psychoanalyzed during residency interviews

[splik]

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Splik, I am curious why you think WashU sticks its head in the sand and why we would consider it unprofessional? Psych illness is damn common so why I would be surprised if somebody has psych illness in their family and is why they are interested in the field.

I am not familiar with what WashU does so I apologize if I was intimating something that is not the case, but Harry suggested talking about a family history of mental illness is "unprofessional", which I disagreed with, and made a link between that knowing that certain biologically oriented programs (Hopkins specifically) have been scathing about the idea that people might choose psychiatry because of a personal or family history of mental disorder. I named Hopkins in particular because I can state with certainty that they historically have had the belief that choosing psychiatry is not different from choosing any other medical specialty, like endocrinology (the example given when I interviewed there a while back) and had nothing to do with more personal experiences. I believe the former PD went as far as to suggest he was suspicious of applicants who made this connection and believed it did a disservice to the field, separating it from other medical specialties. This struck me as bizarre given that there are plenty of people who choose hem/onc because of a family history of cancer and no one would react with suspicion or cries of lack of "professionalism" in that case.

 

[NickNaylor]

Thanks for all the responses! Would it be okay to discuss immediate family members with psych illnesses especially if I'm asked about my childhood and such?

I would agree that bringing up personal experience with mental illness is not "unprofessional" or definitively off the table. However, I think the impact/value of bringing up those experiences is all in how you present it. For example, my father was diagnosed with bipolar disorder and had a fairly severe manic episode while I was in college. In retrospect, this was an important experience for me, led to my initial interest in psychiatry, and, I think, has improved my ability to empathize with those with serious mental illness. I think those thoughts and experiences are relevant to the ultimate question of "why psychiatry?" other than academic interest(s) and career goals.

I agree that any personal experience with mental illness probably shouldn't form the foundation of your interest in psychiatry. But I disagree with the idea that it should be avoided altogether. We are human, and these experiences matter and often shape our interests. Breaking down in an emotional fit during your interview is probably not something you want to do, but I think it's completely reasonable and fair game to talk about experiences which have had a significant impact on your professional development up that point, including any personal experiences you've had.

 

[psychattending]

I am not familiar with what WashU does so I apologize if I was intimating something that is not the case, but Harry suggested talking about a family history of mental illness is "unprofessional", which I disagreed with, and made a link between that knowing that certain biologically oriented programs (Hopkins specifically) have been scathing about the idea that people might choose psychiatry because of a personal or family history of mental disorder. I named Hopkins in particular because I can state with certainty that they historically have had the belief that choosing psychiatry is not different from choosing any other medical specialty, like endocrinology (the example given when I interviewed there a while back) and had nothing to do with more personal experiences. I believe the former PD went as far as to suggest he was suspicious of applicants who made this connection and believed it did a disservice to the field, separating it from other medical specialties. This struck me as bizarre given that there are plenty of people who choose hem/onc because of a family history of cancer and no one would react with suspicion or cries of lack of "professionalism" in that case.

I don't know how Hopkins operates; so I won't comment about that. I agree with you that people sometimes choose to go into medicine or a specific specialty because of their family's experience. Hence why it is a non-issue for us here.

 

[Jules A]

No. This is a job interview, and you need to sell yourself as someone with the academic background and (medical) knowledge necessary to do the job. As much as personal experience (either your own and/or with family) may have influenced your choice in going into psychiatry, bringing this up during an interview is unprofessional. It will make you stand out (negatively) in most cases. I didn't realize how many applicants do things like this as some sort of false bravado in a vain attempt to "set themselves apart" until I became a resident and saw what applicants were and weren't doing.

I have enjoyed reading the different view points and agree with HarryMTieboutMD. If I were on the panel an in depth disclosure of personal history whether it be medical or mental health would lead me to question the individual's boundaries and in psychiatry boundaries are rather important. This isn't about the stigma of mental health because I also wouldn't be impressed by someone disclosing their personal journey with cancer if applying for a position in oncology either. Certainly our life experiences shape our career choices however I prefer someone who is professional and objective over someone riding the coat tails of their personal agenda. Perhaps if the questions are geared toward this type disclosure that organization would be less judgemental? I'd guess it could go either way depending on which faction you get on the panel so I aim for middle of the road just to be safe.

 

[Dharma]

tips for when some shrink pulls that analyst bs:

 

[Therapist4Chnge]

To quote a classic from TLP "Shrinks go into psychiatry to avoid figuring themselves out. The best way to avoid judgment is to become the judge. Overruled. Overruled I say."

I really should go back and read some of his classic posts. I didn't always agree, but he made me think more than most bloggers.

 

[SourceOfDenial]

Interestingly, when interviewing for palliative fellowship spots I got asked several times if I had a personal experience with the field. As a psychiatrist it struck me as ironic that having personal experience was now viewed as a positive.

 

[Therapist4Chnge]

DO NOT bring your mother to the dinner with residents the night prior to interviews.
Yes, this happened.
No analysis/interpretation needed.

Whoa.

This happened to a buddy of mine who was interviewing interns for his investment firm…multiple applicants brought their mothers. He also told me that other applicants tried to negotiate "better" experience/exposure before even starting day 1.

 

[FlowersFromTheSun]

I am not familiar with what WashU does so I apologize if I was intimating something that is not the case, but Harry suggested talking about a family history of mental illness is "unprofessional", which I disagreed with, and made a link between that knowing that certain biologically oriented programs (Hopkins specifically) have been scathing about the idea that people might choose psychiatry because of a personal or family history of mental disorder. I named Hopkins in particular because I can state with certainty that they historically have had the belief that choosing psychiatry is not different from choosing any other medical specialty, like endocrinology (the example given when I interviewed there a while back) and had nothing to do with more personal experiences. I believe the former PD went as far as to suggest he was suspicious of applicants who made this connection and believed it did a disservice to the field, separating it from other medical specialties. This struck me as bizarre given that there are plenty of people who choose hem/onc because of a family history of cancer and no one would react with suspicion or cries of lack of "professionalism" in that case.

Yeah, this is what I was about to say. I know someone who wants to go into GI because their sister developed Crohn's when they were kids. I didn't realize that was unprofessional.... You're just supposed to develop interest in your chosen specialty in a vacuum, I guess?

Nothing makes me dislike medicine more than this idea that doctors are supposed to be robot-people.

 

[HarryMTieboutMD]

Yeah, this is what I was about to say. I know someone who wants to go into GI because their sister developed Crohn's when they were kids. I didn't realize that was unprofessional.... You're just supposed to develop interest in your chosen specialty in a vacuum, I guess?

Nothing makes me dislike medicine more than this idea that doctors are supposed to be robot-people.

Here are some of the issues (and btw I am on the applicant's side)

1. No one of any significance refers to programs as "biological" anymore.

2. Yes, just like in every specialty personal experience/family experience can spark an interest.

3. Though we are (hopefully) advocates for our patients and psychiatric issues vis-a-vis public health, psychiatrists don't like their colleagues having disorders they treat (or in the case of addiction, attempt to and repeatedly fail to treat) even though MANY of them do. And regarding family members, given strong genetic diatheses, well, res ipsa loquitur... It would be great if all PDs/academicians involved in education were as sensible and forward thinking as @psychattending, but this is not the case.

4. As an applicant, one is trying to make an appeal to the program that he or she is worthy of being ranked in a competitive position. Yes, for most decent candidates, matching is not an issue, but psychiatry IS becoming more top heavy, and the better programs (not just the top 3-4) are becoming more competitive. Hence it makes sense to do everything possible to paint yourself in the best light, which means doing well on Step 1, going to a good medical school, and performing well in medical school. Everything else is far less important (multiple PDs on this board have said as much). Disclosing *might* make you memorable (though probably won't because lots of people do it), but you are leaving yourself at the mercy of the opinion/bias/view of who interviews you.

5. While what drives you may be personally important to you, what your program (and co residents) care about is that you work hard, show and do your job, can work well with others, don't dry to deflect responsibility/miss days for BS reasons, etc.

 

[Monocles]

Maybe to provide a different perspective: I applied to almost exclusively analytic and psychotherapy leaning programs and found a lot of the interview questions to be insight provoking and fascinating. Another way to look at the questions (as intrusive or perhaps illegal? as some may be) is to see whether or not applicants are psychologically-minded or introspective with their own selves (again, I'm not commenting on whether or not they are illegal).

Overall for me personally, I had a positive experience and got a lot of free therapy out of it lol.

 

[OldPsychDoc]

...
5. While what drives you may be personally important to you, what your program (and co residents) care about is that you work hard, show and do your job, can work well with others, don't dry to deflect responsibility/miss days for BS reasons, etc.

This.

 

[smalltownpsych]

tips for when some shrink pulls that analyst bs:

Flip it on them. Love it. They take an analytic stance, take it right back at them. "Hmmm. Interesting question. I wonder what makes you ask that?"

 

[psychattending]

Here are some of the issues (and btw I am on the applicant's side)


3. Though we are (hopefully) advocates for our patients and psychiatric issues vis-a-vis public health, psychiatrists don't like their colleagues having disorders they treat (or in the case of addiction, attempt to and repeatedly fail to treat) even though MANY of them do. And regarding family members, given strong genetic diatheses, well, res ipsa loquitur... It would be great if all PDs/academicians involved in education were as sensible and forward thinking as @psychattending, but this is not the case.

4. As an applicant, one is trying to make an appeal to the program that he or she is worthy of being ranked in a competitive position. Yes, for most decent candidates, matching is not an issue, but psychiatry IS becoming more top heavy, and the better programs (not just the top 3-4) are becoming more competitive. Hence it makes sense to do everything possible to paint yourself in the best light, which means doing well on Step 1, going to a good medical school, and performing well in medical school. Everything else is far less important (multiple PDs on this board have said as much). Disclosing *might* make you memorable (though probably won't because lots of people do it), but you are leaving yourself at the mercy of the opinion/bias/view of who interviews you.

5. While what drives you may be personally important to you, what your program (and co residents) care about is that you work hard, show and do your job, can work well with others, don't dry to deflect responsibility/miss days for BS reasons, etc.

Just to return back to this topic and to be more clear about how I (and I would hope the other PDs but maybe everybody is not "forward thinking") see things.
- The reason why I ask what draws you to psychiatry is so that I have something to talk about during our interview time. It helps me to get to know you. It would have to be something pretty outrageous for the answer to negatively impact how I view you.
- It is fine to indicate in an interview that it is a relative with an illness. As others have alluded to, the discussion should not be overly detailed, cross boundaries, and thus become unprofessional. All I need to hear is that your sister has depression and this has opened up your eyes to all the suffering that people with MDD have and you want to have an impact in that area.
- What I care about as a PD is performance, i.e. how you did in med school (and even before), since that is a predictor of how you will perform in residency. If you performed well, I really don't care that you have a genetic risk for illness (or if you even have the illness). I think doing so might even go against the spirit of the ADA.

 

[Samus Aran]

This happened at CHA so I wasn't surprised since it is very psychodynamically-oriented, but I was definitely caught off guard in the moment. I told the interviewer after one particularly invasive question that I wasn't comfortable answering his question and he moved on. To be fair this only happened with one particular interviewer out of four.

 

[MrChance2]

I thought for like 2 seconds about answering a particularly weird question and the interviewer said "No, don't think about it, just say the first thing that comes to mind." I've also gotten "Tell me about your family" where I respond with general stuff about them and what they do for a living, how many siblings I have, where they live etc and get a "tell me more." I don't mind playing along but it seems a bit out of place.

 

[Therapist4Chnge]

I thought for like 2 seconds about answering a particularly weird question and the interviewer said "No, don't think about it, just say the first thing that comes to mind." I've also gotten "Tell me about your family" where I respond with general stuff about them and what they do for a living, how many siblings I have, where they live etc and get a "tell me more." I don't mind playing along but it seems a bit out of place.

Do you know the Dr. Evil monologue….?

 

[thoffen]

I thought for like 2 seconds about answering a particularly weird question and the interviewer said "No, don't think about it, just say the first thing that comes to mind." I've also gotten "Tell me about your family" where I respond with general stuff about them and what they do for a living, how many siblings I have, where they live etc and get a "tell me more." I don't mind playing along but it seems a bit out of place.

What's wrong with saying that you're a little uncomfortable talking about it in that setting?

I guess if they judge you badly for that, then it's not a place you want to be anyway.

If this was an interview with someone who wasn't an analyst, would you feel the same way? Personally, I find talking about family is a great way to get to know someone, but I'm not turned off by people who keep it more private.

 

[Candidate2017]

I was psychoanalyzed at several interviews and this thread prepared me well. There was nothing inappropriate and those interviews were enjoyable. The people bothered by, "Tell me about your family" will likely end up doing med management.

 

[deleted736562]

I was psychoanalyzed at several interviews and this thread prepared me well. There was nothing inappropriate and those interviews were enjoyable. The people bothered by, "Tell me about your family" will likely end up doing med management.

People who talk about personal stuff in therapy are seeking help. They aren't applying for a job. No one should be put under undue pressure to reveal personal things that they may not be comfortable with. It has nothing to do with whether you like therapy or not. More with abuse of power.

 

[Candidate2017]

People who talk about personal stuff in therapy are seeking help. They aren't applying for a job. No one should be put under undue pressure to reveal personal things that they may not be comfortable with. It has nothing to do with whether you like therapy or not. More with abuse of power.

I agree with Thoffen. "Tell me about your family" and "Tell me about your childhood" is just a grownup version of, "Tell me about yourself". I viewed it as an opportunity to, as someone stated above, to demonstrate intellectual curiosity and set myself apart from people who are easily flustered or offended. If you feel pressured or abused into disclosing more than necessary then you're probably unfit to deal with high functioning patients with personality issues who enjoy pressuring you and testing your limits.

 

[deleted736562]

I agree with Thoffen. "Tell me about your family" and "Tell me about your childhood" is just a grownup version of, "Tell me about yourself". I viewed it as an opportunity to, as someone stated above, to demonstrate intellectual curiosity and set myself apart from people who are easily flustered or offended. If you feel pressured or abused into disclosing more than necessary then you're probably unfit to deal with high functioning patients with personality issues who enjoy pressuring you and testing your limits.

"tell me about your family"/"childhood" is borderline fine. BTW, if you think it would be appropriate to reveal personal things to "high functioning patients with personality issues" then you're in for loads of trouble. Actually, I'll flip that and say your ability or lack of to maintain boundaries with your interviewers MAY be telling of your ability to do the same with patients. But then again, that's unfair cause the power dynamics are so radically different.

 

[NickNaylor]

People who talk about personal stuff in therapy are seeking help. They aren't applying for a job. No one should be put under undue pressure to reveal personal things that they may not be comfortable with. It has nothing to do with whether you like therapy or not. More with abuse of power.

I guess I'm not really sure how "tell me about your family" is suggestive of "abuse of power?"

 

[Shikima]

I guess I'm not really sure how "tell me about your family" is suggestive of "abuse of power?"

One could argue, go to other job interviews and see how many ask you about your family.

 

[postbacpremed87]

I am sure that interviewers have a way of getting stuff out of you (especially seasoned Psychiatrists). Honestly, some of us had a less chaotic upbringing when compared to other interviewees. It does not really matter how juicy your past is. In my opinion, it is how composed and confident you are when responding that impresses them. Non-verbal communication wins the day.

 

[MrChance2]

What's wrong with saying that you're a little uncomfortable talking about it in that setting?

I guess if they judge you badly for that, then it's not a place you want to be anyway.

If this was an interview with someone who wasn't an analyst, would you feel the same way? Personally, I find talking about family is a great way to get to know someone, but I'm not turned off by people who keep it more private.

It didn't make me uncomfortable. I just thought it was kinda strange. It seemed a bit more than a casual conversation starter.

 

[TexasPhysician]

It didn't make me uncomfortable. I just thought it was kinda strange. It seemed a bit more than a casual conversation starter.

Agreed. I think it is silly to assume my childhood greatly influenced my career choice.

No one wants to hear that I thoroughly enjoyed multiple fields and would have been happy, knowledge wise, focusing on any of 3-4 fields. Psychiatry beat out the others due to lifestyle factors and ease of establishing a private practice. I obviously don't state this in an interview though.

 

[HarryMTieboutMD]

What's wrong with saying that you're a little uncomfortable talking about it in that setting?

I guess if they judge you badly for that, then it's not a place you want to be anyway.

If this was an interview with someone who wasn't an analyst, would you feel the same way? Personally, I find talking about family is a great way to get to know someone, but I'm not turned off by people who keep it more private.

That's kind of the whole point. Mosts analysts I've encountered are extremely creepy and entirely self absorbed (besides Dr Brenner at UTSW)- thankfully my department kicked all of them out in the 1960s. The intrusive nature of some of their questions is ridiculous, and if I had to interact with one professionally (which I don't plan on doing), I would lawyer up.

 

[Jules A]

What's wrong with saying that you're a little uncomfortable talking about it in that setting?
I guess if they judge you badly for that, then it's not a place you want to be anyway.
If this was an interview with someone who wasn't an analyst, would you feel the same way? Personally, I find talking about family is a great way to get to know someone, but I'm not turned off by people who keep it more private.

Your line of thinking would be much appreciated in an interview and if I felt someone was simply trying to get to know me I wouldn't feel uncomfortable or as guarded. I'm willing to set limits on what I deem to be inappropriate interview questions but it leaves a bad taste in my mouth. If an interview panel is attempting to make me step out of what is culturally accepted as a professional comfort zone with any topic I would likely interpret that as a bit of a power play. If they want to see how I handle pressure toss me in a seclusion room with a floridly psychotic 350lb patient demanding discharge and see how I manage, no need snoop around for my genetic frailties, childhood trauma or lack thereof because that just comes off as creepy.

 

[Nasrudin]

I might be a heretic with regards to my own heresy. But... i'm starting to switch sides. I'm not sure that relaxing in a comfortable seat. And sinking into a cool reflective silence. From which to pull anything out of myself from the unexpected. Or to do that for an interviewee. Wouldn't be loads for more interesting than hearing myself rattle off my tight 2 minutes around the same restrictive questions that i've encountered hundreds of times on the interview trail. Or than trying to hear that type of thing from an interviewee.

Almost. anything. would be better. Playing HORSE at the park nearby. Tuning up our guitars and trying to jam. anything....

 

[thoffen]

Your line of thinking would be much appreciated in an interview and if I felt someone was simply trying to get to know me I wouldn't feel uncomfortable or as guarded. I'm willing to set limits on what I deem to be inappropriate interview questions but it leaves a bad taste in my mouth. If an interview panel is attempting to make me step out of what is culturally accepted as a professional comfort zone with any topic I would likely interpret that as a bit of a power play. If they want to see how I handle pressure toss me in a seclusion room with a floridly psychotic 350lb patient demanding discharge and see how I manage, no need snoop around for my genetic frailties, childhood trauma or lack thereof because that just comes off as creepy.

I absolutely agree with you. It would be grossly inappropriate to do this, and it shouldn't be your responsibility to establish those limits. Unless I were desperate, if I had to, it is not a place I would want to end up.

And, I really only have my own institution as a frame of reference. I feel that no one here really has those intentions, including the psychoanalysts. I imagine that this is the case at other places, but I can't really know. I do think it is worth considering, however, if our discomfort is from imagining intentions that don't exist.

 

[ziggyhope]

I am not familiar with what WashU does so I apologize if I was intimating something that is not the case, but Harry suggested talking about a family history of mental illness is "unprofessional", which I disagreed with, and made a link between that knowing that certain biologically oriented programs (Hopkins specifically) have been scathing about the idea that people might choose psychiatry because of a personal or family history of mental disorder. I named Hopkins in particular because I can state with certainty that they historically have had the belief that choosing psychiatry is not different from choosing any other medical specialty, like endocrinology (the example given when I interviewed there a while back) and had nothing to do with more personal experiences. I believe the former PD went as far as to suggest he was suspicious of applicants who made this connection and believed it did a disservice to the field, separating it from other medical specialties. This struck me as bizarre given that there are plenty of people who choose hem/onc because of a family history of cancer and no one would react with suspicion or cries of lack of "professionalism" in that case.

@splik, I am sorry that was your experience, but my experience here at Hopkins has been very different. Our current PD and program leadership are incredible, I honestly can not imagine any of them making that statement in any capacity. Regardless, I am happy to talking about Hopkins' interesting reputation here on SDN. I can not comment on how this department functioned a decade ago, or even 5 years ago, but what I can say is that the pervasive sentiment on SDN regarding Hopkins psychiatry is fairly inaccurate. We certainly have our faults, especially regarding certain INDIVIDUALS' opinions. However, they are just that, individual opinions.
Anyway, I apologize if I come off as a bit harsh, I have gained a great deal from reading SDN, as well as from your insightful posts, so I want to provide everyone a better understanding of a place I find incredible, and feel privileged to work at each and every day.
Also, please feel free to ask any questions, I'd be happy to help now as I feel I am finally in a position to do so.

 

[clozareal]

I have definitely gotten the stoic zero affect interviews that ask a checklist of incredibly invasive questions during the interview trail. I was actually told during one interview that I had the "correct dimensions of personality structure" to do well in that residency program after a long foray into my parent's relationship with each other and how that affected me growing up. I took this as testing how psychologically minded I was and how much emotional intelligence I have. I would say that you could disclose as much as you want as long as long as it comes off across as insightful and not unprofessional. It's not a therapy session though so don't go too deep into your problems, but it's okay to share surface level detail. I always try to bring my responses back to how I think it's important to self-monitor for countertransference during the clinical encounter.