On leave of absence, not sure if I should go to fourth year?

kakashi1992

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Seeking opinions, please be civil.

I became ill with a schizoaffective disorder bipolar type right before I was scheduled to begin the fourth year of med school. I was studying master's of public health following the first psychotic break that happened the year before. Right now I am on a leave of absence, and given my condition I'm pretty sure I'm not going to residency (can't handle the stress).

Does it make sense then for me to go to M4 just to get the fancy M.D. after my name? I figure the point of fourth year is to get into residency anyway, so is there even a point? Also I have autism and have had bad experiences in the past on rotations... People tell me there are jobs in pharma for MDs but I'm not sure if this is really an option.
 
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xffan624

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Seeking opinions, please be civil.

I became ill with a schizoaffective disorder bipolar type right before I was scheduled to begin the fourth year of med school. I was studying master's of public health following the first psychotic break that happened the year before. Right now I am on a leave of absence, and given my condition I'm pretty sure I'm not going to residency (can't handle the stress).

Does it make sense then for me to go to M4 just to get the fancy M.D. after my name? I figure the point of fourth year is to get into residency anyway, so is there even a point? Also I have autism and have had bad experiences in the past on rotations... People tell me there are jobs in pharma for MDs but I'm not sure if this is really an option.

Start with the question. What type of job/environment do you think would be best for your condition? Then try to answer, would an MD help to achieve that? It seems as if you still have significant disability and based on my limited knowledge of the disorders you describe this will not be going away any time soon.
 
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Banco

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If you have one more year I would fill up with the easiest electives and required rotations and acquire the MD; the degree will still open doors and be a benefit to your CV whether you do residency or not.
 
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bngli

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What kind of job?
Consulting is out of the question

I think health IT jobs would look favorably on the degree too. I don't the ACMIO at our hospital ever actually practiced, but he gets paid like a baller (multiple fancy, expensive cars).
 

Mass Effect

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I'm sorry to hear about your diagnosis. Do you have a regular psychiatrist and is that person an MD/DO? Please don't go to an NP. Get yourself an MD or DO, preferably someone academically linked (since they're in the best position to know what residents at their hospital experience in terms of stress) and discuss this with that person.

I think if you can afford it, you should finish and get your MD. You should also take Step 2 and Step 3 if you can to leave the door open for doing residency later if you decide too.

I'm a psychiatrist. I have seen fully licensed doctors with the disorder you have and have seen other physicians with the full spectrum of other mental health disorders. They function well with the right medications and can do the job. So residency is not out of the question based solely on the disorder. If you decide to do residency, you need the most low stress residency you can find. I will say there are some psych residencies that are brutal, but there are other psych residencies that are very, very, very lifestyle friendly (as in, outpatient medicine months, limited night float, home call). I can't speak for other specialties.
 
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Have you considered Pathology?
No, no, no, no, no! Pathologists are the doctors' doctor--there is a lot of interaction with other physicians, some of whom can be entitled and demanding. It's NOT a good field for someone with mental health issues. The one exception might be if you did a limited Clinical Pathology-only residency and got a job as a clinical chemist or microbiologist.
 
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BacktotheBasics

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Sorry to hear this OP. I can only imagine how hard you must have worked to even be in the position you're in right now and to have doors you've dreamed of and worked towards for the majority of your life now (seemingly) shut. I think @xxfan624 answers your question about whether or not to pursue fourth year the best. I'd like to elaborate more on this difficult process. First, it's unclear as to what job you're considering. You say " People tell me there are jobs in pharma for MDs but I'm not sure if this is really an option" and "what kind of job. consulting is out of the question", so what exactly are the things you are looking to possibly do? I am not asking rhetorically, I really can't tell if you are not considering non-clinical careers or if consulting is out but pharmaceutical rep is in? If you could be a bit more concrete, that would help us help you.

Couple points:

1.) Turns out there is an entire website targeted to people who have strayed off the traditional MD->Residency/Fellowship->Attending path: Look for Zebras | The guide to a fulfilling life for physicians and medical professionals | Look for Zebras. Don't get too excited. At first glance it looks pretty thorough, but the more I look at it, the more it seems to be mainly someone else's gig and way of selling their book dedicated to careers outside medicine (which I'm guessing is their career outside medicine). That shouldn't stop you from mining whatever free information you can from it and consider buying the book if you like what you see there (I'm not associated with the site). The site also includes a "non-clinical careers quiz". I took it myself and did not get an option that made sense given the options I picked so I'm not confident in its utility as a decision-maker, but it may give you some general ideas.

2.) You need to talk to people. That's the only way you're going to learn things. The best opportunities are never advertised or else they'd be common knowledge to everyone. COVID makes in-person difficult, but the upside is that less-stressful and budget friendly virtual meetings are now widely accepted. Start by talking to someone in your specific situation or the best you can find. Reach out via FB messenger or whatever you use. Private message classmates you can trust with your situation and ask them if they know someone in that situation that you can talk to. Be patient and consider everything as this is just an exploration phase. Then, try cold-calling some places that have job offerings you'd be pursuing (for jobs that do and do not require the MD). Don't commit yourself to anything, but try to get a sense of the details.

3.) After you've done #1/#2, try to decide what you want to do and then based off that, decide if you need to do 4th year to keep your doors open or be competitive.

4.) As someone above said, do not let your diagnoses limit you. You have gotten this far. If your desire is truly clinical medicine, find a Psychiatrist and Psych-D/PhD therapist who're invested in you and try to move forward. You may have significant limitations in what you have to do like having a very low stress environment but you should definitely explore these options!

Hope this helps. You will do well.
 
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BacktotheBasics

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I'm sorry to hear about your diagnosis. Do you have a regular psychiatrist and is that person an MD/DO? Please don't go to an NP. Get yourself an MD or DO, preferably someone academically linked (since they're in the best position to know what residents at their hospital experience in terms of stress) and discuss this with that person.

I think if you can afford it, you should finish and get your MD. You should also take Step 2 and Step 3 if you can to leave the door open for doing residency later if you decide too.

I'm a psychiatrist. I have seen fully licensed doctors with the disorder you have and have seen other physicians with the full spectrum of other mental health disorders. They function well with the right medications and can do the job. So residency is not out of the question based solely on the disorder. If you decide to do residency, you need the most low stress residency you can find. I will say there are some psych residencies that are brutal, but there are other psych residencies that are very, very, very lifestyle friendly (as in, outpatient medicine months, limited night float, home call). I can't speak for other specialties.

It irks me when Pathology (or Radiology) becomes a default suggestion to when considering residency alternatives. You should do what you like. It's a field like every other one and has its pros/cons.
 
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24blue8

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If you can, I think you should finish. Get the degree with the easiest course load you can swing. Then reassess.

In training I've witnessed/known residents with the same diagnosis-- one was hozpitalized due to the stress/sleep and eventually came back; others were dismissed or resigned. Different departments and specialities had different approaches and that's also something to consider it residency is ever on the table. People with mental/physical difficulties can and do make it through their training or even just first year and get a license before stopping.

As others have said, there are practicing physicians with the diagnosis who are able to do this job if they were able to find the right treatment for them. But you need to do what's right for you and take care of yourself.
 

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