When it comes down to the decision

[3lefts]

Advertisement - Members don't see this ad

After interviews are over, when it comes down to a program making its rank list, would a history of medical leave 2/2 mental illness put you at risk of being ranked lower than similar applicants without that history? I guess my question is if a person with red flags should try to aim for a greater number of interviews/longer rank list than average? Or would having been invited to an interview put you on the same playing field as applicants without a LOA? Thanks!


Sent from my iPhone using SDN mobile

 

[MacDonaldTriad]

If any group of people should be understanding of a LOA secondary to mental illness it should be psychiatrists, and in a perfect world this would have no effect on your ranking. Unfortunately, the world is not perfect. I'm sure there is a range in how programs would deal with this and it could be viewed as a strength or a weakness depending on a program's philosophy. I do agree with you that once you are invited, things are viewed more level and the interpersonal element factors in. Having said that, most applicants are very nice and behave well during interviews so the application rears its objective head again.

 

[Crayola227]

Mental illness is always a stigma no matter the field of medicine or what stage of your career.

Never forget that.

 

[3lefts]

So, maybe I should aim for 15-20 interviews instead of 10-15? Apply to 40-50 programs plus a handful of deep reaches? Or would that be overkill? (Trying to guesstimate how much money I'm going to need to get together.)


Sent from my iPhone using SDN mobile

 

[Merovinge]

So, maybe I should aim for 15-20 interviews instead of 10-15? Apply to 40-50 programs plus a handful of deep reaches? Or would that be overkill? (Trying to guesstimate how much money I'm going to need to get together.)

It depends on the timing of the problem, how you have recovered, and the rest of the application. In isolation compared to an otherwise equal applicant I would definitely apply more broadly but not go crazy.

 

[3lefts]

Because I started from the beginning when I went back after my leave I will have gone through an entire med school course without issues. My basic science grades are mediocre and my clinical grades are mostly HPs, some Hs. The rest of my application, including step scores (90-something-eth percentile for psych) and letters, should be really strong. I have a lot of extracurriculars/involvement but no real research. Mid-tier medical school.


Sent from my iPhone using SDN mobile

 

[FlowRate]

People approach medical/mental illness disclosures in different ways. Some of it is dependent on the exact diagnosis, some on comfort level, some on institutional culture.

In my opinion, you'll need to sell the idea that you're not likely to need time off again, which you sort of pointed out with your last post. The idea is to acknowledge that you had a problem and then fixed it. But don't lie.

 

[3lefts]

People approach medical/mental illness disclosures in different ways. Some of it is dependent on the exact diagnosis, some on comfort level, some on institutional.

Just run-of-the-mill depression. Started exercising, got on a medication, got a social job, did CBT and DBT with a psychologist and an ACT workbook on my own, learned how to not be debilitated by feeling like a pile of poo, and got better. I'm a pretty boring case. Hopefully I can sell that.

Any thoughts about how many programs I should apply to or how many interviews I should aim for?




Sent from my iPhone using SDN mobile

 

[FlowRate]

Just run-of-the-mill depression. Started exercising, got on a medication, got a social job, did CBT and DBT with a psychologist and an ACT workbook on my own, learned how to not be debilitated by feeling like a pile of poo, and got better. I'm a pretty boring case. Hopefully I can sell that.

Any thoughts about how many programs I should apply to or how many interviews I should aim for?




Sent from my iPhone using SDN mobile

Depends on your step 1 / step 2 / clinical grades / other connections and ECs. Everyone should aim for 10 interviews, with very competitive people being comfortable with 6-8 and less competitive with 12-14. More than that is probably overkill.

I don't know how others feel about this, but you don't even have to say that your leave was for mental health reasons. You could just say you had a medical problem, got treatment, no longer an issue. That catch, of course, is that usually when people don't say what their medical issue was, it's because it was a mental health issue... Like I said, everyone approaches this differently.

 

[Seroquelled]

So, maybe I should aim for 15-20 interviews instead of 10-15? Apply to 40-50 programs plus a handful of deep reaches? Or would that be overkill? (Trying to guesstimate how much money I'm going to need to get together.)


Sent from my iPhone using SDN mobile

I'm from a low-mid tier MD program, had a decent step scores, average grades, lots of leadership and volunteer work, 3 pubs, and a medical LOA for a mental illness. I listed it in ERAS as a "medical problem" but I was honest about if programs asked. I applied to ~55 programs (combo of safeties, reaches, and medium) and got 17 interviews (4-5 of which I'd considered reaches), went on 15. I definitely got fewer and "lower quality" interviews than my peers that were otherwise comparable (tho I can't say why for sure as correlation doesn't equal causation). I got grilled about the LOA/my medical issues relating to it at several interviews... which I thought was not allowed but whatever. Based on my experience, I'd be liberal with applications. Not sure if being honest about the mental health component was good or bad or what I could have done instead given the frequency and specific-nature of the questions I was asked.

 

[splik]

Just to clarify - if you mention it, it is most certainly allowed. Which is to say, they cant ask you what medical problems you have if there's nothing on your application. If you mention having taken a medical leave it's absolutely fair game. Moral of the story is do not mention a LOA as "medical" and find some way of disguising it. Just don't make it ridiculous (I interviewed one guy whos explanation was so incredulous that we didn't rank him, and in fact he did not match into psychiatry at all).

 

[Seroquelled]

Just to clarify - if you mention it, it is most certainly allowed. Which is to say, they cant ask you what medical problems you have if there's nothing on your application. If you mention having taken a medical leave it's absolutely fair game. Moral of the story is do not mention a LOA as "medical" and find some way of disguising it. Just don't make it ridiculous (I interviewed one guy whos explanation was so incredulous that we didn't rank him, and in fact he did not match into psychiatry at all).

What is a credible way to disguise a leave of absence? You can't lie on ERAS can you?

In my case, it was described as a medical leave of absence in my dean's letter so there was no hope of hiding it. I would have thought a medical leave of absence would be better than "I wasn't sure if I wanted to go into medicine" or "I flunked too many classes" or.... what else could it even be? Why would you take a leave of absence? It seems like lying about a relative being ill would be bad karma.

 

[splik]

It would have been too late for you, alas. Typically I advise students to agree with their school or dean of students to come up with some alternative explanation for the LOA on the MSPE. If you don't have your medical school support, I would certainly not encourage lying on ERAS. Some students have successfully put an LOA for "research". When LOAs are mental health related it is sometimes possible for students to work on some very minor research project at the end of that time etc. Really it's a sad state of affairs I have to advise students to conceal this, but medicine is not forgiving of people you know, actually having health problems god forbid, so it is what it is.

 

[Armadillos]

Not advice towards your situation as I don't know your situation, but in general intentionally trying to obscure things by knowlingly being deceptive on a job application/interview seems very ill advised. Thats not to say you put your entire personal life and private medical history on display either.

Talk to your deans about this, they likely deal with multiple people in the exact same situation every year and they have a large incentive to help you match successfully.

 

[Seroquelled]

I have a friend who took a leave of absence because he was diagnosed with (a curable) cancer but needed to focus on treatment and recovery. He did do some minor research at the tail end of the leave but the leave still mentioned it as a medical leave in his letter. It seems really absurd that something like that would negatively impact your long-term career.

 

[Crayola227]

I have a friend who took a leave of absence because he was diagnosed with (a curable) cancer but needed to focus on treatment and recovery. He did do some minor research at the tail end of the leave but the leave still mentioned it as a medical leave in his letter. It seems really absurd that something like that would negatively impact your long-term career.

medicine as culture is really absurd in this country

 

[Amygdarya]

I have a friend who took a leave of absence because he was diagnosed with (a curable) cancer but needed to focus on treatment and recovery. He did do some minor research at the tail end of the leave but the leave still mentioned it as a medical leave in his letter. It seems really absurd that something like that would negatively impact your long-term career.

Cancer - especially a curable one! - is different from mental illness. First of all, in our society as it is right now cancer patients are on the receiving end of a whole lot of empathy/sympathy/concern/encouragement/support ("we care about you, and you can do it!"), while there is still significant stigma against people with mental health issues, as if these are moral failings/defects of character ("why are you lying in bed all day, you lazy ass? Get it together!") (ha, well, I'm not talking about personality disorders here, but rather about something like depression). Second, unlike a cancer that was cured (knock on wood), most mental illnesses are likely to recur, especially under stress - and residency programs, understandably, don't want a resident who may need to take time off because of an illness. It sucks, but that's the way it is.

That said, some programs are more supportive than others. I know people who did residency at one of the evil ivory towers of psychiatry and had to take time off, whether because of depression, other medical illness or childbirth/child care leave, and their program was very supportive. Unfortunately, you can only find out about this kind of thing by talking to people from different programs. And even then, I wouldn't advertise a history of mental illness (even one episode) in my application.

 

[Seroquelled]

Cancer - especially a curable one! - is different from mental illness. First of all, in our society as it is right now cancer patients are on the receiving end of a whole lot of empathy/sympathy/concern/encouragement/support ("we care about you, and you can do it!"), while there is still significant stigma against people with mental health issues, as if these are moral failings/defects of character ("why are you lying in bed all day, you lazy ass? Get it together!") (ha, well, I'm not talking about personality disorders here, but rather about something like depression). Second, unlike a cancer that was cured (knock on wood), most mental illnesses are likely to recur, especially under stress - and residency programs, understandably, don't want a resident who may need to take time off because of an illness. It sucks, but that's the way it is.

That said, some programs are more supportive than others. I know people who did residency at one of the evil ivory towers of psychiatry and had to take time off, whether because of depression, other medical illness or childbirth/child care leave, and their program was very supportive. Unfortunately, you can only find out about this kind of thing by talking to people from different programs. And even then, I wouldn't advertise a history of mental illness (even one episode) in my application.

It was not in my application beyond what had to be in there so I wouldn't be obviously lying in comparison to my dean's letter. The application itself only said medical leave of absence, which again was stated in my dean's letter. On the app, I stated the medical condition had been successfully treated and I noted that I had since completed four consecutive years of medical school without issue. We were told up front that the content of our dean's letters was not negotiable unless it was inaccurate/a mistake and my dean seemed to think that medical leaves would not hurt people's applications and in fact told me that programs could not ask me what the medical problem was.

My friend who had cancer got screwed with interviews and only got 4 total despite applying broadly. Idk the other details of his application but he blames the leave.

 

[Amygdarya]

It was not in my application beyond what had to be in there so I wouldn't be obviously lying in comparison to my dean's letter. The application itself only said medical leave of absence, which again was stated in my dean's letter. On the app, I stated the medical condition had been successfully treated and I noted that I had since completed four consecutive years of medical school without issue. We were told up front that the content of our dean's letters was not negotiable unless it was inaccurate/a mistake and my dean seemed to think that medical leaves would not hurt people's applications and in fact told me that programs could not ask me what the medical problem was.

My friend who had cancer got screwed with interviews and only got 4 total despite applying broadly. Idk the other details of his application but he blames the leave.

I was not criticizing you, just describing my observations. You did the best you could under the circumstances by describing that the condition was successfully treated and that you subsequently went through medical school without issues.
Bottom line is, if having medical leave on your dean's letter is non-negotiable, don't explain it was due due to a mental illness in your application and hope not to get asked about it on your interviews (though, as was stated above, everything in your application is fair game).

Anyway, hope you match to a program that treats you well and gives you good training!

 

[splik]

As trump said "I like the ones who didn't get captured." We don't like doctors who get sick. They're the ultimate failure. Sad, but medicine is a toxic profession. Be strategic. I interviewed a lovely applicant who had cancer during med school, did terrible as a result, but was strategic with their application and matched where they wanted as a result. I have no doubt they will make an excellent psychiatrist.

 

[3lefts]

It was not in my application beyond what had to be in there so I wouldn't be obviously lying in comparison to my dean's letter. The application itself only said medical leave of absence, which again was stated in my dean's letter. On the app, I stated the medical condition had been successfully treated and I noted that I had since completed four consecutive years of medical school without issue. We were told up front that the content of our dean's letters was not negotiable unless it was inaccurate/a mistake and my dean seemed to think that medical leaves would not hurt people's applications and in fact told me that programs could not ask me what the medical problem was.

My friend who had cancer got screwed with interviews and only got 4 total despite applying broadly. Idk the other details of his application but he blames the leave.

Thank you for sharing, it sounds like your leave will come across similarly to mine. I hadn't heard about anyone who took a leave and went back for four years and then went through the application process, so this gives me a much better sense of what to expect. I wish you the absolute best of luck in the match!


Sent from my iPhone using SDN mobile