Would having disability accommodation for anxiety and OCD decrease the value of my med school application? If so, by how much?

[bear632]

Hello Members of SDN,

I hope everyone had a nice weekend. 🙂

Quick Summarized Question:
I have OCD and just started a post-bacc program for med school. I am considering applying for disability accommodations, but am concerned about how med schools will perceive that. Would having disability accommodation for anxiety and OCD decrease the value of my med school application? If so, by how much?

Longer Form Question:
As a non-traditional student who recently began a post-baccalaureate program for med school, I have a question in regards to receiving disability accommodations.

I have moderate OCD which becomes worse before and during major exams. This began in high school (ever since grades "counted") and is something I've managed through college.

Having not been in school since my formal diagnosis a few years ago, and now being back in school, I am strongly considering applying for disability accommodations. Specifically, I think a private test taking space would lessen intrusive thoughts. Extra time would make me less stressed too, although I don't think I would need it. I think I would do better in classes and be less stressed too.

My concern is whether it will decrease the value of my overall application.

Medical schools are understandably vague in their public statements about how their admissions officers view students with disabilities. From my research it seems almost all say it's a case-by-case basis of review.

Here is what Yale says:
"In assessing applicants for admission, it is also appropriate to consider the applicant's current physical and emotional status, cumulative and progressive disability, and drug-induced impairments that may pose obstacles to the safe application of the student's knowledge and skills or prevent effective interaction with patients. Applicants will be reviewed individually and on a case-by-case basis. No otherwise qualified individual with a handicap will be excluded from admission. In accordance with University policy and as delineated by Federal and Connecticut law, the Medical School does not discriminate in admissions, educational programs, or employment against any individual on account of that individual's handicap or disability"

Would having disability accommodation for anxiety and OCD make me a less competitive applicant for medical school? If so, by how much?

Look forward to hearing from people!

Thank you.

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[GoSpursGo]

No, this would not decrease the value of your application. And I generally do not believe that you would need to disclose that you have received testing accommodations until after you get accepted.

Regardless, you should focus on getting the help you need and worry about any potential ramifications later. Having or not having a disability won't matter if you're not able to do well in your studies because you didn't get the help you need.

 

[Crayola227]

Given what it is like for people who have chronic health conditions or mental health struggles to even try to exist in the current medicoindustrial complex environment, and knowing the discrimination many face on a daily basis:

1) The most conservative advice I can give you, is that it is always best to hide these issues as best as you can, but not to the point where your health is harmed or your performance suffers. Finding that balance is difficult, and in some situations, impossible.

2) Even assuming that this doesn't become known and it isn't held against you, I would urge you to consider if you are biting off more than you can chew. Does the OCD or anxiety *only* affect you in test taking scenarios? If so, it might make sense to pursue accommodations and attempt training and practice. OTOH, these conditions can have a way of evolving in difficult to predict ways.

I know of at least one physician who had OCD that affected their ability to complete notes on time. They were mandated to seek therapy by their employer to attempt to control their condition, and they were at serious risk of losing their career over it all.

The main issue, is that it isn't just about completing medical school and going on your way. Most who graduate med school are $250,000+ in debt. Without a license to practice medicine or the ability to be board certified (which comes from completing some or all of residency) one's capacity to earn a good living can be severely limited.

And the other big issue, and can be a rude awakening, is that you will surely find less and less acommodating attitudes for you as a person as you transition from school environments to employment. And don't mistake residency for school, it's employment first and foremost.

It is very difficult for me to recommend medical school and training to all but the most functional and healthy people.

And, discrimination is sadly still very common and you should have no illusions on that front. This comes from my own experience and the direct experiences of people I've had the privilege of working with.

I wish you luck.

 

[Crayola227]

Rule of thumb is that no one cares about your disability if you are able to manage it and mantain an adequate performance, basically, if they would never otherwise have known or guessed you had an issue, then it's fine. As soon as it impacts your performance or "inconveniences" others, you may find that medicine as a field is ironically and shockingly intolerant of many human weaknesses.

 

[Rapsidy]

I’ve had severe OCD since I was 3 years old, and have ADHD treated currently.

Every medical school will have accommodations that are reasonable, aka getting a quiet testing room shouldn’t be a problem whatsoever.

I personally took the quiet testing room but turned down the extra test taking time offered because fighting for accommodations for the step exams is not worth the time it takes to go up against them so I didn’t want to test differently than what step would offer.

Asking for a quiet testing room will not harm you in any way shape or form for your application.

 

[deleted1133766]

This is an important topic for a lot of people.

I would say that if you have OCD or anxiety that it's not an issue because the school's TITLE IX has to give you accommodations based on documentation. You'd be surprised at all the accommodations they can offer too. Some students need comfortable chairs and they take their exams with comfortable chairs!

My school takes care of all students who need accommodations and they encourage any student who needs accommodations to take them.

One of my professors even lectured the class and said "if you need that help and you don't get it, I will personally fight for you to get it."

I asked the director of the student affairs department if any accommodations would interfere with my own application to the school that I attend and they said "absolutely not."

That's just for testing accommodations though. I can't comment on depression and stuff like that.

 

[Goro]

Hello Members of SDN,

I hope everyone had a nice weekend. 🙂

Quick Summarized Question:
I have OCD and just started a post-bacc program for med school. I am considering applying for disability accommodations, but am concerned about how med schools will perceive that. Would having disability accommodation for anxiety and OCD decrease the value of my med school application? If so, by how much?

Longer Form Question:
As a non-traditional student who recently began a post-baccalaureate program for med school, I have a question in regards to receiving disability accommodations.

I have moderate OCD which becomes worse before and during major exams. This began in high school (ever since grades "counted") and is something I've managed through college.

Having not been in school since my formal diagnosis a few years ago, and now being back in school, I am strongly considering applying for disability accommodations. Specifically, I think a private test taking space would lessen intrusive thoughts. Extra time would make me less stressed too, although I don't think I would need it. I think I would do better in classes and be less stressed too.

My concern is whether it will decrease the value of my overall application.

Medical schools are understandably vague in their public statements about how their admissions officers view students with disabilities. From my research it seems almost all say it's a case-by-case basis of review.

Here is what Yale says:
"In assessing applicants for admission, it is also appropriate to consider the applicant's current physical and emotional status, cumulative and progressive disability, and drug-induced impairments that may pose obstacles to the safe application of the student's knowledge and skills or prevent effective interaction with patients. Applicants will be reviewed individually and on a case-by-case basis. No otherwise qualified individual with a handicap will be excluded from admission. In accordance with University policy and as delineated by Federal and Connecticut law, the Medical School does not discriminate in admissions, educational programs, or employment against any individual on account of that individual's handicap or disability"

Would having disability accommodation for anxiety and OCD make me a less competitive applicant for medical school? If so, by how much?

Look forward to hearing from people!

Thank you.

If you can demonstrate that you can handle Medical school, and the admissions committee believes this and accepts you, then the med school is obligated to do what is reasonably possible to get you to graduation.

 

[Naruhodo]

Hi bear632, I agree with the advice above and will just add my perspective as someone who received accommodations in medical school. I had social anxiety and questioned myself constantly. I saw the school mental health provider once (gave me a book of exercises to work through for anxiety which I promptly returned saying that the last thing I had time fore was more homework). But I did get involved with a disability advocacy group on campus, and made friends that helped me feel less like a fish out of water. My clinical year was challenging (as it is for many) and being weak in anatomy I managed to fail my surgery shelf exam by a point (so close!). For the retake I met with the disability office, explained I am a slow reader and that the long question stems of the shelf slowed me down enough that I didn't make it to all the questions. The disability officer said it wasn't his job to question the validity of my disability, and anyone brave enough to ask for help should get it. I received 1.25x test time AND I had a quiet private space for my retake (which I passed with flying colors).

However I was also told that someone like me would not been approved for extra time on the Step exams. The fact that I had made it through the SAT, college, MCAT, all with no accommodations meant the burden of proof needed for NBME to grant extra time just wasn't there. So even if your school grants you accommodations, you likely won't get them for Step. My school had a special Step 1 preparation course for students who had struggled with preclinical material. I'd actually done well in my preclinical classes but I asked if it would be ok to join the group despite not being initially invited (the school said yes). They classmates were some of my favorites (less ego, kind, supportive types) and I loved the camaraderie of the class. I know other people who studied more intensely for step 1, but the group helped keep me sane and grounded. (And for anyone who is nervous, I passed all 3 steps comfortably)

I think my school was on the more open-minded side, and admitted people who wrote openly about physical disability, learning disability, mental healthy/suicide attempts, eating disorders and substance use disorders. I respect these classmates for how far they had come and how they were able to connect to patients facing those challenges, and engage with them in a very humane and kind way. I'd be careful about feeling you have to keep a struggle "hidden". One of my classmates who had a substance use disorder decided he didn't want to be defined by this and not to tell anyone (at least a first). He was a very smart, beloved guy, and hit some bumps (as most people do at some point in med school). None of his roommates (all fellow med students) knew about his substance use history when he relapsed and unfortunately overdosed. In retrospect many of those closest to him felt like they should have recognized the signs and blamed themselves. Secrecy matters less than your life, so if you can find a few close friends in med school to be honest with about your struggles it might lighten the burden and be safer.

 

[Mr.Smile12]

They also have a podcast.

Docs With Disabilities Initiative

The Docs With Disabilities Initiative uses research, education, and sharing of stories to drive change in perceptions, disability policy, and procedures in healthcare education. Our aim is to build more inclusive educational environments for trainees with disabilities and increase representation...

www.docswithdisabilities.org

 

[bear632]

No, this would not decrease the value of your application. And I generally do not believe that you would need to disclose that you have received testing accommodations until after you get accepted.

Regardless, you should focus on getting the help you need and worry about any potential ramifications later. Having or not having a disability won't matter if you're not able to do well in your studies because you didn't get the help you need.

Thank you for your reply, and I apologize if I broke a rule for posting twice I am still learning about how to use this forum.

 

[bear632]

Given what it is like for people who have chronic health conditions or mental health struggles to even try to exist in the current medicoindustrial complex environment, and knowing the discrimination many face on a daily basis:

1) The most conservative advice I can give you, is that it is always best to hide these issues as best as you can, but not to the point where your health is harmed or your performance suffers. Finding that balance is difficult, and in some situations, impossible.

2) Even assuming that this doesn't become known and it isn't held against you, I would urge you to consider if you are biting off more than you can chew. Does the OCD or anxiety *only* affect you in test taking scenarios? If so, it might make sense to pursue accommodations and attempt training and practice. OTOH, these conditions can have a way of evolving in difficult to predict ways.

I know of at least one physician who had OCD that affected their ability to complete notes on time. They were mandated to seek therapy by their employer to attempt to control their condition, and they were at serious risk of losing their career over it all.

The main issue, is that it isn't just about completing medical school and going on your way. Most who graduate med school are $250,000+ in debt. Without a license to practice medicine or the ability to be board certified (which comes from completing some or all of residency) one's capacity to earn a good living can be severely limited.

And the other big issue, and can be a rude awakening, is that you will surely find less and less acommodating attitudes for you as a person as you transition from school environments to employment. And don't mistake residency for school, it's employment first and foremost.

It is very difficult for me to recommend medical school and training to all but the most functional and healthy people.

And, discrimination is sadly still very common and you should have no illusions on that front. This comes from my own experience and the direct experiences of people I've had the privilege of working with.

I wish you luck.

Thank you for being real. Your post was very helpful!

 

[bear632]

Hi bear632, I agree with the advice above and will just add my perspective as someone who received accommodations in medical school. I had social anxiety and questioned myself constantly. I saw the school mental health provider once (gave me a book of exercises to work through for anxiety which I promptly returned saying that the last thing I had time fore was more homework). But I did get involved with a disability advocacy group on campus, and made friends that helped me feel less like a fish out of water. My clinical year was challenging (as it is for many) and being weak in anatomy I managed to fail my surgery shelf exam by a point (so close!). For the retake I met with the disability office, explained I am a slow reader and that the long question stems of the shelf slowed me down enough that I didn't make it to all the questions. The disability officer said it wasn't his job to question the validity of my disability, and anyone brave enough to ask for help should get it. I received 1.25x test time AND I had a quiet private space for my retake (which I passed with flying colors).

However I was also told that someone like me would not been approved for extra time on the Step exams. The fact that I had made it through the SAT, college, MCAT, all with no accommodations meant the burden of proof needed for NBME to grant extra time just wasn't there. So even if your school grants you accommodations, you likely won't get them for Step. My school had a special Step 1 preparation course for students who had struggled with preclinical material. I'd actually done well in my preclinical classes but I asked if it would be ok to join the group despite not being initially invited (the school said yes). They classmates were some of my favorites (less ego, kind, supportive types) and I loved the camaraderie of the class. I know other people who studied more intensely for step 1, but the group helped keep me sane and grounded. (And for anyone who is nervous, I passed all 3 steps comfortably)

I think my school was on the more open-minded side, and admitted people who wrote openly about physical disability, learning disability, mental healthy/suicide attempts, eating disorders and substance use disorders. I respect these classmates for how far they had come and how they were able to connect to patients facing those challenges, and engage with them in a very humane and kind way. I'd be careful about feeling you have to keep a struggle "hidden". One of my classmates who had a substance use disorder decided he didn't want to be defined by this and not to tell anyone (at least a first). He was a very smart, beloved guy, and hit some bumps (as most people do at some point in med school). None of his roommates (all fellow med students) knew about his substance use history when he relapsed and unfortunately overdosed. In retrospect many of those closest to him felt like they should have recognized the signs and blamed themselves. Secrecy matters less than your life, so if you can find a few close friends in med school to be honest with about your struggles it might lighten the burden and be safer.

You are the first person I've been in communication with who has gone through med school with disability accommodation. Thank you for sharing your experience Naruhodo, very insightful.

 

[bear632]

I’ve had severe OCD since I was 3 years old, and have ADHD treated currently.

Every medical school will have accommodations that are reasonable, aka getting a quiet testing room shouldn’t be a problem whatsoever.

I personally took the quiet testing room but turned down the extra test taking time offered because fighting for accommodations for the step exams is not worth the time it takes to go up against them so I didn’t want to test differently than what step would offer.

Asking for a quiet testing room will not harm you in any way shape or form for your application.

Thank you for your response. Yes, quiet testing area is really what would help, so you sharing your experience is reassuring.

 

[Crayola227]

If you can demonstrate that you can handle Medical school, and the admissions committee believes this and accepts you, then the med school is obligated to do what is reasonably possible to get you to graduation.

This is true. The issues usually come when you enter the clinical arena 3rd year and beyond. It's something to be aware of. Because the buck doesn't stop at graduation, and some students end up very surprised at what comes up in their letters, the Match process, interviews, and residency training.

Because the picture can change so much going from the classroom environment to the clinical and job sphere, I just want students to understand more about this transition so it's less of a rude awakening.

As usual, IRL the reality lies in the middle of two extremes you will read about on SDN. There will be the school experience, and helpful and understanding individuals. And then there will be the rest of training, and also difficult individuals and situations for anyone with a disability.

This isn't to say that people with disabilities cannot navigate all this to be successful. But I want students braced that they will encounter difficulties.

I knew people who started medical school and had no idea a residency was required after to practice. More than one! True story. You would have thought that someone, the student or admissions or an advisor, would have ensured they were aware of what the occupational requirements were for their chosen job and $250k+ in debt, but sadly not always. So it always bears to be mentioned that there is another side to medical school, and that is not entry but graduation and residency and beyond.

 

[Crayola227]

You are the first person I've been in communication with who has gone through med school with disability accommodation. Thank you for sharing your experience Naruhodo, very insightful.

I have written a guide somewhere, sort of an accommodations 101, if one were to find themselves in a more hostile environment.

Often the Title officers for disability accommodations are very kind.

However, I have also been told by more than one that I personally worked with, that they had never encountered an industry setting more toxic and difficult and unaccommodating than that of healthcare, to the point that they regularly dealt with illegal behaviors and constantly had to struggle to get students, residents, and attending physicians among other healthcare workers, to get accommodations they were entitled to under the law. These were people who had served in the same capacity in other fields or workplace environments.

I will keep saying, finding accommodations for taking a test or the didactic aspects of medical training is usually not the huge issue and many instructors (many of whom are not always clinicians, either!) are very understanding. But they often only make up just a portion of your training. And they can easily be overrruled by a less sympathetic administration.

Or as I said, as soon as you start rotations you are potentially looking at a rotation-by-rotation battle with whomever is "in charge" of you for the month/week for your already-approved accommodations. You will be told you are not supposed to be retaliated against. But you also may still experience that.

It will depend greatly on the nature of your disability, the accommodations you need, and your particular school and residency as well as what individuals you happen to encounter.

Extra time for tests usually not a big deal, but it was already mentioned that getting those for the Steps (the most important test of med school) can have its challenges.

Anyway check out my post and the links in it, some may or may not apply to anyone.

Not quite sure what to do...true nontraditional here

I'm a nontraditional student, am a mom and am married. I managed to make it into a great school (accepted pre-child) and have done well in the preclinical class work. Then step one came. We only had about 4-5 weeks of dedicated study time, and I just messed it up. I tried, but I began having...

forums.studentdoctor.net

 

[bear632]

I have written a guide somewhere, sort of an accommodations 101, if one were to find themselves in a more hostile environment.

Often the Title officers for disability accommodations are very kind.

However, I have also been told by more than one that I personally worked with, that they had never encountered an industry setting more toxic and difficult and unaccommodating than that of healthcare, to the point that they regularly dealt with illegal behaviors and constantly had to struggle to get students, residents, and attending physicians among other healthcare workers, to get accommodations they were entitled to under the law. These were people who had served in the same capacity in other fields or workplace environments.

I will keep saying, finding accommodations for taking a test or the didactic aspects of medical training is usually not the huge issue and many instructors (many of whom are not always clinicians, either!) are very understanding. But they often only make up just a portion of your training. And they can easily be overrruled by a less sympathetic administration.

Or as I said, as soon as you start rotations you are potentially looking at a rotation-by-rotation battle with whomever is "in charge" of you for the month/week for your already-approved accommodations. You will be told you are not supposed to be retaliated against. But you also may still experience that.

It will depend greatly on the nature of your disability, the accommodations you need, and your particular school and residency as well as what individuals you happen to encounter.

Extra time for tests usually not a big deal, but it was already mentioned that getting those for the Steps (the most important test of med school) can have its challenges.

Anyway check out my post and the links in it, some may or may not apply to anyone.

Not quite sure what to do...true nontraditional here

I'm a nontraditional student, am a mom and am married. I managed to make it into a great school (accepted pre-child) and have done well in the preclinical class work. Then step one came. We only had about 4-5 weeks of dedicated study time, and I just messed it up. I tried, but I began having...

forums.studentdoctor.net

Thank you I will look at the links you have.

 

[Fluidity of Movement]

I'm going to recommend contacting the DOJ or browsing their information about the ADA on the ADA website. All of the things you are worried about, you generally have legal protections. Within the past decade even the ADA was able to remove the "Had accommodations" mark on the MCAT, so now anyone who required assistance has the same MCAT as everyone else.


I haven't kept up with everything the past six years or so, but the DOJ+ADA is going to be a great resource if you have any specific concerns with any specific places.

 

[DNAJB6]

I'm going to recommend contacting the ADA or browsing their information. All of the things you are worried about, you generally have legal protections. Within the past decade even the ADA was able to remove the "Had accommodations" mark on the MCAT, so now anyone who required assistance has the same MCAT as everyone else.


I haven't kept up with everything the past six years or so, but the ADA is going to be a great resource if you have any specific concerns with any specific places.

What do you mean by "contacting the ADA?" ADA refers to the Americans with Disabilities Act which is a federal statute and not a governmental agency.

 

[Fluidity of Movement]

What do you mean by "contacting the ADA?" ADA refers to the Americans with Disabilities Act which is a federal statute and not a governmental agency.

Sorry, I didn't feel like I needed to explicitly state to contact the Department of Justice's Civil Rights Division, Disability Rights Section. Web results for "ADA" and go to the website where they have a bevy of information and resources and people to contact.

 

[esob]

I'm reasonably sure that any school would not know that you had accommodations during your undergraduate unless you disclosed it. I know statistically that ~ 4 % of my medical school class had accommodations, so it is not uncommon. It is also better to have things well established in undergraduate and hit the ground running in med school because I know of two people who needed accommodations and didn't get them until it was too late and ultimately were dismissed.