residency app/interviews question

[Medstudent2018]

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I think I might be interested in going to psychiatry. I wanted to elicit opinions on something that maybe those of you who interview applicants might know. If I was hospitalized at my home institution's psych ward at one point, should I bother applying to the psychiatry program here? Do you think the physicians who treated me might view it as a major red flag? I really want to stay in my current city, but obviously there's only so many programs.

I guess I don't know who all reviews the applications and conducts the interviews for residency admissions...how many interviewers typically evaluate the applicant and do they tend to be clinical faculty (or are they more in research/administration/education who maybe don't see patients as much)? I just don't want to run into any of the ones who treated me, but it may not be a problem if it's the latter group. Clearly I can't request who looks at my app or who I interview with...

 

[wolfvgang22]

The interviews will be by the teaching faculty that work with residents and treat patients on a daily basis. So yes, you could see a doc you have met. Of course they would be curious if you are a worthy candidate.

If it were me, I would apply anyway, if I felt comfortable with the challenge, and if somebody recognizes you just be upfront and honest and don't make too big a deal out of it. Nobody is perfect and anyone who pretends they are perfect is lying. All you can do is show you are dependable, mature, and hard working now. All they can do is say "no" to you. If they say no, it's probably for the best and you'll end up somewhere more fitting anyway.

I would anticipate there may be some gossip at some point, because of human nature, and be prepared to address it maturely if it comes up among residents that you were a patient once upon a time.

 

[MLT2MT2DO]

The interviews will be by the teaching faculty that work with residents and treat patients on a daily basis. So yes, you could see a doc you have met. Of course they would be curious if you are a worthy candidate.

If it were me, I would apply anyway, if I felt comfortable with the challenge, and if somebody recognizes you just be upfront and honest and don't make too big a deal out of it. Nobody is perfect and anyone who pretends they are perfect is lying. All you can do is show you are dependable, mature, and hard working now. All they can do is say "no" to you. If they say no, it's probably for the best and you'll end up somewhere more fitting anyway.

I would anticipate there may be some gossip at some point, because of human nature, and be prepared to address it maturely if it comes up among residents that you were a patient once upon a time.

Of course if there's gossip about this there is a huge arse HIPPA lawsuit waiting for you at the end of the rainbow

Sent from my SM-G900V using SDN mobile

 

[Medstudent2018]

Can't sue if you don't know who blabbed... a couple med students in my class found out, even those who weren't on that clerkship. They didn't anonymize the names on census or rooms either, so couldn't really hide it from the other non-treating teams anyways - a friend almost barged in until she checked the chart she was given. Oh well. It's not like you care anyway when you're running around manic :/

 

[splik]

Of course if there's gossip about this there is a huge arse HIPPA lawsuit waiting for you at the end of the rainbow

Actually this an area of great confusion is not this clear cut at all. Educational institutions (including medical schools) are governed by FERPA laws and there some murkiness to where FERPA ends and HIPAA begins. FERPA allows disclosure of information about treatment without consent including for reasons of admission. What is also sometimes murky is whether residents are students (in my state they are not) or employees.

see 34 CFR 99.31:
§ 99.31 Under what conditions is prior consent not required to disclose information?
(a) An educational agency or institution may disclose personally identifiable information from an education record of a student without the consent required by§ 99.30 if the disclosure meets one or more of the following conditions:
(1)
(i)
(A) The disclosure is to other school officials, including teachers, within the agency or institution whom the agency or institution has determined to have legitimate educational interests.
(B) A contractor, consultant, volunteer, or other party to whom an agency or institution has outsourced institutional services or functions may be considered a school official under this paragraph provided that the outside party—
(1) Performs an institutional service or function for which the agency or institution would otherwise use employees;
(2) Is under the direct control of the agency or institution with respect to the use and maintenance of education records; and
(3) Is subject to the requirements of§ 99.33(a) governing the use and redisclosure of personally identifiable information from education records.
(ii) An educational agency or institution must use reasonable methods to ensure that school officials obtain access to only those education records in which they have legitimate educational interests. An educationalagency or institution that does not use physical or technological access controls must ensure that its administrative policy for controlling access to education records is effective and that it remains in compliance with the legitimate educational interest requirement in paragraph (a)(1)(i)(A) of this section.
(2) The disclosure is, subject to the requirements of§ 99.34, to officials of another school, school system, or institution of postsecondary education where the student seeks or intends to enroll, or where the student is already enrolled so long as the disclosure is for purposes related to the student's enrollment or transfer.

 

[splik]

OP, if you really want to stay at your home institution, and concerned about your treating attendings, why don't you speak to them about this? Where did you do your psychiatry clerkship? Hospitalization per se should not be seen as a major red flag (depending on when it was - was this during med school or before, the reason for it, whether it was voluntary or involuntary, and the current status of your mental health). If this was a really long time ago, they may not even know who you are, and may not have any role in the admissions process. but you may have to work with them, and should consider how that would be for you.

Also it appears you are an MD/PhD student, and for better or for worse (usually for worse), psychiatry programs typically look excessively favorably on MD/PhDs

 

[Medstudent2018]

I suppose I would be okay talking to the clerkship director maybe not the others, since I don't see them for treatment anymore. The reason I haven't told anyone (not even the medical school admins) is because I haven't decided whether or not to report the 6-month medical leave that happened afterwards. It was near the end of grad school, not during medical school so I'm not completely sure if I'm required to tell residencies of it in my ERAS application. Technically I might be able to lump it into me taking a leave from med school to do the PhD, if it doesn't go into the dean's letter and they don't look at my grad school transcript too carefully. Fortunately, I was able to do half the clerkship at the VA, but during the rest of it at least one attending recognized me (there's only so many MSTPs who they get to see inpatient for over a week). If it does end up coming up, I plan to tell them that I'm now in remission and hopefully they don't consider the risk of relapse a liability in a future resident.

 

[Merovinge]

I suppose I would be okay talking to the clerkship director maybe not the others, since I don't see them for treatment anymore. The reason I haven't told anyone (not even the medical school admins) is because I haven't decided whether or not to report the 6-month medical leave that happened afterwards. It was near the end of grad school, not during medical school so I'm not completely sure if I'm required to tell residencies of it in my ERAS application. Technically I might be able to lump it into me taking a leave from med school to do the PhD, if it doesn't go into the dean's letter and they don't look at my grad school transcript too carefully. Fortunately, I was able to do half the clerkship at the VA, but during the rest of it at least one attending recognized me (there's only so many MSTPs who they get to see inpatient for over a week). If it does end up coming up, I plan to tell them that I'm now in remission and hopefully they don't consider the risk of relapse a liability in a future resident.

The risk for relapse is a liability in a resident, but what's important (from your description of mania) is that if it does come up, you describe what you did to address the program. Coming from a program where one of my co-residents was self-managing (poorly) his bipolar disorder has led to some extremely unprofessional situations that has had fallout on many of us.

 

[FlowersFromTheSun]

Don't put the leave in your app if it isn't obvious from a transcript you already have to submit. People in medicine are extraordinarily judgmental about pretty much everything. Don't think you're safe if you describe it as medical leave either. PDs and the like will still ask you about it and pry inappropriately into your health even though it's technically not allowed.

Personally, I would not want to go to a place where people might be biased against me, but if you can present it well during interviews and your symptoms are under consistent control, it might not be a problem? If you were able to get through med school without any major hiccups, I think that should say a lot. Defend yourself if someone asks about it but I wouldn't deliberately introduce the info to anyone. I hate to give advice that plays into stigma, but I think that strategy will get you the best outcome.

 

[wolfvgang22]

Your medical leave was before med school, so you don't have to report it.

 

[HarryMTieboutMD]

OP, if you really want to stay at your home institution, and concerned about your treating attendings, why don't you speak to them about this? Where did you do your psychiatry clerkship? Hospitalization per se should not be seen as a major red flag (depending on when it was - was this during med school or before, the reason for it, whether it was voluntary or involuntary, and the current status of your mental health). If this was a really long time ago, they may not even know who you are, and may not have any role in the admissions process. but you may have to work with them, and should consider how that would be for you.

Also it appears you are an MD/PhD student, and for better or for worse (usually for worse), psychiatry programs typically look excessively favorably on MD/PhDs

Every specialty looks favorably on MD/PhDs- excessively. Why is this a bad thing? Most of the MSTPs I know, both from medical school and in my residency program are great doctors and have done quite innovative and forward thinking research.