Would I jeopardize my chances if I said this?

[Back34]

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I'm a soon - to - be MSIV who finally thinks he knows what he wants to do with the rest of his life. Family medicine was high on my list for a while, but after reconsidering my clerkship experiences, psychiatry was the one rotation that I really had a knack for, enjoyed the most, and felt like I had some valuable insight to contribute to. Let me explain:

I left medical school my first year because of anxiety / depression that was brought on by some issues I was having with my family and fiancee (now ex) all the while trying to do well in school. I held out until late October and finally discussed my situation with the Dean of Student Affairs, who accepted my request to take a medical leave of absence, provided that I seek counseling in the interim, which I did and thoroughly enjoyed. I began again the following year and completed MSI and MSII without any problems and without medication. I had a bit of a flare-up as an MSIII, but not to the extent of the first one, i.e., I was able to work through it and pass the rotation.

Despite the agony that depression induces, I now consider it a blessing as I'm that much more sympathetic to those with mental illness and feel more capable and willing to lead my patients through their difficulties. This is where I feel my calling. I care about these people.

I'm pretty set on psychiatry and would certainly explain my motivation for entering the field in my personal statement and interviews. Not that it's going to change anything I say, but how would programs respond to this? As psychiatrists, I would think that they'd be more understanding than E.R., or trauma surgery, or something like that.

My application is average at best, although I did "honor" psychiatry and did above average on step I (224). I'm also not looking to match into outrageously competitive programs.

 

[Back34]

Sorry, my first submit wouldn't post.

 

[Milo]

I'd say the odds of finding a residency program that looks at your life experience favorably are very good. There's a definite possibility that a residency would consider you a stronger candidate based on this information.

But why risk it? Let's take a look at your competitiveness:

You are a soon to be US grad (assumption here)
great USMLE score (224 is more than enough in psych)
excellent command of the English language (based on your post)
Ability to show empathy
Honors in Psychiatry (which should tranlate into good LoRs)
Not overly interested in a highly competitive program.

You're going to have residencies crawling all over you. Hell, I want you at my program next year! You don't need to play a potential wild card to add to your competitiveness. You're a solid candidate, it would boggle my mind if you matched anywhere besides your first choice.

Congratulations on finding your niche. I think you're going to be tremendously satisfied in psychiatry. (Give me a PM if a residency in the Western US is something you're considering)

 

[Anasazi23]

You know, I generally dissuade people from writing personal, vis a vis, their OWN battles with mental illness in their personal statements. I know firsthand that program directors want the best, healthiest people they can find. I've seen lots of applications get thrown out because their personal statement just seemed too "weird."

I guess it's akin to saying that you're more competitive for a heme-onc fellowship because you have leukemia. Yes, it brings you a somewhat unique perspective on the disease process....but overall....you get the point.

I'd generally recommend you to stay away from that type of thing. Even psychiatrists carry their own biases against mental illness. Remember, they want someone who isn't going to call in sick, will work tirelessly, and has the mental strength to deal with tremendous problems (other patients') all day and remain vigilant on their watch i.e. call, or whenever.

Best of luck.

 

[meisteckhart]

I would also say that it may be best that you not volunteer the information. If it is a strong motivator for you to go into psychiatry, you could say in your personal statement that you have had personal experience with mental illness that has motivated you to want to help those who are mentally ill. The further you go into details, however, the more likely that you may alienate someone reading it. I actually suffered from depression and anxiety in med school, but it is something that runs in my family as well. My grandmother had very severe depression and was in a state facility back when they tended to commit people and throw away the key. Instead of talking about my own illness, I spoke of how her illness had affected me, and in that way I was able to express my motivation without revealing my own pathology. You could try to do the same with an example of a friend or family member, or even a patient you cared for.

The advice I got from the program director at my med school was that you are walking a fine line when discussing your own mental illness. On the one hand, many psychiatrists are motivated by their own illness or that of a family member, and the experience makes them more empathetic and often more aware of their own counter-transference. On the other hand, you don't want a psychiatrist who is there to somehow learn about their own issues at the expense of the patient, or one who is not stable and likely to break down when under stress. If you decide to talk about your own experience, make sure you stress the positive things you have learned, while also reassuring people that you are stable, can work under stress, and can ask for and find help if you need it.

 

[PsychFuture]

You have lots of things going for you, I would not add information that could be seen as a weakness even by mental helath professionals that should be more understanding.

 

[MJD503]

The book: An Unquiet Mind by Kay Jamison touches on this subject often in the latter stages of the book. I would suggest reading her take.

My own personal opinion is not to give out that info. Despite the intrinsic need to be able say you got through it a better man...

Keep it close to the chest, pick your 'battles' because somewhere along the line you will need to disclose the info. From my understanding, via the above mentioned book, she mentions the applications for employment where you need to disclose ALL medical/A&D issues you have that MAY or MAY NOT affect your work performance. So you will deal with this eventually but why do so now? Get your residency secured, show your skills, if your comfortable after a good period of time, maybe you decide to share that info with your professors/classmates at that time.

Good luck! I am a pre/pre-med student hoping to be where you're at some day and I also deal with Major depression on a daily basis though it is very much undercontrol now.

 

[ORBITAL BEBOP]

The book: An Unquiet Mind by Kay Jamison touches on this subject often in the latter stages of the book. I would suggest reading her take.

need to disclose ALL medical/A&D issues you have that MAY or MAY NOT affect your work performance. So you will deal with this eventually but why do so now? Get your residency secured, show your skills, if your comfortable after a good period of time, maybe you decide to share that info with your professors/classmates at that time.

🙄 I have gotten differring opinions on when to tell a program director of any kind of illness. From a legal standpoint (malpractice insurance, etc), when should a director know? Should it be in the personal statement, the interview, or later?

 

[mosche]

I echo the sentiments posted above: disclose nothing negative during the application/interview process. Having worked with Kaplan for several years, I have advised many students at all levels. One thing that programs state about the personal statement is that it is your opportunity to help them see who you are or to explain negative grades/test scores. Well, I am certain that no individual would divulge negative grades/test scores if they were not already given to the schools; so, why would anyone want to divulge other things that could be interpreted as "negative" unless they had to do so?

One of the attendings at my home school said that she only looks at the P.S. to weed out people that she assumes would "bring in too much baggage" (her words, not mine). Well if one attending is admitting to doing that, I assume that there are many more who feel the same but are more discreet -- WHY RISK IT?

Finally, realize that residency is a job. In the real world people are hired because they are expected to fill a void or "serve as a cog" in the system, why would we expect Psychiatry to be any different? After all, the hospital is there for the patient -- not for us. Therefore, while the PD and others might sympathize/empathize with your situation, they are ultimately responsible to the hospital and its patients (e.g. they may view your history as creating more problems than they want to deal with). Likewise, they --the program/hospital-- will not divulge their weaknesses during the interview process. Why not? It's their job to fill their spots, just as it's your job to try to get one of them!

 

[ORBITAL BEBOP]

I heard that during psych interviews, the interviewers ask you about these kind of issues (mental illness, psychotherapy, etc). Are those legal questions? Any input from people who had interviewed for Psych would be helpful too.

 

[Miklos]

I heard that during psych interviews, the interviewers ask you about these kind of issues (mental illness, psychotherapy, etc). Are those legal questions? Any input from people who had interviewed for Psych would be helpful too.

I don't know whether they are legal questions in a residency interview. I suspect that programs would defend them for the same reason medical boards ask them.

California's application, for instance asks among other things (including addiction and neurological problems):

"Have you been diagnosed with an emotional, a mental, or behavioral disorder which impairs your ability to practice medicine safely?"

I suspect that while deciding to grant a license to someone who answers yes, the input of the residency director would be key.

So, there may well be short term gain in withholding information from PDs (e.g. matching), but there may be a long term price to pay when it comes to licensure.

 

[ORBITAL BEBOP]

How is it determined if a person's condition affects his/her ability to practice medicine? I am sure many residents are relatively well controlled with medications and do not need to divulge this information even for licensure. Is this right?

 

[Miklos]

How is it determined if a person's condition affects his/her ability to practice medicine? I am sure many residents are relatively well controlled with medications and do not need to divulge this information even for licensure. Is this right?

Let me put it this way.

HYPOTHETICALLY SPEAKING, if I were to consider withholding information on a medical license application which could be perceived (in hindsight) as misleading state license authorities, I would seek legal counsel beforehand.

When you fill out and sign a license application, you are doing so under penalty of perjury. One of the reasons, a fair amount of physician licenses are revoked is for failing to disclose information on the application.

(In addition, one would have to live with the consequences of having withheld information.)