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ghalazn

Can you be a doctor with a mental illness? Specifically an eating disorder?

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I have bulimia.

I know, it makes no sense. I know how I’m damaging my body; I know the physical consequences of what I’m doing and how horrible it is and damaging it is. Yet I have been bulimic for 2 years of my undergrad; I study and reward myself with a binge after, then I purge. It takes me about half an hour to purge every day so I just account that I went to the gym or something. I know. It’s bad; it’s addicting. Ironically I have done well in school by doing this; I only allow myself to binge when I’m done studying and it motivates me in this really weird way. I just think it’s messed up that I should be helping people when I need help myself; I don’t want to tell anyone because I feel like it would just make me a mentally ill person, not a person who has a shot at medical school.

 

I know how messed up this is and I’ve never revealed this to anyone; I’m very good at hiding it.

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12 hours ago, ghalazn said:

I have bulimia.

I know, it makes no sense. I know how I’m damaging my body; I know the physical consequences of what I’m doing and how horrible it is and damaging it is. Yet I have been bulimic for 2 years of my undergrad; I study and reward myself with a binge after, then I purge. It takes me about half an hour to purge every day so I just account that I went to the gym or something. I know. It’s bad; it’s addicting. Ironically I have done well in school by doing this; I only allow myself to binge when I’m done studying and it motivates me in this really weird way. I just think it’s messed up that I should be helping people when I need help myself; I don’t want to tell anyone because I feel like it would just make me a mentally ill person, not a person who has a shot at medical school.

 

I know how messed up this is and I’ve never revealed this to anyone; I’m very good at hiding it.

Short answer: yes. 

You can be a doctor with a diagnosed mental illness. However, it cannot be uncontrolled, or otherwise severe enough to impact your ability to practice medicine. When a physician applies for licensure, there is usually a question that specifically asks to declare any medical or psychiatric conditions that may affect functioning.

As to whether it has any bearing on medical school admissions is another matter, but I suspect it doesn't so long as it's managed and coped with appropriately.

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22 hours ago, ghalazn said:

I have bulimia.

I know, it makes no sense. I know how I’m damaging my body; I know the physical consequences of what I’m doing and how horrible it is and damaging it is. Yet I have been bulimic for 2 years of my undergrad; I study and reward myself with a binge after, then I purge. It takes me about half an hour to purge every day so I just account that I went to the gym or something. I know. It’s bad; it’s addicting. Ironically I have done well in school by doing this; I only allow myself to binge when I’m done studying and it motivates me in this really weird way. I just think it’s messed up that I should be helping people when I need help myself; I don’t want to tell anyone because I feel like it would just make me a mentally ill person, not a person who has a shot at medical school.

 

I know how messed up this is and I’ve never revealed this to anyone; I’m very good at hiding it.

Yes, I know a few colleagues who have eating disorders, they are under control.  When you get into medical school and eventually into residency, you would have to declare it to the College of Physicians, which may require some sort of monitoring through physicians reports. 

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14 hours ago, LittleDaisy said:

Yes, I know a few colleagues who have eating disorders, they are under control.  When you get into medical school and eventually into residency, you would have to declare it to the College of Physicians, which may require some sort of monitoring through physicians reports. 

they are really picky about that so make sure when you get to that point that in particular that has to reported - I really don't like the way the college classifies and tracks all of this - you have to bring it up every time you do a license renewal or whatever. Even if it was a temporary thing - which is just further stigmatizing all of this when we should be doing the opposite. It creates in my mind more problems than it solves. 

Even the OP's terminology - it is a medical condition, not really "messed up", any more than any other medical condition would be speaking from the physicians point of view.  

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1 hour ago, rmorelan said:

they are really picky about that so make sure when you get to that point that in particular that has to reported - I really don't like the way the college classifies and tracks all of this - you have to bring it up every time you do a license renewal or whatever. Even if it was a temporary thing - which is just further stigmatizing all of this when we should be doing the opposite. It creates in my mind more problems than it solves. 

Even the OP's terminology - it is a medical condition, not really "messed up", any more than any other medical condition would be speaking from the physicians point of view.  

I agree wholeheartedly, there is some sort of stigmatization of mental health among physicians. Even if you have fairly well controlled MDD  or GAD, you have to report it to College of Physicians, who require an annual report of GP or psychiatrist. If you are unfortunately not under control, they sometimes send you to the Physician Health Program, which hasn't been a pleasant experience for some of my colleagues. 

Career as a physician alone creates high rates of burnout, depression and anxiety disorders, which it is fairly common and should not change one's ability to be a competent physician. Unfortunately, CPSO (Ontario) tracks down all medical trainees and practising physicians with mental health diagnoses. If you are fairly under control and follow up with treatment, there shouldn't be much issue for licensing. 

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1 hour ago, LittleDaisy said:

I agree wholeheartedly, there is some sort of stigmatization of mental health among physicians. Even if you have fairly well controlled MDD  or GAD, you have to report it to College of Physicians, who require an annual report of GP or psychiatrist. If you are unfortunately not under control, they sometimes send you to the Physician Health Program, which hasn't been a pleasant experience for some of my colleagues. 

Career as a physician alone creates high rates of burnout, depression and anxiety disorders, which it is fairly common and should not change one's ability to be a competent physician. Unfortunately, CPSO (Ontario) tracks down all medical trainees and practising physicians with mental health diagnoses. If you are fairly under control and follow up with treatment, there shouldn't be much issue for licensing. 

Hasn't been a pleasant experience for many of my colleagues either - and yeah as you point out medicine is a field which has a ton of features that predisposes someone to mental illness - long hours, less than ideal support, suboptimal sleep hygiene, often food and exercise are hard to get to, high levels of stress, compassion fatigue.....I can go on for days here. If you ever get mentally ill is this often toxic soup then you permanently labeled which adds a new stress of its own. The usually isn't in the end much issue for licensing but you can have delays, and more paperwork to detail with. It really is a bit of a mess in my opinion. 

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The CPSO doesn’t track absolutely everybody - they don’t ask about if you have a diagnosis, they ask if you have a medical condition that “could interfere with your ability to practice medicine”. Many people with MDD or GAD or whatever reasonably conclude that their illness is mild enough that they can answer no, and they go on their way. I also know people who have disclosed and not been monitored.

I disclosed, was monitored for two years with the PHP, which was not the funnest thing but also not awful. The PHP was decent with me and were not alarmist or eager to take me off work - they allowed me to work with significant symptoms as long as my psychiatrist approved it and never forced me on a leave. After two years the CPSO realized that I am fine and is now uninterested - though I expect a peak of re-interest when I apply for my independent license.  The delays and extra paperwork was the worst part.

It felt very stigmatizing but it was not the end of the world. 

As to being a physician with a mental illness it adds an extra layer of difficulty but it can certainly be done and it also has its advantages in terms of understanding what it’s like on the other side. 

Happy to chat more about this by PM. 

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Thank you; it doesn’t affect my studies persay. I have tried to stop but it is really difficult. No one around me knows about it because like I said, I am very good at hiding it. So do I have to necessarily report it? Because I haven’t been diagnosed with it formally and I do not plan on going to see someone about it as the effects a diagnosis could have on my application. Thank you! 

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8 hours ago, ghalazn said:

Thank you; it doesn’t affect my studies persay. I have tried to stop but it is really difficult. No one around me knows about it because like I said, I am very good at hiding it. So do I have to necessarily report it? Because I haven’t been diagnosed with it formally and I do not plan on going to see someone about it as the effects a diagnosis could have on my application. Thank you! 

You don't have to report it or tell anyone else. However, I think most reasonable people would suggest that you let someone know (like your family doctor). You've freely admitted that this behavior is physically damaging, takes time out of your day, and is addicting and difficult to stop. These are fairly serious things to live with, considering that the reward is preventing a hypothetical negative impact on your application.

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A diagnosis won’t have an effect on your application. The university is not entitled to know at any point in the process.  However if you want to be a physician there is a certain obligation to manage your health. The stress on you isn’t going to decrease. Early treatment could make the difference between being able to practice medicine and spiralling downhill under the pressure. And I say that as someone who has been down this road (not with an eating disorder but with other mental health stuff). 

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Medicine is full of people with eating disorders, anxiety, depression, substance use disorders etc. Some of of the traits that make us successful in medicine also make us hard on ourselves (perfectionism, desire to please, consciousness, etc). Things can get wildly out of control with the stress of medical school and residency, and so if you can tackle it sooner rather than later then you will be better off. I've seen things get really out of hand for peers with the stress of studying for exams, trying to get into residency,  and then working 80+ hours per week in clerkship/residency. I know peers who have been able to beat their eating disorders before and during medical school, so it is definitely possible. Definitely reach out for help if you can. Good luck with your health issues and medicine journey! You got this.

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10 hours ago, MD2015:) said:

 Definitely reach out for help if you can.

While you should seek help if you need it, it is advisable to do this in the most private and untraceable way possible. That means not going through your university or a physician health program. Those may claim to be confidential but I have seen confidentiality violated to the benefit of the university or employer. It means seeing counsellors and doctors who work independently from employers, universities and boards. Fiercely protect your medical data. Consult with lawyers before disclosing any health information to a university, employer or board (I'm not saying lie, but you need to be extremely careful to avoid disclosing extra information that could be used against you for any reason in the future).

I have seen so many physicians burned because they did what they thought was right and assumed the university/employer/board would treat them fairly and with empathy. Unfortunately, that is frequently not the case. It was much more common that they were targeted, bullied and treated in an unfair or prejudiced manner. 

Medicine is a terrible profession filled with many terrible people who, quite frankly, have no idea how to behave like professionals or even civilized human beings. A surprising number lack basic social understanding and baseline empathy. The only way to protect yourself is to ensure you look out for yourself. Never assume someone will look out for you because they rarely will. The safest thing is to assume everyone has the worst intentions and act to protect yourself in all ways possible. 

I wish it wasn't this way but the longer I am in it, the more I see it. Medicine really is the worst profession. Lawyers treat each other better for gods sake. 

/disheartening but true

//if I could afford to leave medicine, i would do so in a heartbeat. 

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14 hours ago, NLengr said:

While you should seek help if you need it, it is advisable to do this in the most private and untraceable way possible. That means not going through your university or a physician health program. Those may claim to be confidential but I have seen confidentiality violated to the benefit of the university or employer. It means seeing counsellors and doctors who work independently from employers, universities and boards. Fiercely protect your medical data. Consult with lawyers before disclosing any health information to a university, employer or board (I'm not saying lie, but you need to be extremely careful to avoid disclosing extra information that could be used against you for any reason in the future).

I have seen so many physicians burned because they did what they thought was right and assumed the university/employer/board would treat them fairly and with empathy. Unfortunately, that is frequently not the case. It was much more common that they were targeted, bullied and treated in an unfair or prejudiced manner. 

Medicine is a terrible profession filled with many terrible people who, quite frankly, have no idea how to behave like professionals or even civilized human beings. A surprising number lack basic social understanding and baseline empathy. The only way to protect yourself is to ensure you look out for yourself. Never assume someone will look out for you because they rarely will. The safest thing is to assume everyone has the worst intentions and act to protect yourself in all ways possible. 

I wish it wasn't this way but the longer I am in it, the more I see it. Medicine really is the worst profession. Lawyers treat each other better for gods sake. 

/disheartening but true

//if I could afford to leave medicine, i would do so in a heartbeat. 

I agree with NLenger. I have also seen friends get burned for having good intentions and believing that the regulatory bodies and hospitals would be understanding. The profession is surprisingly intolerant and antagonistic. I believe everyone should get help if they need it but if I had to do it myself I would probably do it in the most confidential way with things like using a fake name or cash only payments.  

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13 hours ago, blah1234 said:

I agree with NLenger. I have also seen friends get burned for having good intentions and believing that the regulatory bodies and hospitals would be understanding. The profession is surprisingly intolerant and antagonistic. I believe everyone should get help if they need it but if I had to do it myself I would probably do it in the most confidential way with things like using a fake name or cash only payments.  

And even if they are understanding initially, there is no reason they couldn't use it against you later on. 

I have seen health authorities use a history of mental illness to try and silence professionals (docs, nurses. allied health) speaking out against them (because of concerns the professional has about patient safety, equipment, working conditions etc). They will use your history and then try to frame up situations to portray you as currently unstable. It is a lot easier and preferable for the system to screw you over than to actually address the problem. 

I know a person who used to work for a health organization as an in-house counselor for employees and that person's employer would routinely push the counselor to make inappropriate diagnosis against "troublesome" employees to silence or fire them. The person I know ended up quitting because the organization was so bad to work for. 

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3 hours ago, NLengr said:

And even if they are understanding initially, there is no reason they couldn't use it against you later on. 

I have seen health authorities use a history of mental illness to try and silence professionals (docs, nurses. allied health) speaking out against them (because of concerns the professional has about patient safety, equipment, working conditions etc). They will use your history and then try to frame up situations to portray you as currently unstable. It is a lot easier and preferable for the system to screw you over than to actually address the problem. 

I know a person who used to work for a health organization as an in-house counselor for employees and that person's employer would routinely push the counselor to make inappropriate diagnosis against "troublesome" employees to silence or fire them. The person I know ended up quitting because the organization was so bad to work for. 

I have also heard of similar stories. Things are never as confidential as you think they are if you use an affiliated service. But I suppose it's just too hard to be understanding and compassionate towards each other.

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On a positive note, it makes you much more understanding of people who have a mental illness, which is great if you become a doctor or work in the health field.

Obviously, you know you need help, so I am not going to sit here and tell you that. But as someone who has dealt with this type of issue, I know it's possible to recover. It's a long road, but it's possible. I have no regrets about seeking help. You just have to seek help with professionals who know what you are talking about. Unfortunately, I talked to my family doctor and it didn't go very well. Most people are uninformed about these specific illnesses - especially ones that are glamourized and misrepresented by the media. 

Don't let a mental illness rob you of your dreams. It's already robbing you of enough.

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