Private Mental Health Information Disclosure during interview???

[Neuromyotonia]

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I have received several Psychiatry residency interviews at institutions that have specifically asked me about a history of mental illness as well as psychiatric hospitalization. These application forms are IN ADDITION to ERAS and in my opinion seem inappropriate for several reasons.

1) Neither form has a guarantee of privacy with respect to my mental health information.

2) This could easily be used as a way to not rank applicants, and there is NO assurance to the contrary.

3) This information could easily be disseminated to other institutions and likewise jeopardize my ability to match ANYWHERE.

I have bipolar I and am on an antipsychotic and an antidepressant. I consider myself very well controlled and fully capable of treating patients.

How can these program legally ask such information? Does anyone have any advice? I'm considering cancelling my interviews at these places though I know that lessens my chances of matchinig. (I am a US grad but did not graduate from medical school this year) 😡

 

[notdeadyet]

I've never heard of this nor seen it.

I wouldn't worry about a program director disseminating your application information to other programs. There's no upside for them, they're too busy, and most would probably be rightfully legally worried about doing so.

That said, if I were you, I wouldn't apply further at those places. For one thing, I think asking the question is so ethically dodgy I wouldn't want to train there. For another (and I definitely don't mean this in any judgmental way), you're exactly who they're trying to screen out by asking the question.

If I were you, I'd cancel interviews at these places and then explain your rational.

 

[splik]

name and shame! I think this is outrageous! Unfortunately stigma persists against mental illness in the medical profession and it is ironically nowhere worse than in psychiatry. They really shouldn't be asking these questions at this stage (if at all). Most programs don't want to know, that what the state medical board and physician health programs are for. I wound recommend NOT telling anyone about your bipolar diagnoses except for your psychiatrist, therapist etc especially if it is well controlled. I wouldn't mention it on your licensing forms either if you are saying you are well controlled and there is question of your ability to practice medicine, and you are not asking for any reasonable adjustments.

And you are right, people put a lot of dubious information on their ERAS applications as it is including histories of mental disorder/addiction, and this is NOT confidential in that all the faculty and residents potentially have access to it, along with support staff, and it is not protected health information as it is not a medical record.

 

[Fenster]

I agree. You do not have to disclose anything you don't want to.

 

[MacDonaldTriad]

My BS antenna is not letting me get past this thread.
Really, “several” programs have violated every well-known HR taboo and asked specifically for psychiatric hospitalization histories from potential new employees? Very few programs send out any additional questionnaires beyond the ERAS application. If you are getting requests for additional details, they are aimed specifically at you for a reason, or else I am lead to believe that “several” PDs decided that it would be a good idea to canvas the entire applicant pool with such questions as a way to filter out mental health problems. Am I the only one who sees the later as unlikely?

Even if an application screamed unstable mood disorder, PD’s with a bias against mental illness would just move on. Why would they ask further questions if they had such concerns? Without some context as to why they would ask such questions, it is hard to judge their motivation for asking. None the less, no one should ask these questions unless the applicant opens this discussion. An applicant may choose to do so if some explaining is needed, but this is up to the person applying.

 

[notdeadyet]

Really, “several” programs have violated every well-known HR taboo and asked specifically for psychiatric hospitalization histories from potential new employees? ... If you are getting requests for additional details, they are aimed specifically at you for a reason, or else I am lead to believe that “several” PDs decided that it would be a good idea to canvas the entire applicant pool with such questions as a way to filter out mental health problems. Am I the only one who sees the later as unlikely?

I was wondering about this too.

The one thing I was thinking of is that I know from interviews, if an applicant opens up a topic of discussion, even if it's protected class information, it's fair game (e.g.: I couldn't ask an interviewee if they are married, but if the inteviewee mentions his wife, I can ask what she thinks about moving to Dallas....). I was wondering if the OP mentioned her struggles with mental illness in her personal statement if this made follow-on inquiries fair game?

 

[Neuromyotonia]

I was wondering about this too.

The one thing I was thinking of is that I know from interviews, if an applicant opens up a topic of discussion, even if it's protected class information, it's fair game (e.g.: I couldn't ask an interviewee if they are married, but if the inteviewee mentions his wife, I can ask what she thinks about moving to Dallas....). I was wondering if the OP mentioned her struggles with mental illness in her personal statement if this made follow-on inquiries fair game?

Why would I start a thread like this if it was BS? I can assure you this is 100% real and I have the forms to prove it. I will happily share them after the match process is over. I would rather not name the programs out of concern they will find out.

The questions are in the context of a 'supplemental application' that asks many other generic questions (name, education, program applying to, past work experiences) but at the end are several questions regarding substance abuse, malpractice suits etc. The questions ask about mental illness and psychiatric hospitalization specifically with a yes or no answer required. Each has the seal of the medical school/sponsoring institution at the top. One particular application is freely available on a website for all to see.

@Macdonald: I doubt this was the decision of the PD. Only one supplemental application has specifically asked about psychiatric hospitalization. These applications are both generic from the sponsoring institution as opposed to being from the residency program specifically. I'm sorry you think I'm making this up (why would I?) but this issue is very real.

 

[Psychotic]

Why would I start a thread like this if it was BS? I can assure you this is 100% real and I have the forms to prove it. I will happily share them after the match process is over. I would rather not name the programs out of concern they will find out.

The questions are in the context of a 'supplemental application' that asks many other generic questions (name, education, program applying to, past work experiences) but at the end are several questions regarding substance abuse, malpractice suits etc. The questions ask about mental illness and psychiatric hospitalization specifically with a yes or no answer required. Each has the seal of the medical school/sponsoring institution at the top. One particular application is freely available on a website for all to see.

If it is freely available, why not mention the program here to see if others have also received instructions to fill it out. That way you can get some idea if you have been targeted.

Did the programs specifically tell you to fill out these forms, or did you simply find the forms on their website? I ask because a couple of programs I applied to through ERAS still had paper applications on their websites - I looked them over and did not notice any such questions, but I also did not bother to fill them out and would not have done it if required since these programs accepted ERAS.

One program I have scheduled an interview at has sent an extensive list of documents I must sign and attest to, but I assume this is typical for all programs at some point in the process pre or post match. Questions about disciplinary actions, malpractice or other lawsuits, etc., are included. Permission for them to conduct a criminal background check, too. There may also be question about substance abuse, but nothing on the forms gave me, personally, any pause.

 

[Neuromyotonia]

If it is freely available, why not mention the program here to see if others have also received instructions to fill it out. That way you can get some idea if you have been targeted.

Did the programs specifically tell you to fill out these forms, or did you simply find the forms on their website? I ask because a couple of programs I applied to through ERAS still had paper applications on their websites - I looked them over and did not notice any such questions, but I also did not bother to fill them out and would not have done it if required since these programs accepted ERAS.

One program I have scheduled an interview at has sent an extensive list of documents I must sign and attest to, but I assume this is typical for all programs at some point in the process pre or post match. Questions about disciplinary actions, malpractice or other lawsuits, etc., are included. Permission for them to conduct a criminal background check, too. There may also be question about substance abuse, but nothing on the forms gave me, personally, any pause.

I can attest with almost 100% assuredness that I've not been targeted. These forms appear standard and I am certain that other applicants have received this form as well. Boy, wouldn't it be great if we lived in a world where you could freely post these things without fear of retaliation? Sorry for my reluctance but it's just the world we live in.

 

[Psychotic]

I can attest with almost 100% assuredness that I've not been targeted. These forms appear standard and I am certain that other applicants have received this form as well. Boy, wouldn't it be great if we lived in a world where you could freely post these things without fear of retaliation? Sorry for my reluctance but it's just the world we live in.

So do you personally know others who have received the forms? How can you be 100 percent certain you have not been targeted, and that others have also gotten the forms, unless perhaps as was suggested by something you mentioned in your PS? Did you mention personal struggles with mental health in your PS as motivation to become a shrink? Did you open the door to this kind of inquiry?

I would not fill these forms out prior to an interview. If I was really interested in the program, I would go to the interview and see if they bring it up. And if they do, I might then voice my concerns about the legality and appropriateness issues, see what they say. Otherwise, as others suggested, just cross these programs off your interview list, because something is fishy.

 

[Neuromyotonia]

So do you personally know others who have received the forms? How can you be 100 percent certain you have not been targeted, and that others have also gotten the forms, unless perhaps as was suggested by something you mentioned in your PS? Did you mention personal struggles with mental health in your PS as motivation to become a shrink? Did you open the door to this kind of inquiry?

I would not fill these forms out prior to an interview. If I was really interested in the program, I would go to the interview and see if they bring it up. And if they do, I might then voice my concerns about the legality and appropriateness issues, see what they say. Otherwise, as others suggested, just cross these programs off your interview list, because something is fishy.

I mentioned nothing in my personal statement whatsoever. While my empathy for the mentally ill informs my care of psychiatric patients, it hasn't in my opinion been the overriding reason for pursuing psychiatry. The science and the patients are what I love the most.

 

[Psychotic]

I mentioned nothing in my personal statement whatsoever. While my empathy for the mentally ill informs my care of psychiatric patients, it hasn't in my opinion been the overriding reason for pursuing psychiatry. The science and the patients are what I love the most.

My interview offer experience is n=17, so limited, but I have not been asked for any such health disclosures, although one program has asked for an attestation about substance abuse issues. My point being that something smells here, and it appears to be the program itself. Unless you are desperate for an interview at these programs, I would punt.

 

[notdeadyet]

Why would I start a thread like this if it was BS?

I'm not implying this was BS. You can see from my post that I didn't include that portion of MacDonaldTriad on purpose. I was only agreeing with the idea that maybe this was in response to something in the personal statement. I believe you, I was just wondering about the circumstances.

I haven't seen paperwork like these at the places I applied. I haven't heard of it, even from the (several) friends with mental illness who went into psych residencies. I'm not distrusting, I'm just puzzled.

 

[MacDonaldTriad]

Let me start by apologizing for the use of BS. If these forms are coming from some government entity ahead of an interview granted through ERAS, sadly I find this very believable and I pity the poor program that is subjected to this as their first impression. It is inappropriate, objectionable and probably illegal.

Neuromyotonia, I support your not posting the program. I wouldn’t blame you for not interviewing there, if you don’t, it might be useful to tell them why. I have to assume that the program needs this sort of data to fight the pressures that are insisting on doing this.

 

[Neuromyotonia]

Let me start by apologizing for the use of BS. If these forms are coming from some government entity ahead of an interview granted through ERAS, sadly I find this very believable and I pity the poor program that is subjected to this as their first impression. It is inappropriate, objectionable and probably illegal.

Neuromyotonia, I support your not posting the program. I wouldn’t blame you for not interviewing there, if you don’t, it might be useful to tell them why. I have to assume that the program needs this sort of data to fight the pressures that are insisting on doing this.

Apologies to all for the oversensitivity. All comments have been quite helpful as sources of advice or even just to vent. As soon as the programs submit their rank order list, I'll go ahead and give you guys links to the notorious supplemental applications.

Perhaps I can make this a public policy issue to shine a light on in the future when my training is done...

 

[michaelrack]

It's been a long time since I applied for residency. However, in the past when I applied for jobs at state psych hospitals, I would get 2 applications: 1) job application, which did not ask for any legally suspect info and 2) hospital privilege application, which asked about mental illness etc.

Neuromyotonia, are these apps that ask for mental health history for hospital privileges (although even if they were, I think it is a little too early in the process for you to be getting them)?

 

[Neuromyotonia]

It's been a long time since I applied for residency. However, in the past when I applied for jobs at state psych hospitals, I would get 2 applications: 1) job application, which did not ask for any legally suspect info and 2) hospital privilege application, which asked about mental illness etc.

Neuromyotonia, are these apps that ask for mental health history for hospital privileges (although even if they were, I think it is a little too early in the process for you to be getting them)?

Not for hospital privileges that I can see on the application. They are billed as supplemental applications that have the insignia of the sponsoring institution on them.

 

[Psychotic]

Not for hospital privileges that I can see on the application. They are billed as supplemental applications that have the insignia of the sponsoring institution on them.

Were you sent these forms and instructed to fill them out? Or did you come across them on the website and assume you need to fill them out? Is there a deadline for turning them in? Like are you supposed to return them prior to your interview? Or at your interview? Do they say anything about requiring this information pre-match?

I would ignore the forms for now. Go to the interview and see if they ask about it. Or, as I would be inclined, just punt the interview. This is a highly unusual request based on everything I have experienced and read.

 

[PhinyGage]

I can attest with almost 100% assuredness that I've not been targeted. These forms appear standard and I am certain that other applicants have received this form as well. Boy, wouldn't it be great if we lived in a world where you could freely post these things without fear of retaliation? Sorry for my reluctance but it's just the world we live in.

I do recall my Program/GME SPECIFICALLY asking its trainees to disclose any mental illnesses at the contract renewal. I do not recall any during the interview or ERAS, and I dont remember signing anything in the initial contract.

I was very offended by this, but my answer would not have changed regardless of my status. This is one of very few times where I would allow my common sense to rule over my professional honor. It's just not worth disclosing this information.

I'd rather put "No" and pray that I do not become manic or severely depressed during residency.

 

[OldPsychDoc]

Is this possibly limited to a couple of specific states? We, for example, will not interview candidates who will be ineligible for state licensure here, and this is an institutional, not program policy. (Our specific exclusion is for # of times failed on USMLEs, so not something we need to ask for via supplementals, since it's already in the ERAS.)

 

[shan564]

I applied to like 100 programs last year, and the only supplemental materials that anybody asked for was a request for USMLE transcripts by one program (which seemed silly, since the NBME sends official USMLE materials to ERAS, but I didn't think too hard about it). I've never heard of anybody else having to fill out supplemental materials either. Is this a new thing?

 

[Fenster]

I applied to like 100 programs last year, and the only supplemental materials that anybody asked for was a request for USMLE transcripts by one program (which seemed silly, since the NBME sends official USMLE materials to ERAS, but I didn't think too hard about it).

ERAS doesn't send the entire transcript to the programs - specifically the second page on your score reports.

 

[splik]

ERAS doesn't send the entire transcript to the programs - specifically the second page on your score reports.

your score report is NOT the same as your transcript and isn't supposed to be used as such. The USMLE transcript is a one page document that lists your scores for all the exams you have taken and that is all.

 

[Fenster]

your score report is NOT the same as your transcript and isn't supposed to be used as such. The USMLE transcript is a one page document that lists your scores for all the exams you have taken and that is all.

Yes, and that is sent to the programs by ERAS and not available to the applicant. So, if a program had asked for a transcript and the applicant was able to send one, he most likely sent the score report?

 

[masterofmonkeys]

umm some STATES require that all STATE EMPLOYEES (which residents are sometimes considered) give this information. I am guessing that this is what this is part of. Some programs will try to weed out 'lost causes' early on by giving out their own forms that reproduce the questions asked without actually being 'official paperwork'. I am guessing that is what you've been seeing.

It's pretty shady that they do so as I typically only see mental health on those forms.