Schizophrenic Psychiatrist?

[deleted276313]

I'm just wondering your own personal opinion on this matter...

Do you think it's possible for someone who is diagnosed with schizophrenia that is not of the residual type to be able to apply themselves to a point where they could actually get into medical school and head down a path of psychiatry, even though they are afflicted with such a devastating disease...where medications seem to not work well under huge stress?

---

Members don't see this ad.

 

[Anasazi23]

Probably not.

 

[Faebinder]

I'm just wondering your own personal opinion on this matter...

Do you think it's possible for someone who is diagnosed with schizophrenia that is not of the residual type to be able to apply themselves to a point where they could actually get into medical school and head down a path of psychiatry, even though they are afflicted with such a devastating disease...where medications seem to not work well under huge stress?

No if the disease onset was pre-medical school or during med school or during residency.

I did encounter a previous ER Psychiatrist diagnosed with schizophrenia late onset (of course that person was not working anymore). Very sad thing to see. If they got the right genes and environment, Psychiatrists are just as vulnerable as any other doctor or human being.

 

[Doctor Bagel]

When I first started visiting SDN ages ago, I swear there was a poster here who had been diagnosed as schizoaffective either prior to starting medical school or during medical school. As I recall, she graduated and started a psych residency program. I have no idea the level of control she had, though, or really anything else about her.

 

[whopper]

Is it possible? Yes.

However its unlikely. I hate saying that. Several patients I see struggle just to stay compliant on medication. Even when several patients reach the so called "baseline" they still have residual symptoms.

Stressors which can lead to decompensation will be a-plenty in medschool and residency.

I would not hold a mental illness against a candidate unless I saw reason to believe that their mental illness was affecting their ability to perform the job. The odds that schizophrenia would affect someone's ability to perform in medical school or residency would be very high.

Schizophrenia comes in varying degress, and forms. Late onset, paranoid type, female sex, etc can all lead to a lesser chance of decompensation. The odds of success would be higher depending on the factors, but even under the best of circumstances I don't think the person would have a very strong and unfair handicap against them.

 

[deleted276313]

Ya, I have schizophrenia; the disorder was very sudden, which I know gives a better prognosis than those who develop it over time. We have me almost completely stable on medications, although my medications need to be increased (we decreased hoping that I didn't need a high dose of Seroquel, but I need it to be at least 600mg).

Ever since my diagnosis, I have been very compliant with medications, and I seem to be in the group that doesn't have anosognosia (thank God). I have a huge goal on getting into medical school, and I know that if I try hard enough, I can get in.

I'm lucky though; we caught the disease before I deteriorated badly - we got it, if you will, in the early stages. We are thinking the subtype is paranoid, which is another good thing, since that seems to have a better outcome than disorganized or catatonic. While on medications, all positive symptoms go away, unless I'm on a dose that's too small; when that happens, the symptoms re-surge when I'm stressed. We have found that higher doses of Seroquel work very very very well for me though; I just get a ton of side effects >.< (dystonia & drowsiness & weight gain ftl).

I guess I probably should have given that information as well when I created the thread, especially the tidbit about catching the disease before it escalated to a point where I was destroyed mentally.

 

[peppy]

I'm glad to hear that you are doing well and have found a medication that works well for you.
I do think that the stress issue is a serious concern though. Knowing that you tend to function worse when stressed, is it really worth risking your health and happiness to pursue such a stressful career path?
It might be helpful to try to think about what appeals to you about being a physician and think about if there are other careers that could offer you those kinds of rewards without all the pressures that getting through medical training require.

 

[deleted276313]

I'm glad to hear that you are doing well and have found a medication that works well for you.
I do think that the stress issue is a serious concern though. Knowing that you tend to function worse when stressed, is it really worth risking your health and happiness to pursue such a stressful career path?
It might be helpful to try to think about what appeals to you about being a physician and think about if there are other careers that could offer you those kinds of rewards without all the pressures that getting through medical training require.

As I was trying to say, when I'm on a higher dose of my medication (I'm waiting for my doctor to call me back and confirm going on the higher dose increase), I'm absolutely fine. My psychiatrist cut my dose in half because I was having some nasty side effects, and now I'm somewhat under-medicated. Overall, when I'm on the right amount of meds, I handle well under stress.

Thank you for all your input.

And the only other career that would suit me is probably being a neuro-psychologist, and that requires a doctorate as well . I have determined that I am going to get a doctorate of some kind, whether it be in medicine, or in a branch of psychology. I'm not dumb, and I'm not going to let this mental illness get in the way of my goals >.> . It's just unfortunate that so many people with schizophrenia deteriorate and don't come back from that state. While I'm not very lucky to have developed it, I am lucky in the sense that I don't have it as bad as others do.

Please note that my original post was a general hypothetical, and not necessarily about me, even though I'm having trouble with being under medicated at the moment.

 

[billypilgrim37]

Well, getting a doctorate would probably be about half as stressful overall as going to medical school, so seriously consider that.

 

[deleted276313]

Well, getting a doctorate would probably be about half as stressful overall as going to medical school, so seriously consider that.

I know that; I just have my mind set on medical school.

What I'm going to do is go through with the pre-med program along with my major (psych) and if I start to get overwhelmed by the amount of classes I have, I will drop it and then make for a run with getting a doctorate. I'm only a freshman, so I have a while to think about things.

I know I have the cognitive ability to get into medical school; it's not a question of that, but rather my ability to handle all the pre-requisite classes.

 

[peppy]

I'm glad you are thinking about the PhD route as well. Honestly, that might end up being more rewarding if your primary area of interest is mental health rather than medicine in general, since psychiatry is such a small part of med school training.
For the first two years of med school, you will have to devote a large amount of brain space to topics like renal physiology and biochem pathways, then in third year you get to experience joys like getting yelled at by OR nurses, inspecting unbearably foul-smelling bed sores, and other things that the kind of people who like psych generally do not revel in.

The other advantages to going the PhD route is that if for any reason you were unable to finish the full PhD, you would most likely not be stuck with as much debt than the typical med school grad, and it's my understanding that in many cases you can leave a PhD program with a masters degree to show for your work at least.
If you have a problem during med school that forces you to leave or gets in the way of getting matched with a residency, you have nothing to show for it except for huge debt and no real job skills that will help you pay it off (an MD or DO degree by itself is basically worthless unless you are able to complete a full residency).
In a situation where you have an illness that could potentially become disabling, that is something to really think about.

 

[deleted276313]

I'm glad you are thinking about the PhD route as well. Honestly, that might end up being more rewarding if your primary area of interest is mental health rather than medicine in general, since psychiatry is such a small part of med school training.
For the first two years of med school, you will have to devote a large amount of brain space to topics like renal physiology and biochem pathways, then in third year you get to experience joys like getting yelled at by OR nurses, inspecting unbearably foul-smelling bed sores, and other things that the kind of people who like psych generally do not revel in.

The other advantages to going the PhD route is that if for any reason you were unable to finish the full PhD, you would most likely not be stuck with as much debt than the typical med school grad, and it's my understanding that in many cases you can leave a PhD program with a masters degree to show for your work at least.
If you have a problem during med school that forces you to leave, you have nothing to show for it except for huge debt and no real job skills that will help you pay it off (an MD or DO degree by itself is basically worthless unless you are able to complete a full residency).
In a situation where you have an illness that could potentially become disabling, that is something to really think about.

It is, I agree. I was also looking at other fields of medicine such as emergency medicine, neurology, etc.

The issue I have about being a psychologist is that is pays a lot less ($70k with a doctorate), and you are limited to psychotherapy for treatment instead of having the ability to prescribe medications (and I don't consider that very small amount of psychologists who are able to prescribe medicine since they represent such a small, minuscule part of the field).

 

[Faebinder]

It is, I agree. I was also looking at other fields of medicine such as emergency medicine, neurology, etc.

The issue I have about being a psychologist is that is pays a lot less ($70k with a doctorate), and you are limited to psychotherapy for treatment instead of having the ability to prescribe medications (and I don't consider that very small amount of psychologists who are able to prescribe medicine since they represent such a small, minuscule part of the field).

Seriously, you got enough stress in your life. MD would just make it worse, although it might feed the ego in the long run, you gotta look at your overall happiness. Plus you would be on the cutting edge of research to improve the future of the disease treatment.

Best of luck in whatever you choose, you are the kind of patient that makes us happy to be in this job. Some who doesn't have anosognosia.

 

[whopper]

I hate saying this, and I mentioned this in other threads, but there will be some prejudice against you if applying into medical school with a mental illness.

Good for you that it was caught early, and you seem to know the value of compliance.

What would cause me some serious concern is there is a lot of data showing that nonadherence to a usual sleep/wake cycle can mess you up mental health wise. In medical school, burning the midnight oil is common, as is losing a lot of sleep during residency.

The process of medical school itself IMHO is mentally unhealthy.

However please do not limit your potential. Have a realistic sense of what you can and can't do, and do all you can so long as you can handle it.

 

[jettavr6]

Two cases of physicians with Schizophrenia that I have heard about were in the fields of Radiology and Pathology. What was told to me was that they both had paranoid schizophrenia, and were otherwise doing ok. Makes sense that they entered two fields which they could excel in, while minimizing patient interaction.

 

[fly77]

One of my collegues referred this book to me and it is very informative as well ideal for you. Dr. Saks writes about her life with schizophrenia and her journey through college, etc. She is currently a professor at the Univeristy of Southern California Gould School of Law and an adjunct professor of psychiatry at the University of California.
The name of the book is:
"The center cannot hold, my journey through madness" by Elyn R. Saks

I believe this will inspire you! Don't give up on your dreams, if it doesn't work at least you will know you tried. Best of Luck!

 

[whoopi]

I am a commercial pilot with a progressive eye condition. It is probable that my eyesight will begin deteriorating rapidly within the next several years, but not until after I have my 747 certification. It has always been my dream to fly what my pilot father called "the big girl," so I just can't give up until I know if I can successfully fly her on transatlantic flights - just like my dad did.

I'm pretty sure the regular exams will pick up any serious eyesight problems before they significantly affect my piloting abilities - so I probably won't be putting any passengers at serious risk. I might not make it through before I go blind, but it's really important that I try.

Just wondered if any of you think this is similar to someone wanting to become a physician and make judgments about people's health - indeed, affecting whether they live or die - with a condition whose hallmark is a progressive loss of cognitive/social/executive function.

Would any of you mind being on my first flight to London in the captain's seat?

 

[loveoforganic]

I don't believe schizophrenia is necessarily a degenerative disorder with proper treatment, though, correct? That's a crucial part of your analogy.

 

[michaelrack]

That's a crucial part of your analogy.

Hopefully it's just a hypothetical/analogy, and not whoopi's real plans

 

[whopper]

Just wondered if any of you think this is similar to someone wanting to become a physician and make judgments about people's health - indeed, affecting whether they live or die - with a condition whose hallmark is a progressive loss of cognitive/social/executive function.

There are some similarities, but also differences.

Schizophrenia is a disorder where there really is much more to be learned. For example we know that dopamine, serotonin and the glutamate receptors are involved. There are probably several more involved in ways we do yet understand. It can have an extremely variable presentation, and several people respond to certain medications while others don't.

Medical school is also as you know (your profile mentions you are an attending) a very long, hard, at times tedious and expensive process. If one were to pull out of that process, they may be doing so at hundreds of thousands of dollars worth of debt.

So the decision to pursue a medical degree, and practice as a doctor while one has schizophrenia has to be taken very seriously. If this were a situation where one could try, and if they failed there'd be no consequences other than the loss of time, I'd be more likely to say go for it. However I've seen enough of my friends not make it through the process..some of them unfairly so. One of them accrued 6 figures of debt while in medical school, and now is working in construction.

I would never tell a person I did not know well to forget about it. Some people can overcome great obstacles. However we can't blindly endorse someone try something as if this is a motivational Rocky movie. The person has to learn what they can handle, get the most information, and make their own informed decision.

 

[whoopi]

The person has to learn what they can handle, get the most information, and make their own informed decision.

And at what point do others have the right to an informed decision. e.g.
the federal/state gov't (which pays for much of medical training) and
the medical school (which rejects someone in favor of you) and
THE PATIENTS?
Do you tell each patient during clinical yrs that "I'm a medical student, and you deserve to know that I've been diagnosed with a psychotic disorder known as schizophrenia - but my doctor and I believe it is currently under good control?"
And after you become a physician, will you be telling each and every patient you meet?
If not, why not? Do they really have no right to this information right up front?

Would you support such a person becoming a police patrol officer with a gun without notifying the academy or the prospective employer?

Anybody want to be on the first transatlantic flight with my hypothetical pilot whose sight may be getting worse as we speak, but (s)he might not know it yet - and the stress of a 10+ hour flight might exacerbate it?

Schizophrenia is a condition that may be stable, possibly even remitted. But if it worsens, the physician affected may not realize the impact on judgement, concentration, thought process until after it is too late.

This is not like a painful condition wherein the affected physician can make a definitive decision ahead of time like, "I will not see patients when I'm on opiates."

This is really not the same as an addicted professional who is either using or sober, for which there is a definitive test that you could (conceivably) administer each day before work.

A professor in med school laid out a pretty basic way to determine whether you should fear that something (involved in your medical practice) is unethical or might be affecting your judgement: If you think your patients would find it disturbing to know, and you're avoiding letting them find out - you probably should not be doing it.
So let me ask again: Will you tell all your patients up front?

I'm really sorry, but this is not just about you and fulfilling your dream.

 

[nancysinatra]

A professor in med school laid out a pretty basic way to determine whether you should fear that something (involved in your medical practice) is unethical or might be affecting your judgement: If you think your patients would find it disturbing to know, and you're avoiding letting them find out - you probably should not be doing it.
So let me ask again: Will you tell all your patients up front?

I'm really sorry, but this is not just about you and fulfilling your dream.

Then you should apply the same argument to all the things that could make a patient queasy about having any doctor treat them. Did you have a low MCAT score or have to apply twice to get into med school (yikes!)? Have a tremor and write illegible orders (go away!)? Are you a marriage therapist whose divorced (eek!)? A primary care doc whose obese? What I'm saying is, I'd be shocked if impairment isn't going on all the time at some level. Sure, schizophrenia stands out. But to be all puritanical does not seem super realistic to me.

Those pilots aren't volunteering their eyesight data to the flying public. They're being TESTED, as you pointed out. You could test doctors for cognitive skills, which actually does happen to some extent in the form of board exams. People have every right to pursue their dreams. And plenty of people get quite far and still never make it to their dream because they have been deluded all along for all sorts of reasons that have nothing to do with schizophrenia. Sure, all the things people are saying about the stress of medicine is true, but that doesn't make it our job to sift out the people who shouldn't pursue their dreams and the ones who should.

Also, schizophrenia can be misdiagnosed. Let me turn over to you all the charts I've seen saying "hx of bipolar, schizophrenia AND schizoaffective d/o." Sometimes the "hx" doesn't even go back more than a few months, so how they diagnosed schizophrenia I'm not sure...

 

[whopper]

And at what point do others have the right to an informed decision. e.g.
the federal/state gov't (which pays for much of medical training) and
the medical school (which rejects someone in favor of you) and
THE PATIENTS?

The easy answer is to simply read up the laws in the state concerning this issue.

However if you want a real discussion, this is more of a complex issue than I really feel like I'm qualified to answer because I haven't read enough of the laws regarding that, or have taken the input of experience and the opinions of others in regard to this matter. From my limited understanding, I don't know if institutions have made preparations to deal with this issue becuase it does not occur much.

From my own opinion, there has to be a balance of privacy vs self disclosure. I don't know if anyone has made any mental health guidelines that doctors must follow in terms of being able to practice medicine. E.g. if the person has schizophrenia, must they report it to every agency? The residency program that accepts a person with a mental illness must believe that person is fit to practice as a doctor, or they shouldn't pass the person. The reality though from what I've seen is several programs let people squeek by so long as they don't do something too extreme like make sexual advances on patients because the fear of a lawsuit from a former resident.

From my experience, and what I'm learning, instutitions, and the law often do not deal with an issue until that issue happens, and there was a big stink made for there to be an institutional and legal response. Several of the landmark cases concerning mental health have only happened in the last 10 years on issues that you figured would have already been answered. Several issues have not yet been answered. I bet you not enough schizophrenic people have applied or got into medical school and residency to warrant an institutional response from the big bodies in medicine such as the AMA or APA on how to deal with it, and I don't see it happening anytime soon either. Medical schools and residencies will more likely go the route of least resistance and just not accept a mentally ill person, but not tell the person why they didn't accept them, or they will let them squeek by, ask them politely to leave and let the next institution deal with them, as is the case with several medical professionals who are not fit to do their jobs.

 

[nancysinatra]

Several of the landmark cases concerning mental health have only happened in the last 10 years on issues that you figured would have already been answered. Several issues have not yet been answered. I bet you not enough schizophrenic people have applied or got into medical school and residency to warrant an institutional response from the big bodies in medicine such as the AMA or APA on how to deal with it, and I don't see it happening anytime soon either.

Don't you think this at least partly has to do with the fact that the atypicals mostly started coming out fairly recently, in the 1990s, if I'm correct? Also, schizophrenia for many years has been associated with downward drift. Both these factors would diminish the numbers of schizophrenic people applying to medical or other graduate schools. Nonetheless, reintegration into regular life should still be the ideal goal of treatment, I would think, as opposed to marginalization. The fact that we don't achieve this shouldn't change the goal. And for individuals who do achieve it, they should hardly be chastised or discouraged.

Another difference between medicine and aviation is that on an airplane, you can't go get your glasses if they're lost. Do airlines require 20/20 and perfect color vision? If so, ok. But medicine does not require us to provide a health record, presumably because outside of the OR, most doctors have time to react on a scale that allows for treatment of problems. If people feel the need to change that, then go ahead, plead your case. Then we can all submit our health records to the powers that be.

 

[Journy]

I am a medical student and was diagnosed with “severe mental illness.” However, I am very well-controlled and people don’t seem to notice. I believe that if you are well-controlled (ie are compliant) and have a good support system—you can do it. Be aware that it is not all peaches and flowers—it can be a real struggle. Thus, it comes down to how bad you want it and how much you are willing to sacrifice. There is a lot of stress that comes with the medical degree; however stress can be found in any job (PHD included). Does this mean that all people with mental illness should be unemployed or work jobs that society judges are fit for someone with a mental illness? This question may be answered differently depending on what kind of pre-conceived ideas one has concerning the subject. The fact is many people have mental illness and because of stigma many remain silent, especially, those with things to lose. With the advent of new medications and earlier intervention, mental illness can look a lot different from yester years.
Now some people do bring up the point concerning the care of patients, which is an important one. In my personal experience with mental illness, I actually would have preferred going to a doctor with their own experiences because I personally felt that there would be less stigma and hence they would be more empathetic. In addition, I felt that such persons would have a greater understanding of my illness. Whether this is true or not is debatable, however, this is how I felt/feel. This feeling was solidified after having a really bad experience with a doctor (not a psychiatrist) who treated me like I was less than desirable after reviewing my medication list.
However, having said all of this, I wish I had considered the PHD route more than I did—so seriously consider it. And also FYI: be prepared if need be, to take a break which may or may not result in paying double tuition. So if economy is of concern, be aware of potentially obtaining a large debt. Unlike other medical illnesses, there are no scholarships (at least that I know of) that are aimed at helping mentally ill students obtain a medical degree. Thus, go to the cheapest medical school possible.

 

[whopper]

A professor in med school laid out a pretty basic way to determine whether you should fear that something (involved in your medical practice) is unethical or might be affecting your judgement: If you think your patients would find it disturbing to know, and you're avoiding letting them find out - you probably should not be doing it.
So let me ask again: Will you tell all your patients up front?

I'm really sorry, but this is not just about you and fulfilling your dream.

Don't agree.

The bottom line is patients have a right to know that their doctor can do the job. Problem is with a doctor with a severe mental illness this can push it to a grey area. Its a chronic illness, and in some people, even if well controlled may present with symptoms now and then that can affect practice. What makes it more difficult is the issues at stake are very serious.

Some schizophrenics have their disorder well controlled to the point where they can work without their disorder affecting their job. Should those people have to declare to the public they have schizophrenia?

Its not a black and white issue. Its going to depend on the individual's severity of illness. Hence its going to be difficult to answer it in a black and white (yes or no) manner.

Don't you think this at least partly has to do with the fact that the atypicals mostly started coming out fairly recently

Difficult to answer the question because several of the more recent landmark cases were brought about due to several factors-the equal rights movement, applying the 14th amendment to mentally ill people etc. The introduction of atypicals and SSRIs have certainly affected the way society deals with the mentally ill. Has it caused any dramatic changes with the landmark cases? I don't know yet-I've only done 25% of the fellowship.

 

[whoopi]

Which circumstances (that are likely to destroy the physician's ability to know whether his judgement is compromised) do not need to be disclosed to patients?

How about financial interest in the lab to which the MD refers patients?
How about sleeping with the (very expensive) drug rep?
How about accepting golf trips to Barbados from the manufacturer of the splint the patient doesn't really need?
Active drug addiction with possible current intoxication?
Operating on the husband of the woman with whom the physician is having an affair?

There is a difference b/w choosing to have your judgement compromised by some of the behaviors listed above and having a medical condition that produces the same result. But either way, on any given day, you may think your judgement is intact when, in fact, you wouldn't know if it isn't.

When someone tries to break into your house and your spouse is running into the woods to chase him, and you've called the police to go after them in order catch the bad guy while protecting your spouse...do you want that officer to be the one with schizophrenia?

You have to admit that there are consequences to be considered beyond a prepubescent naive, "just follow your dreams."
It's not only about you. There are others involved in the consequences of your choices.

 

[dl2dp2]

Which circumstances (that are likely to destroy the physician's ability to know whether his judgement is compromised) do not need to be disclosed to patients?

How about financial interest in the lab to which the MD refers patients?
How about sleeping with the (very expensive) drug rep?
How about accepting golf trips to Barbados from the manufacturer of the splint the patient doesn't really need?
Active drug addiction with possible current intoxication?
Operating on the husband of the woman with whom the physician is having an affair?

There is a difference b/w choosing to have your judgement compromised by some of the behaviors listed above and having a medical condition that produces the same result. But either way, on any given day, you may think your judgement is intact when, in fact, you wouldn't know if it isn't.

When someone tries to break into your house and your spouse is running into the woods to chase him, and you've called the police to go after them in order catch the bad guy while protecting your spouse...do you want that officer to be the one with schizophrenia?

You have to admit that there are consequences to be considered beyond a prepubescent naive, "just follow your dreams."
It's not only about you. There are others involved in the consequences of your choices.

I'm not sure if you are a psychiatrist, but what you say suggests that your understanding of schizophrenia as a disease is somewhat skewed. A few patients (~10-15%) make a very good recovery after the first psychotic break, especially if medication compliant. You make it sound as if once someone were given the label of schizophrenia, there is no chance of recovery and the person will be forever impaired. Such misconceptions are precisely the origin of stigma and outright prejudice suffered by many of the mentally ill.

In your example, if the police officer were well controlled on meds, and is generally smarter and more competent, I see no reason to not summon him instead of someone else.

In terms of the original question, if someone has a *history* of schizophrenia, and currently has no positive symptoms, AND the negative/cognitive symptoms are attenuated sufficiently to pass all the requirements to become a psychiatrist--I don't see how such an individual is any less competent than someone equally comparably able without a history. The more likely scenario is that if someone had IN FACT had "classic" schizophrenia, the chance of him/her finishing med school and get licensed to practice is VERY VERY low.

The diagnosis itself isn't necessarily accurate, and there's certainly no way yet in which we can reliably predict the course in a particular patient. In fact, if someone can finish med school and residency without a problem, it points to a generally favorable long term prognosis. Seeing that schizophrenia is likely an imprecise label and the patient population is heterogeneous, using this label as a mode of job selection constitutes a form discrimination.

 

[Doctor Bagel]

A professor in med school laid out a pretty basic way to determine whether you should fear that something (involved in your medical practice) is unethical or might be affecting your judgement: If you think your patients would find it disturbing to know, and you're avoiding letting them find out - you probably should not be doing it.

Being a little concrete here, but I can think of all sorts of examples where this is unworkable. Some patients might find it concerning to know that their physician is an atheist, or gay, or a mormon, or a diabetic, or hypertensive, or catholic, or all sorts of random things. Lots of patients would find anything that actually makes physician human (you know, flawed in some way) disturbing, so I guess if we followed that advice to the letter we'd be obligated to disclose all sorts of stuff to our patients that's really none of their business. On a mental health issues, should a physician with well-controlled issues of MDD, GAD, OCPD (lots of docs seem to have this) disclose that? Honestly, if it's controlled, why does the patient have a right to know? How is well-controlled schizophrenia different?

 

[whoopi]

My point all along has been that Schizophrenia has an important difference from many other possible limitations to becoming a physician:
If the condition worsens, the very nature of the condition may prevent the physician from knowing that judgement is impaired - thus preventing the physician from being able to properly decide whether he/she is stable enough to practice today.
Being well-controlled yesterday or last week does not mean the physician is sure that's still true today.

I'm not saying that everyone with schizophrenia is always in this state, but that the person with schizophrenia cannot always rely on his/her own ability to judge his/her own stability.
MAYBE patients have a right to know that.
Assuming the OP is going into medicine to work for patients' best interest, he/she needs to be thinking about it.

As to whether the OP has schizophrenia, for the sake of argument, I'm assuming he/she told the truth about whether it's been carefully diagnosed.
If the OP doesn't have it, our discussion is relevant for med school applicants who do.

So when DO patients have a right to know up front about a physician's possible/probable limitations on medical judgement?
In what situations should a physician disclose such a limitation of judgement to a med school, residency, or patients?

 

[michaelrack]

How about sleeping with the (very expensive) drug rep?
.

When you write "very expensive", are you referring to the drug or the rep??

Either way, probably not wise to disclose to the patient

 

[michaelrack]

But medicine does not require us to provide a health record, presumably because outside of the OR, most doctors have time to react on a scale that allows for treatment of problems. If people feel the need to change that, then go ahead, plead your case. Then we can all submit our health records to the powers that be.

Actually, medicine does require a health record in some circumstances- I have had to submit a doctor's statement (summary of recent h and P) when applying for hospital staff privileges.

Most medical schools want medical students who have the technical/cognitive/communication abilities to be primary care docs. This includes the ability to respond to codes- quick reaction.

I have served on a psychiatry residency selection committee in the past. Signs of psychotic illness or prior treatment of psychotic illness (tardive dyskinesia) are looked down upon. That may not be the way things should be, but that's the way things are.