Quoted: Med school interviews and severe anxiety disorder

[Doodledog]

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I don't know if I meet the criteria for social anxiety disorder, but the symptoms are pretty much the same.

Basically in social performance situations the bottom of neck gets really tight - causing me to have reflex swallowing to try to relax the muscle, but it never relaxes. When I say tight, I mean stone tight. So tight in fact it's difficult to breathe, in addition my lungs vasoconstrict/bronchospasm - I don't really know which, but it gets so bad that I barely have enough air to talk. I'll move my lips but I can't physically form words.

In the past it's always been treated as something that is just anxiety or imaginary, but actually I'm beginning to think it's actual norepinephrine surges that's causing the bronchospasms.

I've done some research that norepinephrine causes vasoconstriction in the lungs via alpha 1 receptors, so I'm going to try an alpha 1 blocker and see if that helps.

But in the mean time if it doesn't help I'm not really sure what to do. I've worked really hard and overcome a lot of (other) adversities in my life. I've gotten a good GPA and MCAT and ECs - but it's just I'm worried that I'm physically handicapped from being able to perform well in my interviews because of this. I'm afraid that interviewers won't take me on as a student if I sound so severely out of breath and nervous during my interviews. This problem has been ongoing and I've tried many conventional treatments but nothing in the past indicated for anxiety or asthma has worked. But I believe the problem with beta blockers is that they block epinephrine receptors but not norepinephrine, which is really what I believe is causing my vasoconstriction.

My question is, what should I realistically do? I'm thinking about asking my doctor to write me a letter so I can give my interviewers ahead of time saying that this is a physical disability. To please give me the opportunity to show my abilities without judging my shortness of breath that I'm not currently in control of. But I don't know if that will work because every medical school posts the basic physical requirements of their students which includes good communication skills. So they have every right to discriminate against me.

I've done so many things, I've done speech classes, I've done CBT, I've done all kinds of medicines, but nothing has worked or even mitigated my symptoms. I'm more than willing to try harder but I need to know what to do.

I don't have any great solutions other than to go ahead and apply. I think you need to try some different doctors and therapies, but that's up to you.

For those who wish to reply, please make your replies be relevant to the actual questions asked in the next to last paragraph related to interview strategies with medical schools. Replies providing medical advice suggestions beyond "see your doctor" will not be posted.

 

[Goro]

STRONGLY suggest that you do not apply until this condition is under control. Let's game out your proposed scenario:

You apply, and assuming that you're competetive, you're granted an interview. This is assuming that the Admissions office doesn't deep-six your application in doing some preliminary screening by thinking that you don't meet the minimum physical requirements.

The interviewers are most likely to NOT be forewarned of your condition.

You come for the interview, and you have your panic attack.

That will get you rejected. Nothing personal here, but we expect you to be able to handle the pressure of an interview, reasonably assuming that the pressure of practising Medicine is quite intense. Would you behave the same way in applying a touriquet? Dealing with a suicidal patient? In an interview with an anxious Alzheimer's patient? At your residency interview?

Good luck!

I don't have any great solutions other than to go ahead and apply. I think you need to try some different doctors and therapies, but that's up to you.

For those who wish to reply, please make your replies be relevant to the actual questions asked in the next to last paragraph related to interview strategies with medical schools. Replies providing medical advice suggestions beyond "see your doctor" will not be posted.

 

[NotAProgDirector]

From the OP:

Thank you for the response. I don't go into a full panic attack, it's mostly just a shortness of breath that gives the appearance of nervousness. I have in the past given presentations and interviews and am able to complete them, so it doesn't prevent me from being able to perform the routine, it's just I won't at all look confident.

I am going to go with Tildy's advice and try different therapies and I am going to apply this cycle, I anticipate multiple interviews so anyone particular interview isn't going to make or break my season.

 

[Goro]

The appearence of nervousness would probably get you rejected or low-wait listed at our school, alas.

From the OP:

 

[NotAProgDirector]

From the OP:

I imagine most people going into a medical school interview will look nervous. There's nothing wrong with showing something human, it's ok to be nervous.

Unfortunately for me the cause of my anxiety isn't entirely psychological, as I have adrenergic dysfunction. However, I have overcome other challenges and I will meet this challenge as well.

Thank you for your input.