Mental disease and residency applications? Stigma?

[nolee]

How badly does mental disease look on your residency application? I read a lot of posts on SDN that say things like “don’t let anyone know you have XXXX” or “residency programs really look down on mental illness”—I don’t know what to do at this point. I’m thinking I can slug it out two more years until after I get into residency to be treated, but at this point (MS2) I wonder if I can really get through clerkships without going on meds. So is there a consensus on how mental disease is currently viewed? Is it better than it was 5 years ago? Thanks so much all, and sorry for the depressing topic :-(

To clarify: I have progressively worsening OCD and severe anxiety

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[ChillDawg]

*resists impulse to open thread in Incognito Mode*
Stigma, what stigma?

But in all seriousness, you aren't doing anyone any favors by delaying treatment (pharm or non-pharm) for literally years...

Is it something that has to be disclosed? I'd imagine not, and would probably refrain from doing so. I'm sure the old guard at least has reservations about candidates with treated mental illness in regards to their resilience, warranted or not.
(Untreated would probably be a huge red flag, not to mention a huge mistake)

 

[futuremdforme]

Can someone clarify why they would need to know about the meds? Is seeing a therapist (ie someone who can treat you but who won't give you a label) an option?

 

[PL198]

what stigma? why would there not be an adverse reaction about people who make important decisions having a medical condition that alters their decision making capability?

 

[Donald Juan]

OP, why do you think that getting treatment now means it will be on your residency application? I don't remember having to disclose my medical history to anyone.

 

[NotAProgDirector]

You will not need to disclose anything, unless you end up requiring a leave of absence. Even in that case, you are not legally required to disclose why you took an LOA -- but if you take an LOA and don't disclose the reason, programs may "assume the worst" which could be much worse than the truth.

 

[nolee]

Thanks so much for the responses all! I guess I'm a little paranoid because treatment would be through my school so wouldn't any residency director be able to (at least theoretically) pull up my charts?

 

[WingedOx]

Yeah, med school has a great way of bringing out and worsening mental health issues, and such problems are likely way more common in your classmates than you'd think. Get the help you need, or you'll regret not doing it sooner.

 

[Rumor13]

Would you, as a physician, ever recommend to a patient that they put off seeking treatment for a medical condition that was negatively impacting their life and only had the potential to get worse? No. So why would you think the answer should be any different for yourself?

Medical school is extremely hard on the body and mind and if you aren't handling it as well as you think you could if you sought help, then you'd be making a mistake to not seek help. Nobody has a right to know anything about your medical record but you and your healthcare providers. And if you're ever asked "is there any reason why you believe you would be unable to fulfill or carry out the duties of this position?", you answer can answer no, even if you are diagnosed with a psychiatric disorder, so long as you are managing it, even if you can only manage it due to treatment. You don't see diabetics answering yes to these types of questions even though without their insulin they could become hypoglycemic during a shift and become incapacitated.

If you have a medical issue, psychiatric of bodily, that is stable (with or without treatment) then you are stable and fit for work, period.

 

[gracie369]

You will be fine not disclosing for residency applications. However, depending on the diagnosis and how the application is worded you may have to disclose to the medical board when you apply for a full license. I think some states ask and some don't. Pick a state and download the application to see for yourself. Full disclosure wins. If they find out that you've tried to hide something they specifically ask for it could be a bad situation.

 

[GaiusOctavius]

If they want to get fired, sure

how much oversight of this is there really?

 

[Wordead]

how much oversight of this is there really?

A lot.

 

[Rumor13]

how much oversight of this is there really?

At the hospital I used to work at before med school, the EMR logged every time you accessed a different patient's record and if you accessed a patient's records you were not assigned to/wasn't in the scope of your job to access, it would flag the access for review by an administrator. One time I typed misspelled my patient's name and accessed the wrong file and I got an email the next day to submit an explanation for the "inappropriate access". Luckily it was no big deal because it was obvious I made a one letter typo, I immediately exited the file as soon as I noticed the basic info like DOB didn't match, and I didn't open any of the care, billing, or history notes. Had I not quickly exited or been stupid enough to snoop around, the situation could have went down veryyyy differently.

Obviously every hospital does not have a system as airtight as the one I was at, but I guarantee there is some form of monitoring that constantly looks for HIPAA violations and privacy breaches.

 

[Rumor13]

In addition to things like this, our EMR actually has a special pop-up that comes up anytime you access a mental health record, asking if you are sure you want to proceed.

Hospitals take this stuff very seriously. Just imagine a local news story about a supervisor illegally accessing his employee's health records...

We had similar pop-ups for any patient with mental health issues, family issues/disputes, and well known people/celebrities. However, the pop-up did not ever indicate why or by who the file had been sealed extra tight.

And the hospital administration would probably just kill the supervisor. Mystery murder of an employee is better than HIPAA violations PR-wise for Hospitals.

 

[charmiedermie]

How badly does mental disease look on your residency application? I read a lot of posts on SDN that say things like “don’t let anyone know you have XXXX” or “residency programs really look down on mental illness”—I don’t know what to do at this point. I’m thinking I can slug it out two more years until after I get into residency to be treated, but at this point (MS2) I wonder if I can really get through clerkships without going on meds. So is there a consensus on how mental disease is currently viewed? Is it better than it was 5 years ago? Thanks so much all, and sorry for the depressing topic :-(

To clarify: I have progressively worsening OCD and severe anxiety

It obviously won't look good. The stigma with residency is pretty well-justified from their end when you're taking care of others. Get treatment and keep it hidden.