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Medical student with mental illness?


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Hi all, just wondering about what happens to medical students with mental illness around licensing/residency. I have not yet been asked about it/have not incurred problems thus far but getting the impression/lots of informal conversations advising that mental illness diagnosis is definitely something to be avoided at all costs. Wondering why - is this something you're asked about on residency applications? Will I be able to pursue a career in medicine? I would ask my mentors or admin staff at my university but I'm nervous about what consequences there might be. Have not disclosed so far to anyone other than my psychiatrist at my university. Looking for others in a similar situation to learn about the prospects.

Without giving away too much about my identity/situation, my mental illness is not the usual depression/anxiety, I tried medication for some time and didn't find it helpful, did a bit of therapy, modified my lifestyle to be more aware of potential mental illness episodes. However, still see a psychiatrist occasionally to check-in, make sure I'm on an okay path. Diagnosed during undergrad.

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Residency programs are not allowed to ask about any medical conditions, including mental health issues. If any were to ask, the best course of action is generally to lie and deny any conditions, then report the program for violating CaRMS rules. According to current rules, your diagnosis should have no direct bearing on your ability to match to a residency program of your choosing.

Licensing is a bit of a different issue in that most provincial colleges require a disclosure of any conditions which has or could reasonably affect ability to practice competently. This is fairly vague and the line isn't well-specified, so this sort of disclosure would depend very much on your personal situation. Mental health conditions that are outside the typical anxiety/depression would, in my opinion, generally require disclosure, but it's impossible to say without more details (which you absolutely should not provide on a public forum). If in doubt, this would be a good question for your psychiatrist. Such disclosures can cause some headaches, mostly as regulating authorities may require compliance with certain steps to ensure any risks to patients are minimized, but are necessary if your condition could impact patient care in a significant way.

For the most part, health conditions should not impact an overall ability to practice medicine, though could impact what you practice and how you go about things. Someone missing a hand cannot be a surgeon, for example, but could likely make a fine psychiatrist. Likewise, someone with a history of addictions issues might require frequent checks on medication stores if they were to work as something like an anesthesiologist, with easy access to highly-addictive substances. If you've made it through medical school successfully, regulatory bodies generally won't prevent anyone from practicing.

People are generally told to avoid mental health diagnoses, not just because of possible disclosure to regulatory bodies, but also for insurance purposes. You have to disclose any diagnoses for insurance, and that can be costly, or leave you open to gaps in your insurance for at least a certain period of time. However, this "do not get diagnosed" mantra should really only apply to mild conditions that do not necessarily require medical intervention to address effectively, and mostly because of the insurance effects - anything serious enough to require disclosure to a provincial college should absolutely get diagnosed and treated, because at that point it is a danger not just to the practitioner but their patients as well. If you've already been diagnosed, then there's not much point stressing about it - disclose when legally required, do not disclose when not legally required, and adhere to any treatment plans required to ensure safety when treating patients, if any are necessary at all.

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1 hour ago, mysteriousM said:

Hi all, just wondering about what happens to medical students with mental illness around licensing/residency. I have not yet been asked about it/have not incurred problems thus far but getting the impression/lots of informal conversations advising that mental illness diagnosis is definitely something to be avoided at all costs. Wondering why - is this something you're asked about on residency applications? Will I be able to pursue a career in medicine? I would ask my mentors or admin staff at my university but I'm nervous about what consequences there might be. Have not disclosed so far to anyone other than my psychiatrist at my university. Looking for others in a similar situation to learn about the prospects.

Without giving away too much about my identity/situation, my mental illness is not the usual depression/anxiety, I tried medication for some time and didn't find it helpful, did a bit of therapy, modified my lifestyle to be more aware of potential mental illness episodes. However, still see a psychiatrist occasionally to check-in, make sure I'm on an okay path. Diagnosed during undergrad.

I think that legally you would have to disclose your mental illness when you apply for your postgraduate clinical license with CPSO in Ontario. It shouldn't affect your independent practice license if your mental illness is under control, the CPSO asks for a GP or psychiatrist annual assessment, and if you are doing quite well, it shouldn't affect your licensing at all!

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20 minutes ago, LittleDaisy said:

I think that legally you would have to disclose your mental illness when you apply for your postgraduate clinical license with CPSO in Ontario. It shouldn't affect your independent practice license if your mental illness is under control, the CPSO asks for a GP or psychiatrist annual assessment, and if you are doing quite well, it shouldn't affect your licensing at all!

Thanks! So it's just to the College - it wouldn't be going on my residency applications? I was concerned about red-flags, especially with all of the Spots for Docs information - seems like it would just give programs a reason to reject me...

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4 minutes ago, mysteriousM said:

Thanks! So it's just to the College - it wouldn't be going on my residency applications? I was concerned about red-flags, especially with all of the Spots for Docs information - seems like it would just give programs a reason to reject me...

No residency program is allowed to ask you if you are known for mental illnesses during your interviews.

If everything goes well during preclerkship + clerkship, and you don't have any issues during medical school, no residency program should know that your health condition. 

As I said previously, you do have to disclose your mental health condition to CPSO legally. I know quite a few people in the same situation, they are quite stable, beside going to see their psychiatrist or GP for annual assessment, they don't have any issues with licensing. 

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17 hours ago, mysteriousM said:

Hi all, just wondering about what happens to medical students with mental illness around licensing/residency. I have not yet been asked about it/have not incurred problems thus far but getting the impression/lots of informal conversations advising that mental illness diagnosis is definitely something to be avoided at all costs. Wondering why - is this something you're asked about on residency applications? Will I be able to pursue a career in medicine? I would ask my mentors or admin staff at my university but I'm nervous about what consequences there might be. Have not disclosed so far to anyone other than my psychiatrist at my university. Looking for others in a similar situation to learn about the prospects.

Without giving away too much about my identity/situation, my mental illness is not the usual depression/anxiety, I tried medication for some time and didn't find it helpful, did a bit of therapy, modified my lifestyle to be more aware of potential mental illness episodes. However, still see a psychiatrist occasionally to check-in, make sure I'm on an okay path. Diagnosed during undergrad.

To OP, if your health condition is well managed with your psychiatrist, I won't necessarily disclose it to your medical school. Unless you will need accommodation during preclerkship or clerkship, i.e: more time for exams, less calls or less overnight shifts etc.  

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