I have my MD degree (took 7 years), but never applied into residency. Here's what happened in med school:
I did well in my first year- mostly A's and B's. Did decide to take an extra year to graduate so i could go at a more relaxed pace during preclinical and because I had a history of migraines. Taking an extra year was generally accepted at my school (lots of people took this path).
Sometime in my second year of school, I began to feel fatigued. I also started having increasing problems with my balance. My reflexes were brisker. First neurologist I saw was not affiliated with my school. She worked me up for MS (no spinal tap), lupus, and almost every zebra one could possibly think of. All tests came back negative and she told me she didn't think I was "faking things", but that it might take 7 years to get a diagnosis- perhaps someday my ANA would turn positive.
Fatigue progressed, as did migraines. Saw another neurologist, this time an attending from my school. He accused me of faking my reflexes, screamed at me that I was just depressed, and wrote these things in my chart, unbeknownst to me. After this, many of my primary doctors at the student health center started treating me like a psych case. I was placed on antidepressants, which made me feel really goofy and spacy. I went in frequently with what felt like a lot of thyroid symptoms. my TSH was checked and I was reassured my gland was okay.
Prior to clinical years, got another neurology opinion from an outside doctor. He thought I had depression or chronic fatigue syndrome. By this time, I was growing increasingly scared about clinical rotations and my stamina. I felt really really tired, like I might slip into a coma- but I never did. My legs felt weak, like my muscles had been replaced with jelly. Increasing problems with balance.
Passed step 1 on first try but did below average
Clinical years:
OB/GYN: passed- did at outside facility
IM: had a really hard time (this was before the 80 hour limits), especially with call, which triggered severe migraines. I was laughed at on wards, screamed at for trying to call in sick and so I dropped out after 3 weeks and took the rest of the rotation off to rest
FP: passed- did at outside facility
Surgery: failed. Did 4 weeks of burns, which was mostly ICU patients when i hadn't really learned the floor patients yet. Also, I did not know my way around the hospital yet. Learning my way around was really difficult because I had to always fight to keep my balance and not fall down. Going into the surgeries was painful because I was asked to hold up the patients' limbs, while trying to keep my balance and answer a wide range of non-burn surgical pimp questions that I hadn't yet studied for. I had increasing trouble running up stairs with the team and would get the most excruciating migraines if I pushed myself too hard physically. I did get good evaluations on the second half of surgery, but my school asked me to repeat the whole rotation since I tanked the shelf. I was absolutely exhausted and felt like I could easily slip into a coma.
I took some time off and got some more second opinions from my school's neurology headache clinic:
First I saw a pain fellow. He worked me up for some things, but when the tests came back negative, he decided that I was not sick except for migraines. I was reassuredmy thyroid was okay when my TSH came back normal. He put me on propranolol. He ignored my complaints of arm and leg jerks and wrote in my chart that everything I said should be treated as "hearsay", as I was a medical student and likely overly influenced by reading things in my textbooks. Student health center docs really treated me like I had psychosomatic compliants after that. I had no idea what was written in my chart.
Next i saw a neurology attending from the headache clinic (fellow left, so I was transferred to attending). He essentially agreed with fellow and wrote in my chart that I needed therapy and couldn't handle the stress of medical school, etc etc.
I felt sicker than ever, with increased headaches and fatigue so profound in retrospect I probably should have been using a motorized wheelchair. Just getting out of my car required thrusting my body into the car door to open it.
Second attempt at surgery: failed again- I could tell I was being watched very closely by the team. In fact one of the resident's I worked with was the same one from my first attempt. She screamed at me for being slow, etc... was very abusive. I went to the student health center a lot with complaints of dry skin, constipation, hair loss (I had lost about half my hair), etc. Reassured my thyroid was okay.
The student progress committee asked why I was having difficulties. I repeated what the neurologists had told me. So they asked me to see one of their psychiatrists. I was to see the psychiatrist, take time off, finish up all of my other rotations and then come back and do surgery.
In the mean time, I went back to the first neurologist who urged me to see the campus disability office and get a letter stating that I was to take elevators instead of stairs, etc etc Neurologist also repeated zebra labs and MRI and this time did a spinal tap, which was negative. She said I had "something akin to MS, but not MS"- she did not know, but believed I was sick/ neurologically ill.
Peds: Got good evaluations but missed the shelf by one point. Had to go back to student progress committee, who almost kicked me out. One dean, a pediatric neurologist, told me I should consider leaving med school, as "no residency program would want you with your track record anyways". I tried to explain that I had been worked up for MS, but they were more interested in talking to the psychiatry attending they had asked me to see. Another dean, the associate dean, kept calling me "different". It was well known that he led meetings every two months with the course instructors to discuss the problem students. I have no proof, but I really feel like they were talking about me like I was a basket case.
Psych: passed but felt very very uncomfortable because all the attendings knew I had seen their colleague and had "issues". One attending asked me how much antidepressant I was on, etc. I felt talked about behind my back, and like they were doing continual psych evals on me. In the mean time, I still had issues with fatigue, and my balance was so bad I had trouble sitting upright on chairs with wheels, etc
IM: did well
Surgery: had to pull out of first site because they kept referring to the fact that I had failed before and I felt highly scrutinized. No mention had been made about my disability letter (in fact, the instructor in charge of the surgery course was completely unaware that I had a letter- it apparently was not being brought up at the course instructor meetings), etc- only that I had failed and was a problem student. After this switch I did okay. I did well on the first service and average on the second one where I was being very closely watched by the surgery course instructor. I can understand why they wanted to watch me more closely, but the net effect was that it made me lose my balance more, etc
4th year:
started using cane for balance.
Honored in several electives, but was reprimanded for going too slow in IM.
Pulled aside by dean, who was concerned I would not pass the clincal part of step 2. He also called me "different" again.
I did pass step 2 and with no accomodation other than using my cane.
I graduated in good standing, but never applied into match, In fact, I didn't even get a dean's letter until a year later and it said that I would not finish school unless I overcame my "issues". I had never collected letters of reccomendation, as I felt completely mislabeled and discouraged, and thoroughly talked about by my attendings.
I applied into an MPH program instead and towards the end of this I finally got diagnosed by one of my neurology attendings, who is an incredibly kind soul.
As it turns out, I have Hashimoto's Encephalopathy. It's a rare complication of the thyroiditis, and ultrasound of my gland showed it to be full of tiny nodules. Most people who have HE are euthyroid. It can cause severe migraines, ataxia, fatigue, myoclonus, coma, plus a host of other symptoms. As I was going through school, case reports of my illness were collecting in the medical literature, and other schools were even discussing it in grand rounds.
It's treated with steroids and is often reversible if caught early.
After I found out my diagnosis, I went back through my chart (which was 4 inches thick) to see how many times I had come in complaining of thyroid symptoms (quite often) and that's when I saw all the comments made by my instructors. I was devastated.
Some time (and 3 steroid treatments) has passed and I'm doing better. My balance is much improved, as is the fatigue. I still have migraines, but they are improved.
My question is: if I someday feel strong enough to pursue residency (most likely in neuro), how do I explain all of the above?
I understand that doctors need to be in tip-top shape, and need to be competent so they can do right by their patients, and it's the school's duty to make sure that they graduate good students. But at the same time, I feel let down. I went back to my school's own doctors over and over, begging for a diagnosis and they treated me like I was nuttier than a jar of skippy. And then this was passed around to my course instructors, I'm sure.
Is this situation salvageable? If so, how?
I did well in my first year- mostly A's and B's. Did decide to take an extra year to graduate so i could go at a more relaxed pace during preclinical and because I had a history of migraines. Taking an extra year was generally accepted at my school (lots of people took this path).
Sometime in my second year of school, I began to feel fatigued. I also started having increasing problems with my balance. My reflexes were brisker. First neurologist I saw was not affiliated with my school. She worked me up for MS (no spinal tap), lupus, and almost every zebra one could possibly think of. All tests came back negative and she told me she didn't think I was "faking things", but that it might take 7 years to get a diagnosis- perhaps someday my ANA would turn positive.
Fatigue progressed, as did migraines. Saw another neurologist, this time an attending from my school. He accused me of faking my reflexes, screamed at me that I was just depressed, and wrote these things in my chart, unbeknownst to me. After this, many of my primary doctors at the student health center started treating me like a psych case. I was placed on antidepressants, which made me feel really goofy and spacy. I went in frequently with what felt like a lot of thyroid symptoms. my TSH was checked and I was reassured my gland was okay.
Prior to clinical years, got another neurology opinion from an outside doctor. He thought I had depression or chronic fatigue syndrome. By this time, I was growing increasingly scared about clinical rotations and my stamina. I felt really really tired, like I might slip into a coma- but I never did. My legs felt weak, like my muscles had been replaced with jelly. Increasing problems with balance.
Passed step 1 on first try but did below average
Clinical years:
OB/GYN: passed- did at outside facility
IM: had a really hard time (this was before the 80 hour limits), especially with call, which triggered severe migraines. I was laughed at on wards, screamed at for trying to call in sick and so I dropped out after 3 weeks and took the rest of the rotation off to rest
FP: passed- did at outside facility
Surgery: failed. Did 4 weeks of burns, which was mostly ICU patients when i hadn't really learned the floor patients yet. Also, I did not know my way around the hospital yet. Learning my way around was really difficult because I had to always fight to keep my balance and not fall down. Going into the surgeries was painful because I was asked to hold up the patients' limbs, while trying to keep my balance and answer a wide range of non-burn surgical pimp questions that I hadn't yet studied for. I had increasing trouble running up stairs with the team and would get the most excruciating migraines if I pushed myself too hard physically. I did get good evaluations on the second half of surgery, but my school asked me to repeat the whole rotation since I tanked the shelf. I was absolutely exhausted and felt like I could easily slip into a coma.
I took some time off and got some more second opinions from my school's neurology headache clinic:
First I saw a pain fellow. He worked me up for some things, but when the tests came back negative, he decided that I was not sick except for migraines. I was reassuredmy thyroid was okay when my TSH came back normal. He put me on propranolol. He ignored my complaints of arm and leg jerks and wrote in my chart that everything I said should be treated as "hearsay", as I was a medical student and likely overly influenced by reading things in my textbooks. Student health center docs really treated me like I had psychosomatic compliants after that. I had no idea what was written in my chart.
Next i saw a neurology attending from the headache clinic (fellow left, so I was transferred to attending). He essentially agreed with fellow and wrote in my chart that I needed therapy and couldn't handle the stress of medical school, etc etc.
I felt sicker than ever, with increased headaches and fatigue so profound in retrospect I probably should have been using a motorized wheelchair. Just getting out of my car required thrusting my body into the car door to open it.
Second attempt at surgery: failed again- I could tell I was being watched very closely by the team. In fact one of the resident's I worked with was the same one from my first attempt. She screamed at me for being slow, etc... was very abusive. I went to the student health center a lot with complaints of dry skin, constipation, hair loss (I had lost about half my hair), etc. Reassured my thyroid was okay.
The student progress committee asked why I was having difficulties. I repeated what the neurologists had told me. So they asked me to see one of their psychiatrists. I was to see the psychiatrist, take time off, finish up all of my other rotations and then come back and do surgery.
In the mean time, I went back to the first neurologist who urged me to see the campus disability office and get a letter stating that I was to take elevators instead of stairs, etc etc Neurologist also repeated zebra labs and MRI and this time did a spinal tap, which was negative. She said I had "something akin to MS, but not MS"- she did not know, but believed I was sick/ neurologically ill.
Peds: Got good evaluations but missed the shelf by one point. Had to go back to student progress committee, who almost kicked me out. One dean, a pediatric neurologist, told me I should consider leaving med school, as "no residency program would want you with your track record anyways". I tried to explain that I had been worked up for MS, but they were more interested in talking to the psychiatry attending they had asked me to see. Another dean, the associate dean, kept calling me "different". It was well known that he led meetings every two months with the course instructors to discuss the problem students. I have no proof, but I really feel like they were talking about me like I was a basket case.
Psych: passed but felt very very uncomfortable because all the attendings knew I had seen their colleague and had "issues". One attending asked me how much antidepressant I was on, etc. I felt talked about behind my back, and like they were doing continual psych evals on me. In the mean time, I still had issues with fatigue, and my balance was so bad I had trouble sitting upright on chairs with wheels, etc
IM: did well
Surgery: had to pull out of first site because they kept referring to the fact that I had failed before and I felt highly scrutinized. No mention had been made about my disability letter (in fact, the instructor in charge of the surgery course was completely unaware that I had a letter- it apparently was not being brought up at the course instructor meetings), etc- only that I had failed and was a problem student. After this switch I did okay. I did well on the first service and average on the second one where I was being very closely watched by the surgery course instructor. I can understand why they wanted to watch me more closely, but the net effect was that it made me lose my balance more, etc
4th year:
started using cane for balance.
Honored in several electives, but was reprimanded for going too slow in IM.
Pulled aside by dean, who was concerned I would not pass the clincal part of step 2. He also called me "different" again.
I did pass step 2 and with no accomodation other than using my cane.
I graduated in good standing, but never applied into match, In fact, I didn't even get a dean's letter until a year later and it said that I would not finish school unless I overcame my "issues". I had never collected letters of reccomendation, as I felt completely mislabeled and discouraged, and thoroughly talked about by my attendings.
I applied into an MPH program instead and towards the end of this I finally got diagnosed by one of my neurology attendings, who is an incredibly kind soul.
As it turns out, I have Hashimoto's Encephalopathy. It's a rare complication of the thyroiditis, and ultrasound of my gland showed it to be full of tiny nodules. Most people who have HE are euthyroid. It can cause severe migraines, ataxia, fatigue, myoclonus, coma, plus a host of other symptoms. As I was going through school, case reports of my illness were collecting in the medical literature, and other schools were even discussing it in grand rounds.
It's treated with steroids and is often reversible if caught early.
After I found out my diagnosis, I went back through my chart (which was 4 inches thick) to see how many times I had come in complaining of thyroid symptoms (quite often) and that's when I saw all the comments made by my instructors. I was devastated.
Some time (and 3 steroid treatments) has passed and I'm doing better. My balance is much improved, as is the fatigue. I still have migraines, but they are improved.
My question is: if I someday feel strong enough to pursue residency (most likely in neuro), how do I explain all of the above?
I understand that doctors need to be in tip-top shape, and need to be competent so they can do right by their patients, and it's the school's duty to make sure that they graduate good students. But at the same time, I feel let down. I went back to my school's own doctors over and over, begging for a diagnosis and they treated me like I was nuttier than a jar of skippy. And then this was passed around to my course instructors, I'm sure.
Is this situation salvageable? If so, how?
