Quoted: Narcolepsy and medical school

[Doodledog]

Posted for a member - I have no particular insight into this condition and how it would affect medical school or residency.

I am currently a sophomore and am toying with the idea of applying to medical schools. I believe I have the grades, E.C.s, passion, and work ethic to succeed in medical school, but I question the plausibility of residency. I have narcolepsy and I am currently well controlled (sleep 6-8 hours a night, no naps, generally awake/alert throughout the day, never experienced cataplexy, etc.) however I am unsure how I will respond with rotating schedules and much less than 5/6 hours of sleep a night on a regular basis. What I have been unable to find out is if residency programs would be willing to provide certain accommodations such as keeping a more consistent schedule (ex: not excessively flipping between nights and days) or, if worst came to worst - a lightened workload. I would absolutely put forth all of the effort required (and beyond) during residency; it would just give me some comfort to know that programs would also be willing to work with me if need be. Also - I am most interested in pediatrics if that makes any difference.

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[NotAProgDirector]

Unfortunately, I think you will find that most residency programs will not be able to be terribly flexible with their schedules. Each resident schedule links with the others, so that it becomes very difficult to adjust one resident schedule without adjusting them all. So, for example, a program might have a "night float" rotation (where you cross cover patients at night) where three different residents each work 4 nights in a row in a rotating schedule (then working some days in the 8 days in between). If you wanted some different schedule, then everyone else's schedule would need to change also.

Also, most residents find that when they work nights, it's difficult to sleep during the day. You get some sleep, but end up being somewhat sleep deprived, even if you work 5-6 nights in a row.

Last, many residency programs still include 24 hour shifts. I don't know where most peds programs are on this. Since most peds programs are small and 24 hour shifts (esp on weekends) are the most efficient way to cover the services, I worry that they may still be common. Whether they will still exist 4-5 years from now, who knows.

On the other side of the argument, one could clearly claim narcolepsy as an ADA protected illness. I believe there was a prelim intern recently who claimed she could not work at night, and was given an entire internship based on days only. You could certainly try the same. The counter argument is likely to be that there is a different curricular focus at night, and hence missing all nights is not an option. Whether this would put an "undue burden" on the employer is unclear. It clearly would make you very unpopular.

There are a few shared pair positions in the match -- where you and someone else share a spot, get half the salary, half the schedule, lasting twice as long. There are not many, and I expect many of them are targeted to a couple who share the spot.

 

[Soparklion]

I think that it is doable, if you choose the right specialty. Many ivy rotations have interns work straight nights instead of rotating calls, which provides consistency that you can adapt to... Just look around for the right program and don't even think about anything surgical, anesthesiology, emergency...