Should I be open about my diagnoses

[kakashi1992]

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Hi everyone,

Thanks for reading this and I greatly appreciate any opinions on this matter.

So I am a student who has spent more time on medical leave than perhaps other students due to mental illnesses.

My question to you all is: Should I put my diagnoses in my notable characteristics in my dean's letter. AKA should I be open about my diagnoses when applying to residency programs?

 

[Lem0nz]

No.

You can be open about it after the match though if you feel it will be helpful to get support from your program to continue therapy/maintenance, etc.

 

[kakashi1992]

Why?

 

[Tenk]

Why?

Because it makes you a liability from a PDs standpoint and you will likely be discriminated against. Mental health and addiction both are taboo in medicine. It’s somewhat better than it was decades ago but it’s still awful. Don’t do it.

 

[kakashi1992]

Thanks for the explanation

Well in that case, how do I explain the time off?

Just be vague about it like, "I had an illness but I recovered"?

 

[NickNaylor]

Thanks for the explanation

Well in that case, how do I explain the time off?

Just be vague about it like, "I had an illness but I recovered"?

All you are required to disclose is that you took a medical leave of absence. Your health information is legally protected, and you aren't obligated to say anymore than that. Frankly, if you interview at a program that is extremely probing of the circumstances, I would run far away, because that's not a good sign.

I'm an academic psychiatrist and interview residency applicants, and I would agree with the general advice that you probably shouldn't disclose your mental health history. There are a lot of caveats to that and there are, perhaps, some circumstances in which it's not a totally unreasonable idea, but generally speaking that information is far more likely to harm you than help you.

 

[Chelsea FC]

Yep all the mental health awareness and wellness talks they give are all BS. They will discriminate against u in a hot minute if they find out the details about your medical LOA

 

[Mad Jack]

Don't disclose details until post-match. Make sure to notify HR once you're onboarding so they can have a plan in place if you have an ADA-qualified disability

 

[Splenda88]

Thanks for the explanation

Well in that case, how do I explain the time off?

Just be vague about it like, "I had an illness but I recovered"?

Yes.

 

[operaman]

Agreeing completely with the others: do not disclose ahead of time. If your letter writers are aware of them, make sure they know you do not wish them to be shared.

The only caveat might be if your illnesses resulted in inpatient psych stays or other such things that might become an issue with licensure. If it was just school LOA to get yourself together then that shouldn’t be an issue.

I’m torn on the disclosing after match though. If it’s something that is likely to become an issue it may be worth disclosing, but then that also runs the risk of putting you under the microscope early. The benefit I see is that you have some legal protections if the program is aware of a disability, but then again if your performance is so bad that you are falling back on the ADA you may be screwed regardless.

You will definitely want to be very selective in your choice of field and choice of program. The residency forums and Reddit and Twitter are full of stories from people with mental illnesses who washed out of residency. Some are inevitable and many wholly unrelated to their illness, but some come from poor specialty and program selection. For example, if your illness is one where sleep deprivation can render you nonfunctional, be wary of small surgical subspecialty programs with “home” call since they typically end up working 36+ hours straight without even violating ACGME rules. Look for programs in the field that use a night float or in house call with a post call day, or even consider a different field. The other classic example is that people with substance abuse problems should avoid fields like anesthesia where you would have easy access to those substances.

 

[efle]

If I recall correctly one of the documents I signed said "to my knowledge I have no health concerns that may interfere with completing my resident duties" or something similar.

Can someone answer "no" to that with a record of mental health issues requiring hospitalization or prolonged leaves of absence? Wouldn't something like that fall under a health concern that could stop you from reporting to work for weeks at a time?

 

[Matthew9Thirtyfive]

If I recall correctly one of the documents I signed said "to my knowledge I have no health concerns that may interfere with completing my resident duties" or something similar.

Can someone answer "no" to that with a record of mental health issues requiring hospitalization or prolonged leaves of absence? Wouldn't something like that fall under a health concern that could stop you from reporting to work for weeks at a time?

Not if it’s currently under control without concern for decompensation in the future.

 

[Redpancreas]

Nick Naylor's advice is best for the pre-match. Once matched, only you and your support system will know if you need help. If you need help, when notifying your program, communicate with as few people 1-2 people (ex. Program Director, 1 out of 4 chiefs) and stick to dealing with those people. We're all supposed to be professionals but information finds its way to leak. Feel free to PM for advice for your specific case.

 

[Neopolymath]

Not if it’s currently under control without concern for decompensation in the future.

The key to these questions is to answer them like a highschool dropout would not like how the form actually reads. Don't read the grammar too seriously and dissect each word like a lawyer.

I'm being totally serious. Of course there is always some non-quantified chance OP could have a problem in the future so it depends on where you draw the line. I would answer questions like this within the spirit of the question not based on some philosophical fact that life is unpredictable and know one knows the future.

For example, if you have always had a dulled sense of smell (benign, hereditary etc etc) and you fill out the fit test OSHA form saying as much then congrats you now are a healthy young person getting "evaluated" so you can do a fit test that you have probably done several times already in your life as if you might have some legit health risk against wearing an N-95 lol. Just a random example I saw someone go through in undergrad.

I feel similarly about this. Sometimes the technically correct answer isn't the right answer so OP should be honest with themselves and think about this.

 

[Splenda88]

Nick Naylor's advice is best for the pre-match. Once matched, only you and your support system will know if you need help. If you need help, when notifying your program, communicate with as few people 1-2 people (ex. Program Director, 1 out of 4 chiefs) and stick to dealing with those people. We're all supposed to be professionals but information finds its way to leak. Feel free to PM for advice for your specific case.

Not sure what US high is like but I have heard people said it's a lot of gossiping. If true, big programs are like US high school all over again.

 

[coolkat712]

Hi everyone,

Thanks for reading this and I greatly appreciate any opinions on this matter.

So I am a student who has spent more time on medical leave than perhaps other students due to mental illnesses.

My question to you all is: Should I put my diagnoses in my notable characteristics in my dean's letter. AKA should I be open about my diagnoses when applying to residency programs?

You don’t need to indicate anything unless they ask you, if they ask you let them know what your diagnosis is, I am sure they will understand. Also I hope you feel better mental health is the most common health problem these days but know that it is cureable and you will eventually overcome it.