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Quoted: Depression and medical career

Doodledog

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The following was sent to me by PM

Does controlled clinical depression affect the chances of getting into a competitive residency? If so, what will it take to compensate for it?

I've had clinical depression (or something like it) for years. In recent years, I've become much more adept at managing it. I am at the beginning of medical school.

If you were on a competitive medical residency selection committee: you come across two candidates who are equally matched. One of them has clinical depression, but is better than the other candidates in certain ways. What would those ways be? Two good research papers vs. one? "Good" medical school vs. a "regular" medical school?

If you were on a committee to select a fellow or an attending: how would you answer the above scenario?

I just need to know the skew of the playing field and play accordingly.

Thanks in advance for your opinions and stories.


I am not a PD (and I am not aPD), but I personally would have little or no concerns about supporting anyone at any level with well-controlled depression. It's not clear how I would know about it as an adcom, fellowship director, etc, but even assuming I did, it would not affect my evaluation of an applicant in any way. We'll see what the real aPD and others say.
 

rmbsstock

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der control"what will it take to compensate for it?"
My answer might be a surprise to you. I believe that a candidate with a clinical depression, who is smart enough to work on keeping this depression under control, has already showed us a lot. In my opinion this is a big plus for this candidate that he/she showed in action that something major in their life will not stop them from reaching their goal.
Also, the clinical depression candidate has first hand experience on how people feel and what can be done to lift them up when they are depressed. He/she knows what works and what does not.
I believe a candidate with a controlled clinical depression knows how to ask for help when needed, and is not afraid of seeking it.
Also, (it is my theory) most people with clinical depression has seen a lot in life. So the stress of work is going to be easy compared to what they have seen in the past. I know you might be thinking that it could add more to their depression. But, that did not happen in my experience. In fact they felt that what people were complaining about was easy to them since they have been there and done that...
 

NotAProgDirector

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As a PD, I would not know about your depression unless 1) you tell me about it, in your PS for example, or 2) you require an LOA from school -- and even in that case, it would be your choice to tell me whether it was for depression or "health reasons" or "a personal issue" etc. So, if it really is controlled, I won't know about it.

What if I do? I think that will depend on the PD and the program. The big concern with depression is that it may worsen during your residency and then require an LOA, or schedule adjustments, or ADA accommodations. Sleep deprivation common in residency tends to worsen depression. If your depression did worsen during residency and a physician documents that the sleep deprivation is a likely cause, you could insist on having overnight call removed from your schedule -- this would be an ADA issue and likely required by law. Once this has happened to a PD (or they have heard a story about it) they may decide to pass on those with declared mental illness. Some may see it as a strength, as mentioned above.
 

eforest

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I graduated from med school with bipolar disorder and had to explain away a leave of absence that occurred during school. I was vague but did indicate it was for mental health reasons. I figured that PD's would be able to read between the lines, so why not be up front? I matched at my top choices.

As for what aPD is saying- mental illness can be affected by sleep deprivation and scheduling issues. I have difficulty doing overnight calls- I can do them, but I feel they are generally very disruptive. So, I targeted programs with night float systems. I paid a lot of attention to hours, and tried to get the inside scoop on which programs work their residents hard. My rank list took into account health insurance mental health and drug benefits, schedule, location, and reputation for being benign or malignant. These factors were more important than rank of program.
 

error404

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In general, I would just avoid sharing that information with anyone. Don't talk about it in your PS, and unless you have to disclose because of academic or leave of absence issues, never bring it up.

Some people stigmatize any mental health problem, even well controlled. So play the admissions game and keep the playing field level.
 
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