definitely looking for some advice here. I recently failed my OB gun rotation because I had a really bad manic episode. I failed due to professionalism. I showed up late to the rotation once and I ended up walking out of the OR a couple times, but came back. I haven’t had any professionalism lapses in my file before this. But I’m really nervous. Because of how my program works, I have to go to the SRP and present my case. They can decide if I need to go higher. This is my first failure in Med School and the only mistake I’ve had. I had one evaluation that is currently pending a title nine I am currently on a leave of absence, but I’m considering coming back . I was just diagnosed with bipolar after the rotation. What are my chances for a dismissal? Does anybody have experience with us at all?

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I'm sorry to hear that. I think if you explain that it was the manic episode of an undiagnosed BPD that you were just diagnosed with, I could see them being understanding. I don't think any sane person would try to punish an unmedicated, unknown mental health disorder.
 
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Really sorry you're going through this.

Unfortunately, I don't think any of us can give you solid advice on what your chances of dismissal are. It is likely specific to your school, your school policies, and the timeline of disciplinary action/when you reached out for help. Your best friend or your worst enemy is likely going to be your dean, and they will likely determine if they think you can successfully return to school with appropriate medical treatment and possibly accommodations
 
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I’m sorry you’re going through this. I think honesty is the way to go. Your faculty may decide they don’t want someone with bipolar disorder as a physician, but if you try to skate around what happened, they’ll probably just dismiss you because they smell BS.

There are successful physicians who have bipolar disorder and practice. They are treated properly just like any other patient. You also will need to look into going to residency in states that don’t discriminate on the basis of mental health stuff. Pamela Wible, while controversial, has a pretty good and fairly recent list of states.
 
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I’m definitely looking for some advice here. I recently failed my OB gun rotation because I had a really bad manic episode. I failed due to professionalism. I showed up late to the rotation once and I ended up walking out of the OR a couple times, but came back. I haven’t had any professionalism lapses in my file before this. But I’m really nervous. Because of how my program works, I have to go to the SRP and present my case. They can decide if I need to go higher. This is my first failure in Med School and the only mistake I’ve had. I had one evaluation that is currently pending a title nine I am currently on a leave of absence, but I’m considering coming back . I was just diagnosed with bipolar after the rotation. What are my chances for a dismissal? Does anybody have experience with us at all?
I am so sorry to hear you’re going through this. No one is going to be able to provide a professional opinion unless your full case is laid out which I do not recommend here, and I certainly don’t have that professional opinion.

What I’d say is that you seem to have some, but not complete insight into the degree of your transgressions. One manic episode would be an isolated event and wouldn’t explain the persistent behavior that put you in this position.

While I’d be ignorant to say that Bipolar isn’t a significant contributing factor, there are likely other personality traits or deficiencies which may be in your control. Seek care and develop a maintenance plan for your disorder, but also reflect hard and take accountability for and address those. If after doing that you’re unsuccessful, it is what it is and you have to move on.
 
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I am so sorry to hear you’re going through this. No one is going to be able to provide a professional opinion unless your full case is laid out which I do not recommend here, and I certainly don’t have that professional opinion.

What I’d say is that you seem to have some, but not complete insight into the degree of your transgressions. One manic episode would be an isolated event and wouldn’t explain the persistent behavior that put you in this position.

While I’d be ignorant to say that Bipolar isn’t a significant contributing factor, there are likely other personality traits or deficiencies which may be in your control. Seek care and develop a maintenance plan for your disorder, but also reflect hard and take accountability for and address those. If after doing that you’re unsuccessful, it is what it is and you have to move on.
I haven’t had any previous professionalism issues. I did get hospitalized after the event. This is the first I have gotten in trouble besides losing my passport on a school trip. It was weird event, I started talking to myself and became delusional for most of the time. I hate how everything played out. I totally lost myself
 
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I haven’t had any previous professionalism issues. I did get hospitalized after the event. This is the first I have gotten in trouble besides losing my passport on a school trip. It was weird event, I started talking to myself and became delusional for most of the time. I hate how everything played out. I totally lost myself
At my school, any clerkship failure automatically gets reviewed by a committee. My dean is trying to delay the process as much as he can but he has to forward it. It’s a messy event and he feels awful for me
 
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Very sorry to hear about what you are going through. I went through something similar during M3 year, had severe major depressive episodes and was actively suicidal, I borderline failed 2 clerkships and had several professionalism complaints that I had to present to SRP. After seeking advice from faculty I trust I chose to be forward with everything. My school's admin were sympathetic and supportive, gave me resources to get better treatment. Nothing negative ended up going on my record except for the low clerkship grades (but weren't failures) I am doing ok applying to residencies right now. They did hold me accountable in the sense that if anything else comes up, I have to report to them and potentially face more action.
 
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Very sorry to hear about what you are going through. I went through something similar during M3 year, had severe major depressive episodes and was actively suicidal, I borderline failed 2 clerkships and had several professionalism complaints that I had to present to SRP. After seeking advice from faculty I trust I chose to be forward with everything. My school's admin were sympathetic and supportive, gave me resources to get better treatment. Nothing negative ended up going on my record except for the low clerkship grades (but weren't failures) I am doing ok applying to residencies right now. They did hold me accountable in the sense that if anything else comes up, I have to report to them and potentially face more action.
Thank you for sharing that, this is the first hopeful thing I have heard.
 
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Get a lawyer and begin to establish a paper trail. Reach out to your school's disability office and register your disability with the school if they allow you to do so. Keep you head up.
 
As others have mentioned, this is an unfortunate situation and I hope you're doing well now. Your health and well being remain the number one priority.

No one can tell you exactly how this will play out. But I think it's worth thinking about it from a few different angles: legal, academic due process, disability, and social (I'm trying to come up with a better term, this is the best I've got).

Legal issues are complicated because they are very locale oriented -- what's "true" in one jurisdiction may bot be elsewhere. In general, the law protects those with known disabilities and acute illnesses. If you have a known disability you can ask for reasonable accommodations, and assuming that your school finds them reasonable and does not alter their minimum standards they should meet them. This will protect you going forwards, but rarely can you claim disability in retrospect. When you're acutely ill like this, laws can protect your ability to take a medical LOA. However mental health issues are extremely complicated -- as the illness itself usually entails a lack of insight by the patient. Hence you ended up with unprofessional behavior, and no way to extricate yourself from the situation before things escalated. A don't know how much a lawyer can help you at this stage -- if you want to contact one for personal advice, fine. But I would not get them entangled with your school -- that's sure to come across as defensive and that's not a good look for this problem.

Academic due process is going to be your next big hurdle. Your best option IMHO is to be completely honest about the situation - lack of prior episodes, lack of insight while your behavior unraveled, embarrassment and remorse for what happened, and a willingness to make amends. I agree with @Goro's recommendation above to read your student handbook in full and know the process. Whom reviews this, what options do they have, what appeals do you have, what outcomes can you expect. Keep track of whether your school does everything they are supposed to. Don't tell them if they do not -- it becomes a very useful lever if you ultimately lose and they try to dismiss you. The legal system will rarely overturn a profession's well reasoned decision to expel a student But it has no mercy when a school doesn't follow its own written protocol.

Part of academic due process is Title IX, which you mentioned in your post. This unfortunately makes this into a bigger issue that may spiral out of control. This means that your behavior resulted in someone feeling uncomfortable due to gender -- unwanted sexual advances, banter with innuendo, or something along those lines. There is an entirely separate process for addressing Title IX issues, with a separate group of evaluators. Title IX is a huge deal because if someone complains to the Feds that their complaint wasn't taken seriously, the school can lose all federal funding. So schools have a tendency to believe the accuser/victim, and punish the other party. This should also be in your handbook, and will have a completely different process. You will go through both separately, and need to "pass" both reviews to continue.

Regarding disability, as mentioned above this mostly applies moving forward. Remember that disabilities do not "explain away" poor performance. You are expected to ask for accommodations as needed to maintain adequate performance. If you were to have another episode like this, no amount of explaining that it was out of your control would suffice.

Last, social issues. You should probably assume that your story has spread through your school. I'd hope for privacy, but I'm sure your behaviors were relatively public, and people talk. Assuming you're allowed to restart, you'll need to work with these people again and you'll need to be prepared for how you want to address it. You can ignore it and just pretend nothing happened. Or you can be open with people whom you work closely with that they "may have heard stories" and try to clear the air. Neither solution is perfect, you'll need to pick what you want to do. And different environments may need different solutions.

As you go into your reviews, you should also consider what you think a good next step would be. They will likely ask you -- as a way of assessing your introspection. How long should you be stable on meds before you're allowed back in? Should you repeat the entire MS3 starting next year, including clerkships you passed? If you were to return to the same OB site, how would you navigate that? These are all questions to which you should have answers -- and understand that asking for too much too quickly will not be held in your favor.

So, in summary:

Number one priority is getting better. Your school is probably going to want to see a sizable period of stability on medications, could be up to 6 months. Trying to get back in "right away" so you can graduate as quickly as possible is not going to support your assertion that you understand the gravity of the situation.

A lawyer is probably most helpful in navigating the Title IX issues. That's the type of lawyer I'd work with, if you're going to hire one at all. They do not come with you to any hearings, and you don't mention that you have a lawyer to anyone.

Know your academic due process backwards and forwards, same with Title IX. Keep notes on everything - every meeting, whom was there, etc. Make sure that keeping notes is allowed (although it usually should be). Never record anything unless you're certain you have permission, which is very unlikely.

Try to find some local supports / mentors. This is going to be a tough process, you want someone to lean on. These people should be outside the due process envelope. They are not coming to your meetings to support you -- they are there for between meetings and decisions for personal and moral support.

Assuming you are allowed to resume training, consider how that's going to happen and how little/much of this you are willing to share with others, understanding that both over and undersharing can have consequences.

Also, you need a canary. These were bird that coal miners took into the mine shafts to warn them when the air was bad. Sadly, the canaries did that by dying. In your case, you need someone you trust that's close to you to watch your behavior. They are empowered to tell you is you're starting to show manic behavior. And you MUST listen to them. Even if you're certain they are wrong. Because you can't see it. This is really hard, but it's what you need in the short term.
 
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