Many people suffer from depression, anxiety and other mental disorders. It’s endemic in the culture – everyone is vulnerable, including medicine School students.
Based on nearly 200 studies, about 27% of 129,000 medical students in 47 countries reported suffering from depression or having symptoms of it at some point during their medical studies, according to a 2016 study published in the Journal of the American Medical Association. Some smaller studies since have reported even higher rates. Depression also increases dramatically during the year of internship or the first year of residency.
In medical school, even more students will suffer from anxiety than depression, whether it’s a short, mild episode or something that lasts much longer, according to some studies.
How, then, does a thoughtful student who has had a previous episode of mental illness approach the subject once he has decided to apply to medical school? Like a psychiatrist and former Dean of Student Affairs and Admissions, I recommend that applicants consider this aspect before applying and not wait to be accepted into medical school.
Unless your experience with mental illness was the main reason you wanted to go to medical school, it is unlikely to be part of the main application or personal essay on why why you want to become a doctor. However, it is very likely that it will come out in a additional writing about obstacles in life or shortcomings in your education.
Address this from the start. Admissions committee reviewers aren’t happy with unexplained gaps or vague smokescreens about what really happened. If you had to drop out or take time off from the program for hospitalization or rehabilitation, explain why.
Maybe the stress that led to the situation is a good place to start. This can likely include lifestyle contributions. For example, poor sleep is a known physiological factor that can trigger depression. If this was a major provocation for depression, how has this changed and how have you been able to control this in the future?
Lack of exercise, a poor diet loaded with processed carbohydrates, taking on excessive tasks, and other circumstances require thought. If you are subject to any of them, think about it and start living your life in a new way. Setting an example for future patients begins with your personal insight and life experience. It may also include continuing to take medication, following your doctor’s instructions, attending therapy regularly, or other ways to protect the psyche such as mindfulness or deep breathing.
Waiting until medical school to address these factors is not a good idea. You might get into medical school, but if you haven’t tried to lead a healthy lifestyle, mood swings or excessive anxiety will strike again. These concerns are rarely single and resolved. If you want to attend medical school and accept the stress and demands, you must work on the solution ahead of the game.
Personal statements in the primary medical school application may include a short section on mental illness if that is the reason you decided to go to medical school. It could be a family member, a dear friend or yourself.
But remember that medical school includes many specialties, and so do admissions committees. Too much emphasis on one area may not convince the majority of the committee that you will be equally dedicated or effective in all areas. Medical students must be broadly competent and only later will they have the opportunity to specialize.
Gaps without explanation or insufficient discussion can lead to uncomfortable questions during a interview. The plan during the interview would generally be the same as for the application. Avoiding a direct question is not recommended, but not every detail is necessary.
Show insight and growth in emotional and physical health. It’s important to disclose how you’ve empowered your lifestyle with tools and a support team. These same tools will allow you to manage future questions and stressors.
Any period of more than two weeks in which you were not performing should give you pause. Plan how this might be described in the application process and what has been done to prevent it from happening again. You don’t have to describe every detail, but it’s important to include the progress you’ve made on any treatment plan and how you’ve adopted a healthy lifestyle that can protect you from symptoms returning and you keep in top shape.
It should be noted that the abuse of alcohol, marijuana or any other type of drug addiction is complex and often begins with periods of anxiety or depression. Undergraduates often underestimate the impact of this in those early college years when it seems like “everyone is doing it.” Panic disorders and depression often worsen during substance use.
I advised the students, in addition to undergoing therapy, to volunteer for programs like Mothers Against Drunk Driving and other community groups that help teens avoid substance abuse. It’s best to choose to get preventative help or early intervention when symptoms of a problem appear.
Self-reflection is important for every candidate. Will medical school be a good decision for your health? Med school probably isn’t the healthiest choice, but if you go, will you have the tools to battle stressors and succeed?
The answer is not simple and varies from school to school. Some considerations like sleep deprivation can be problematic for most medical students and doctors. A young man I knew considered medical school for psychiatry, but ultimately decided not to go to medical school and went on to earn his doctorate in clinical psychology. He avoided years of nightly calls that he knew would repeatedly throw him into depression.
Although it seems way ahead of your choice of residence, some prospective medical students are starting to set their sights on a certain program that might not be beneficial to their health. For some people, sleep deprivation and alterations in the sleep-wake cycle can be intolerable. I have known people who had to leave emergency medicine or neurosurgery programs because of debilitating depression. While these specialties may be appealing for other reasons, they may not be the healthy choice that keeps someone going indefinitely.
I also know people who have had to leave residency programs due to almost uncontrollable mood swings. These people may end up finding a job after medical training that allows for more regular sleep, or they may try to work in the same field in a different capacity. With better sleep schedules, they can practice and enjoy careers in other areas of medicine. Keep an open mind to diverse specialties is a healthy decision.
Students with a history of mental illness can certainly become doctors. Many more students will develop depression or anxiety for the first time during their medical training. There is help, but students must admit a problem and be willing to seek help and commit to making health-promoting decisions along the way.
If a student is unable to put a plan in place that will help protect them from periods of anxiety and depression as much as possible, then they should think twice about whether medical school is the right option.
If you decide medical school is right for you, make good choices about where you train that will support your total personal growth. You know the adage about square pegs and round holes. Look for what will help you be your best.