Need advice on how to address psychiatric illness in interviews

[CfromLA]

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So, I need a little advice. I'm a nontrad and am going to apply next year to med school, and I'm wondering how to treat some personal medical problems I had. I was diagnosed with Bipolar Disorder ten years ago, and in the first few years of college I struggled with it it, which led to me failing some classes and then withdrawing from all classes I took for an entire year (that's withdrawing from every class attempted each term).

I ended up taking some time off, then changed from an art to science major (so I've had a lot of schooling), and then taking some time off to start a family. I've been relatively stable for seven years, back in school for two years and my grades are now A's and B's. However, I'm not sure how to address this in my applications and interviews. They will surely ask about the discrepancy in my grades. I'd like to be honest, but I'm afraid of stigma, possible discrimination, and appearing to be a poor candidate. My doctor advised me to not disclose it, and instead say something along the lines of not knowing what I wanted to do, not being motivated, etc.

I realize that overcoming hardships and illness/medical problems is viewed positively. But if your medical problem is MENTAL illness, it seems that view wouldn't likely apply, and would instead be negative.

Aside from this issue and the early "transcript blemishes," I'm intelligent and feel I'm a strong candidate. I'm committed to becoming a physician, and know there are successful doctors out there with this disorder. Does anyone have any thoughts or advice about this? I'd appreciate it all.

 

[sunny1]

Honestly, I'd probably go with the suggestion from your doctor to make up other reasons for it. I'm not saying it's right, but I do think there is still a stigma out there and some of the people who come across your application would be concerned about possible future relapse despite your ability to prove otherwise (long term stability, support system, etc.).

 

[fobw]

I say don't disclose unless it's specifically asked.

I'm an alcoholic in recovery with 10 years of sobriety. Only one of the bazillion schools to which I applied asked about addiction history. Other than that one secondary, I left it completely out of my story. If it weren't for the stigma of alcoholism and the threat of relapse, it would have been a huge asset in my personal statement. But the stigma and the threat are real, and there's no way to predict how I'll be perceived if I out myself.

You have two jobs, from my perspective.

Job 1: Make absolutely sure that your disease is maintainable, particularly when you're sleep deprived and/or under stress. Getting into medical school is the easy part: make sure you can handle it, and that you can handle being in residency without control over your schedule. You need to believe your own story.

Job 2: Figure out how to explain your rough transcript years, and make absolutely sure you don't give adcoms any more reason to doubt you. The higher your cumulative GPAs, the less suspicion you'll be under. But I can't imagine that a year of W's will go unnoticed. Lots of candidates have sizeable transcript indiscretions; you need a believable story for why you won't commit further indiscretions once you're in med school.

May you have peace in figuring all this out. Good luck!

 

[sindadel]

My gut says disclose, but I don't really know. Lying is awfully risky, especially in person.

What a difficult issue. And what a shame there still is such stigma surrounding mental illness.

 

[notdeadyet]

Follow fobw's advice. I would not go out of my way to advertise any medical history (in which alcoholism and bipolar disorder would be included) which could be interpreted as something that the stresses/pressures of medical school, residency, and a medical career might cause to return.

And as fobw said, do a long look in the mirror and make sure that you're up to what medical school will be, which is a long road of much stress and unfamiliar situations. Your comment that you have been "relatively stable for seven years" begs the question of what "relatively" means and what happens when you're not. Don't answer that here. Just answer it for yourself.

As for "lying" about it on applications or essays, there's really no need. Don't advertise your medical history. If you're asked about all the W's on your transcript, say you needed to leave school for medical reasons (which is true). If you have a nosy interviewer press you on it, which they probably won't, tell them you'd rather not go into it.

 

[CfromLA]

Thanks for the advice, fobw. And congrats on 10 years.

 

[CfromLA]

Thanks notdeadyet. And--I know you said not to answer--but the "relatively" comment was in reference to when I was pregnant and off meds. Thanks for the advice. It's always appreciated from someone who has been through the interviewing process.

 

[DrJosephKim]

My 2 cents:

Never lie.

It's always OK to keep things somewhat vague (I was going through some personal issues/struggles... I went through some personal difficulties... It involved some complex health issues... etc.)

Focus on the positive, the present, and the future. (although I went through some serious struggles, I've now learned such and such from those experiences, and now more than ever I'm determined and ready to ...)

 

[combatwombat]

I may be completely wrong here but it sounds to me like you could write a knock-your-socks off personal statement with your story. Sure, revealing a history of bipolar could potentially hurt your application in some people's eyes. However, the 'disease' we call 'bipolar' is extremely broad - it can include people who are so agitated that they cannot study, whereas others can be quite high-functioning (i.e. Ted Turner). Instead of judging you based on the note that you have bipolar, I'd bet that adcoms will instead judge you by how you've handled your 'affliction', what you have learned from it, and how stable you seem.

 

[CfromLA]

My 2 cents:

Never lie.

It's always OK to keep things somewhat vague (I was going through some personal issues/struggles... I went through some personal difficulties... It involved some complex health issues... etc.)

Focus on the positive, the present, and the future. (although I went through some serious struggles, I've now learned such and such from those experiences, and now more than ever I'm determined and ready to ...)

Thanks mdjkim.. It's reassuring to know people have gone through difficult personal problems or similar situations and have been successful.

I tend to agree with you on the matter. I would feel uncomfortable lying about it, but think a vague reference to it would be the best route. One of my concerns with lying and NOT telling them why my early transcript is bad, is that I can't think of a good reason to explain a term of straight A's, followed by a term of straight F's, then a year of W's. Can I realistically attribute that to "not knowing what I wanted to do," "flakiness," or "being a slacker?" That almost seems worse than having personal health issues that I don't want to discuss (though that would lead the interviewer to draw their own conclusions about what the problems could be). Additionally, it's one of the major reasons I became interested in medicine. If asked why I went back to school to pursue a different degree in my late twenties, I'd need to come up with another lie. Saying "well, I just changed my mind and decided to be a doctor" seems like a difficult sell. (Yes--I know--I wouldn't actually say that, but you get the point.)

Perhaps a combo of the two options is best. I don't know. I guess I'll just have to do what feels right when I get there. Thank you for your comments.

 

[CfromLA]

I may be completely wrong here but it sounds to me like you could write a knock-your-socks off personal statement with your story. Sure, revealing a history of bipolar could potentially hurt your application in some people's eyes. However, the 'disease' we call 'bipolar' is extremely broad - it can include people who are so agitated that they cannot study, whereas others can be quite high-functioning (i.e. Ted Turner). Instead of judging you based on the note that you have bipolar, I'd bet that adcoms will instead judge you by how you've handled your 'affliction', what you have learned from it, and how stable you seem.

Interesting...does anyone else have any opinions about focusing on this in my PS? It seems pretty bold, and fairly risky, but possibly a great PS. Any current doctors or med students have an opinion on this? Thanks combatwombat.

 

[SonyaB]

I say not. The society is still highly discriminative to mental disorders, even the medical society.🙄

 

[notdeadyet]

I say not. The society is still highly discriminative to mental disorders, even the medical society.🙄

ESPECIALLY the medical society. Most physicians do not see the "successful" management of bipolar disorder, they see the failures.

Most physicians' exposure to bipolar disorder will be limited to their required inpatient psych rotation. Bipolar disorder will bring memories of folks with suicidal ideation, hallucinations, gradiosity, etc. Not good.

Someone with completely well-managed bipolar disorder is not a risk in medicine. Someone who could relapse into bipolar would be an extreme risk. Most clinicians will not be able to distinguish which camp you are in from a 45 minute interview.

It is a liability. Do not bring it up. Do not lie, but focus your essays and your interview on what a great doctor you'll be. Do not focus on your medical history.

 

[lord_jeebus]

Interesting...does anyone else have any opinions about focusing on this in my PS? It seems pretty bold, and fairly risky, but possibly a great PS. Any current doctors or med students have an opinion on this? Thanks combatwombat.

Too risky. Could help with some readers, but not worth the risk.

In my experience, the personal statement never gets you in, but can easily keep you out.

 

[notdeadyet]

One other thing worth mentioning:

You do not want to be cliche in your application. When you read through med school applications, you see certain trends and themes. When someone falls into one of these themes, they are less of an individual. They become a "type".

You want to stand out from the rest of the crowd. Unfortunately for a lot of applicants, the way in which they best stand out from the crowd is exactly how a lot of other folks do. So they end up blending in.

Here's a few themes of personal statements that I personally think are best avoided, as they're so common as to blur into one:

Sirens Screaming in the Night. This is the personal statement written by the EMT that is in love with the EMS experience and the autonomy he or she feels out in the field. It varies from the congradulatory to the I'm-cool-because-I'm-jaded. It seems to focus on all the skills and abilities they demonstrate in their job on the rig that they will exceed after about a month on rotations. Not good.

There I Was in a Developing Nation. This seems to follow a neat script of "here I am in _____" written in a way that is very visual and first person and immediate. Then the essay goes back and traces how their life lead up to this month in Uganda or summer in Peru or somesuch. Oftentimes you get the impression that the experience was largely based on how cool it was to be in a developing country for a while.

Look What I Overcame. This is another trend that can be tiresome if it's not done incredibly well (and it's often not). When it's about growing up poor and discriminated against in Missisisippi, it can be very effective. When it's about immigrating to this country by slow boat from Cambodia, it can be very telling. But it's usually about overcoming a disease or illness and how it will make you a more sympathetic or insightful physician. These are way too common.

The best applications do not follow a script and aren't about One Thing. The best applications are ones in which the reader walks away with a pretty good impression of who you are as an individual. If who you are is an EMT, or a Guatamala Visitor or a Broken Hip survivor, you're not starting off strong. Readers want to get an impression of a well-rounded, well-developed individual whose story can't be summarized in an elevator pitch.

Just my $0.02...

 

[lord_jeebus]

In my opinion, you don't even need a theme.

Keep It Simple.

Who are you?
How, honestly, did you decide on a career as a physician? Can you prove to me that you know what you're getting into?
What are you looking for in a medical school? Why are these things important for your career goals?
Why are you a stronger candidate than most of our applicants, who will not get an interview due to the high number of applications?

Answer all of that clearly and in a genuine way, and I say you're in the 97th percentile of personal statements.

If you can do all that, then focus on the gravy - how to package yourself so I can simplify who you are, remember that, and make a clear argument for admission on your behalf.

 

[tport]

Hi CfromLA,

I suffered from severe panic disorder my freshman year of college. My grades really suffered, too. Thankfully, I got it fully under control and have worked very successfully full-time as a teacher for the past seven years. My disorder was one of the biggest reasons I wanted to go in to medicine. Now that I'm applying, I struggled with whether or not to put it in my statement as well. At first, I had a very big paragraph of my statement dedicated to what my time with the disorder was like, and how I got out of it. However, my advisor had me scrunch it down to a simple couple of sentences. It made more sense to me later on, because that is simply not who I am anymore. It was a really big deal back then, but now it is not. So, I did put it in my statement, and my advisor was a bit worried about it because of the stigma, but she said that as long as I made it clear that I am currently very successful and competent, then it should be ok. Honestly, I know that the stigma is there with many in the medical field, but if they're going to boot me out b/c of it, then it'll just make me want to go in to the field even more to get rid of the stigma. I have complete faith I'll get in. It is a part of me that I am not ashamed of. I would just suggest adding it in to your statement tactfully, briefly, and matter-of-factly, and then going on to state what a great, competent, well-rounded individual you are now who is completely empathetic and understanding and who is totally dedicated to the field of medicine. I'm sure there is so much more to you than your disorder -- and that's what's important! I'm not sure yet whether or not this has worked for me, but I have a good feeling that it will! Good luck!

 

[Pauligirl]

I strongly agree with the others that suggest you to not bring up your illness. I wouldn't even call it disclosing because as far as I know there's no little box on the app specifically asking you about mental illness is there? I don't see it as lying by not bringing it up.🙄

My undergrad transcript is probably similar to yours. I have many W's and E's (because I didn't bother dropping the classes). The last time I checked I think it showed 138 completed credits out of 180 attempted.😳 And that's not including the screw-ups I had at community college before attending a university.

Not too long ago I was diagnosed with a learning disability. Do you think I'm going to bring it up when I apply to a professional/grad school? Hell no! I don't want anyone's pity and I in no way want it to be a determining factor in my admission. I'm just not the sort of person who will proclaim "look at me! Look what I've overcome!" I view that sort of thing as being whiney and kinda attention seeking. BUT I will register with the college's disability services AFTER I am accepted, just in case I do need accomodation. While checking out the disability resources that various schools offer I noticed "emotional disorders" mentioned. You should look into it at your school if you haven't already.

So if/when someone asks me about my past mistakes I will simply say "I was not focused." Which is a truthful answer. I doubt anyone is going to ask why I wasn't focused. 😕

You might want to check into your college's policy on academic forgiveness/grade removal policy. 👍

Hope you figure out a reason or solution as to why you feel the need to mention your illness.

Best of Luck in your endeavors!🙂

 

[Lacheln]

So if/when someone asks me about my past mistakes I will simply say "I was not focused." Which is a truthful answer. I doubt anyone is going to ask why I wasn't focused. 😕

Incorrect, they are extremely likely to ask why you weren't focused, because they are going to want to know what's different now and what you learned from it.

I don't think discussing the challenges you've faced from a learning disability qualifies as attention seeking. It's an opportunity to share what you've learned about yourself and how to handle problems, as well as how it may improve your patient interaction skills. No adcom is going to go "oh, she had a learning disability, all is forgiven" but by bringing it up you have a chance to spin a negative into a positive. And an answer like "I was immature" is a bit less powerful.

To the OP, as everyone else said, there's no need to mention it (just like any other medical issue), there's nothing morally questionable about not bringing it up.

 

[CfromLA]

Thank you for your advice, everyone.

 

[sitthakim]

I think this brings up the question of what adcoms expect from applicants, which obviously varies from school to school. I'd like to think there's at least ONE school out there willing to accept a candidate who went through some period of struggle and managed to grow and change from it, as long as they could see clearly that growth had occurred and things are different now. Personally I find it an unreasonable expectation that people should always have had everything Figured Out. I would think that if you could demonstrate that you are capable of doing well in class, well on your MCAT, that you are involved, and that you truly desire to be a doctor, SOMEONE will forgive you for not having been the Perfect Premed from the time you were six.

 

[Lacheln]

I think this brings up the question of what adcoms expect from applicants, which obviously varies from school to school. I'd like to think there's at least ONE school out there willing to accept a candidate who went through some period of struggle and managed to grow and change from it, as long as they could see clearly that growth had occurred and things are different now. Personally I find it an unreasonable expectation that people should always have had everything Figured Out. I would think that if you could demonstrate that you are capable of doing well in class, well on your MCAT, that you are involved, and that you truly desire to be a doctor, SOMEONE will forgive you for not having been the Perfect Premed from the time you were six.

I think a large part of why med schools stigmatize mental illness is because stress is a high risk factor for relapses. Sleep deprivation is a high risk factor for relapses. Many people who are successfully managing their illness were only able to do so after spending a lot of time on improving their stress-management skills, establishing a regular exercise routine, and getting 8-9 hours of sleep a night. I'm not at all saying it's not possible to succeed in medical school with bipolar disease, but it is more of a gamble than with someone who is struggling with a more quantifiable disease like diabetes etc., especially when you consider the potential consequences of someone having a manic episode during the clinical years.

(Again, I am NOT saying success isn't possible, just saying why it would be very risky to disclose prior to admission.)

 

[CfromLA]

Many people who are successfully managing their illness were only able to do so after spending a lot of time on improving their stress-management skills, establishing a regular exercise routine, and getting 8-9 hours of sleep a night.

8-9 hours of sleep? They must not have kids...

 

[Lacheln]

8-9 hours of sleep? They must not have kids...

Of course there are people with kids. I guess I should have said 7-9, but bipolar patients are exquisitely sensitive to disruption of their internal clock. I've read studies that show 25-65% of manic episodes are precipitated by sleep deprivation, even mild. And then the mania reduces sleep even more, leading to a nasty downward spiral that can happen very, very quickly. It's something that simply has to be dealt with, like any other illness that requires accommodations.

 

[CfromLA]

Of course there are people with kids. I guess I should have said 7-9, but bipolar patients are exquisitely sensitive to disruption of their internal clock. I've read studies that show 25-65% of manic episodes are precipitated by sleep deprivation, even mild. And then the mania reduces sleep even more, leading to a nasty downward spiral that can happen very, very quickly. It's something that simply has to be dealt with, like any other illness that requires accommodations.

I was just making a joke. I'm the OP and have been dealing with type I bipolar disorder for ten years. I'd like to point out, though, that everyone requires different amounts of sleep--even those with mental illness. I do better on 6-7 hours of sleep (which is good because my sleep is frequently disrupted by my daughter!). Being sleep deprived doesn't necessarily lead to an episode. There are often many contributing factors, and sometimes none. That being said, many manic depressives DO require longer periods of sleep like you said. Adequate sleep, good diet and exercise are good advice for everyone. But I needn't go on about this. I just didn't want you to think I was being snotty or insensitive with my comment. (Note to self: stop telling unfunny jokes.)

 

[Lacheln]

I was just making a joke. I'm the OP and have been dealing with type I bipolar disorder for ten years. I'd like to point out, though, that everyone requires different amounts of sleep--even those with mental illness. I do better on 6-7 hours of sleep (which is good because my sleep is frequently disrupted by my daughter!). Being sleep deprived doesn't necessarily lead to an episode. There are often many contributing factors, and sometimes none. That being said, many manic depressives DO require longer periods of sleep like you said. Adequate sleep, good diet and exercise are good advice for everyone. But I needn't go on about this. I just didn't want you to think I was being snotty or insensitive with my comment. (Note to self: stop telling unfunny jokes.)

Ah, sorry, that is funny in retrospect. 🙂 I forgot that you are the OP and I'm a little touchy about this subject - I have a parent with bipolar I, and have seen so many flippant/ignorant remarks about the illness at various times. You are right , of course, that people vary.

I worked at a residential psychiatric facility for a while, and a large part of the reintegration plans involved structured, consistent sleep. It's not that one night of sleep deprivation, or even a few, is guaranteed to set off a mania, it's just that it's a pretty big risk factor, which is why I brought it up. Exercise and nutrition both contribute to healthy sleep patterns and emotional regulation, so while it is good advice for everybody, it's particularly important for some people. Anyway, you clearly know all this, I'll shut up now. 😀

So, have you decided what approach you're going to take?

 

[njbmd]

So, I need a little advice. I'm a nontrad and am going to apply next year to med school, and I'm wondering how to treat some personal medical problems I had. I was diagnosed with Bipolar Disorder ten years ago, and in the first few years of college I struggled with it it, which led to me failing some classes and then withdrawing from all classes I took for an entire year (that's withdrawing from every class attempted each term).

I ended up taking some time off, then changed from an art to science major (so I've had a lot of schooling), and then taking some time off to start a family. I've been relatively stable for seven years, back in school for two years and my grades are now A's and B's. However, I'm not sure how to address this in my applications and interviews. They will surely ask about the discrepancy in my grades. I'd like to be honest, but I'm afraid of stigma, possible discrimination, and appearing to be a poor candidate. My doctor advised me to not disclose it, and instead say something along the lines of not knowing what I wanted to do, not being motivated, etc.

I realize that overcoming hardships and illness/medical problems is viewed positively. But if your medical problem is MENTAL illness, it seems that view wouldn't likely apply, and would instead be negative.

Aside from this issue and the early "transcript blemishes," I'm intelligent and feel I'm a strong candidate. I'm committed to becoming a physician, and know there are successful doctors out there with this disorder. Does anyone have any thoughts or advice about this? I'd appreciate it all.

Resist the American trend to "tell all" and just say that you had an illness from which you recovered. You do NOT need to go into detail about your medical problems in a professional school interview. You are not going to be asked about specific medical problems and you are not required (nor wanted) to disclose these. Application to medical school is not the same as an appearance on the Jerry Springer Show. We don't want to know specifics of everything in your life.

Overcoming a potentially debilitating illness, whether mental, neurological, respiratory, cardiac, digestive or musculoskeletal IS overcoming difficulty. You can elaborate on what you have learned from the process without going into the process.

You do not need to "explain" withdrawals, poor grades or anything else on your transcript unless specifically asked. In that case, do NOT disclose the specific nature of your medical problems. Too much personal information is a very negative item even if your medical problems involved diabetes. Know when to keep personal items to yourself. This shows that you understand the nature of privacy, especially your own.

 

[CfromLA]

Resist the American trend to "tell all" and just say that you had an illness from which you recovered. You do NOT need to go into detail about your medical problems in a professional school interview. You are not going to be asked about specific medical problems and you are not required (nor wanted) to disclose these. Application to medical school is not the same as an appearance on the Jerry Springer Show. We don't want to know specifics of everything in your life.

Overcoming a potentially debilitating illness, whether mental, neurological, respiratory, cardiac, digestive or musculoskeletal IS overcoming difficulty. You can elaborate on what you have learned from the process without going into the process.

You do not need to "explain" withdrawals, poor grades or anything else on your transcript unless specifically asked. In that case, do NOT disclose the specific nature of your medical problems. Too much personal information is a very negative item even if your medical problems involved diabetes. Know when to keep personal items to yourself. This shows that you understand the nature of privacy, especially your own.

Thanks for the input. I think I'll follow this advice.