QUOTED: Depression in Residency

[NotAProgDirector]

I've had depression for 10 years that has been adequately controlled on meds but started to worsen during the end of my intern year. I'm now in my 2nd year of pediatrics residency and on a rotation in the subspecialty I want to go into but I am having a really hard time holding it together and difficulty concentrating. (Basically, I feel like I am functioning at a 3rd or 4th year med student level in terms of presenting, A/P, etc because of it). I'm seeing a psychiatrist to get my meds adjusted and am going to start seeing a therapist. My questions are these:
- Should I let my chiefs or program director know what is going? Would letting them know have more of a negative effect on me than having a month or two of sh**ty performance before I get the meds sorted out?
- Should I just resign myself to the fact that I'm not going to get a fellowship in this subspecialty but I will have tepid letters at best and start working on an alternate career plan? Thanks for your advice.

Whether or not to alert your PD is very personal and program specific. I'd like to think that most PD's would try to help you with this. On the other hand, you are responsible for your own performance, and hence perhaps you are asking the wrong questions here. First, perhaps you only think your performance is poor -- depression involves catastrophic thinking, so perhaps your performance is fine, but you perceive it as not. Second, if your performance really is as poor as you say, maybe you need a leave of absence to get this dealt with, rather than continuing with a poor performance.

The only way to answer that first question is to get honest feedback from your current supervisors, and from your PD. Hence, I'd encourage you to talk to your PD about this if you feel that you are at a supportive program. You're not looking to excuse poor performance, you're wondering whether your performance has been adversely affected by your health issues.

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