Would Love Some Good Advice

[soglad]

So here is my deal.

During med school I had a really really hard time but didn't understand why. I did pretty well academically but it was a struggle more for me than for others. I had to work way harder and got really really stressed out. Very, Very long story short I decided to spend some time doing research after med school partly because of a family problem that was also going on and partly because of this. I got some help for the first time in my life. Turns out I was diagnosed with a learning diability and severe ADHD at the root of everything. I was skeptical so I sought second and third opinions and all three people came to the same diagnosis. I have always been very bright but looking back I can clearly see this has been something that has been a part of me since I was very,very young. I have had many successes and many failures and it is clear now why because to have that hyperactive brain and that sensitivity is a double edged sword and it some situations it can lead you to do amazing things and be great but when I get overwhelmed watch out because I will shut down and fail.

20 years ago things were different and I slipped through the cracks probably because I'm smart and resilient. During medical school I now see that the reason I got so stressed is because I had no support or understanding and I was in a situation that was completely incompatible with my problem. I think for me to get through med school like that speaks to my many strengths and just how much I "wanted it" and love it. The bottom line is I am extremely bright, sensitive, compassionate and resilent and thats how I survived med school even though it was a huge struggle.

Moving forward I truly believe I could be an awesome resident, but the way I now understand my brain works I know that in times of sensory overload I just completely shut down. To be successful like most people with ADHD I need things to be presented to me in a way that is not overwhelming. I'm just so sensitive I just can't help it otherwise I get very stressed out and disaster may ensue. Now being aware of this, I understand that I may not be able to change it but I can make choices being conscious of it. I have decided to try and arrange a part time spot in either medicine, psychiatry or family medicine for intern year because that will slow things down during what I know will be a difficult time. I dont care how long it takes me or where I go or even what specialty I end up in because I want more than anything to finsih my intern year.

My question is how should I go about this? Should I tell PDs why I am negotiating a part time spot or should i just try and do it? Is it in my interest to admit that I got this diagnosis or is it better to be vague? How do I broach the topic of part time positions? Is there any hope for me?

I really can't help the way I am but I'm a good guy and I care about this a lot as evidenced by the fact I made it through med school with a legitimate learning condition and no support or accomadations. I just need things slowed down a bit for me to survive. Any advice would be appreciated.

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[Doctor Bob]

I have decided to try and arrange a part time spot in either medicine, psychiatry or family medicine for intern year because that will slow things down during what I know will be a difficult time.

Huh? A part time spot? Is that even possible?

 

[DarthNeurology]

So here is my deal.

Turns out I was diagnosed with a learning diability and severe ADHD at the root of everything. I was skeptical so I sought second and third opinions and all three people came to the same diagnosis.


To be successful like most people with ADHD I need things to be presented to me in a way that is not overwhelming. I'm just so sensitive I just can't help it otherwise I get very stressed out and disaster may ensue.

I have decided to try and arrange a part time spot in either medicine, psychiatry or family medicine for intern year because that will slow things down during what I know will be a difficult time.

Wow, that is really sad that you had to face that during medical school, and not knowing what you condition was.

However, I see a couple obstacles to obtaining a residency:

1. Very few programs, perhaps none (at least as far as I know), offer part time residency positions. This is simply because the program is supposed to be concentrated i.e. you will see hundreds of cases in a given time period. As in general surgery, surgery residents want to get many different types of cases done, similarly in medicine or pediatrics, you may be on your 100th case of UTI, but maybe something happens a little bit differently each time and you learn to observe how different patients present, and you learn management skills.

2. While I understand your desire to have things slowed down, or perhaps presented sequentially, even if you were part time, your time on the wards would probably be no different from any other resident, i.e. you probably would I guess have to carry the same number of patients, i.e. ten or fifteen, and you would have to keep track of all of them when you are on. I think you could only get more time in between your shifts, but this might not be advantageous as you wouldn't get to see the full course of a disease process if you had ever other week off.

3. Some PDs might not want to hire you with a learning disability and ADHD, . . . however, if you mention it in your personal statement, you might need to talk about how you have "overcome" the ADHD and learning disability . . . as saying that you easily become overwhelmed won't look good during interviews.

However, having said that, I would do some major research about work place accomodations for people with ADHD and learning disabilities, if you are diagnosed then I would think the residency program would have to make some accmodations. Would they give you less patients?? I don't know if they could do that, but perhaps they could if you agreed to extend your residency training by a year or something.

Most "super residents" are able to juggle a large number of patients with seeming ease, so I think that multi-tasking is important, in terms of knowing when to go back and look at something with a patient.

I think you need a dry run of your abilities in an observership or externship first, then you can answer the question of "How will you cope on the wards with your learning disabilities?" instead of just saying how you will need extra time and things presented to you differently. Show them how you have modified your work strategies to overcome the learning disabilities.

 

[Top Gun]

So here is my deal.

During med school I had a really really hard time but didn't understand why. I did pretty well academically but it was a struggle more for me than for others. I had to work way harder and got really really stressed out. Very, Very long story short I decided to spend some time doing research after med school partly because of a family problem that was also going on and partly because of this. I got some help for the first time in my life. Turns out I was diagnosed with a learning diability and severe ADHD at the root of everything. I was skeptical so I sought second and third opinions and all three people came to the same diagnosis. I have always been very bright but looking back I can clearly see this has been something that has been a part of me since I was very,very young. I have had many successes and many failures and it is clear now why because to have that hyperactive brain and that sensitivity is a double edged sword and it some situations it can lead you to do amazing things and be great but when I get overwhelmed watch out because I will shut down and fail.

20 years ago things were different and I slipped through the cracks probably because I'm smart and resilient. During medical school I now see that the reason I got so stressed is because I had no support or understanding and I was in a situation that was completely incompatible with my problem. I think for me to get through med school like that speaks to my many strengths and just how much I "wanted it" and love it. The bottom line is I am extremely bright, sensitive, compassionate and resilent and thats how I survived med school even though it was a huge struggle.

Moving forward I truly believe I could be an awesome resident, but the way I now understand my brain works I know that in times of sensory overload I just completely shut down. To be successful like most people with ADHD I need things to be presented to me in a way that is not overwhelming. I'm just so sensitive I just can't help it otherwise I get very stressed out and disaster may ensue. Now being aware of this, I understand that I may not be able to change it but I can make choices being conscious of it. I have decided to try and arrange a part time spot in either medicine, psychiatry or family medicine for intern year because that will slow things down during what I know will be a difficult time. I dont care how long it takes me or where I go or even what specialty I end up in because I want more than anything to finsih my intern year.

My question is how should I go about this? Should I tell PDs why I am negotiating a part time spot or should i just try and do it? Is it in my interest to admit that I got this diagnosis or is it better to be vague? How do I broach the topic of part time positions? Is there any hope for me?

I really can't help the way I am but I'm a good guy and I care about this a lot as evidenced by the fact I made it through med school with a legitimate learning condition and no support or accomadations. I just need things slowed down a bit for me to survive. Any advice would be appreciated.

Forget internal medicine or family medicine. You're going to be working at a fast pace during those residencies, and there will be many times when you have critically ill patients or patients who are crashing. Even when you have stable patients, you'll get plenty of sensory overload because, as an intern, you'll be carrying like 12 patients, and there will be at least a hundred things to get done every day: discharge planning, labs to follow, notes to write, studies to order, consults to call, etc.,etc...

In your case, I'd pick a specialty that's relatively low-key. Assuming you have the grades and USMLE scores, go for derm or ophtho.

And I highly doubt there are any part-time residencies out there.

 

[Top Gun]

Or you could go for radiology.

 

[Ariee]

Please look into shared-residency programs.

Here you go: http://www.nrmp.org/res_match/special_part/us_seniors/shared_residency.html

You'll have to find someone to match up with. Will probably be a mommy/daddy doctor.

Also, google some more on shared-residency programs and you can find some ppl listing their experiences.

I wish you the best of luck,
A

 

[Doctor Bob]

Please look into shared-residency programs.

Huh. I learn something new every day.

 

[Ariee]

Ya, it is pretty neat isn't it Dr. Bob?

I think that only really prestigous programs offer it like Brighams, I'm not sure, b/c I haven't really looked into it. It be nice if the face of medicine progressed to more residency programs offering this track, it humanizes medicine for the mommy doctor, IMHO.

G'luck!

 

[Taurus]

Please look into shared-residency programs.

Here you go: http://www.nrmp.org/res_match/special_part/us_seniors/shared_residency.html

You'll have to find someone to match up with. Will probably be a mommy/daddy doctor.

Also, google some more on shared-residency programs and you can find some ppl listing their experiences.

I wish you the best of luck,
A

It's a neat concept but I don't think it solves the OP's problems. When the OP is on duty, he/she will be overloaded with sensory signals and responsibilities.

 

[NotAProgDirector]

You can search for shared pair/part time programs in Freida also. It's selectable in the "options" section. There are 35 IM programs nationwide that consider shared pairs. Usually, the pair is a couple -- they share a residency slot (and usually a clinic, or cover for each other), allowing one of them to be home at all times.

As others have mentioned, most part time slots will be 1 month on / 1 month off. When you're on service, you'll be just as busy as the full time residents. It's not clear whether this would be effective for your problem. being a resident is much busier than being a student.

Rads and derm are not a piece of cake, and you'd need stellar performance in medical school plus some research to have a chance. Stating your reasons above for them would not impress anyone.

You could consider pathology. It's still lots of work, but because it's disconnected from patient care directly, the pressures are often self imposed. PM&R is also a possibility, although you'd need to do a prelim year for that.

 

[Groove]

I think you sound like the perfect psych resident. Your condition would give you additional insight and empathy. I can't speak for how stressful psych residencies are, but the knowledge base would certainly be less intimidating than what you would be up against in say... IM or FP.

I would definitely NOT mention any of your personal problems/issues with a PD. I think it would be extremely naive to entrust that information to them and expect fair treatment. If I were a PD, and you told me your story, I would probably act very understanding and sympathetic but I would be thinking about all the nightmare scenarios that could ensue with you as a resident in my program. I'd smile and shake your hand, but I'd probably have you deleted off the rank list before the shuttle even had you back at your hotel. No offense, but play it smart if you really want a shot at residency.

Also, have you considered that medicine might not be the best career choice for you? Good luck.

 

[DrJosephKim]

In some ways, I'm tempted to say: go with your gut and confide in your PD if you feel that he/she will understand and support you. However, sometimes these types of things are better handled by a supporting counselor. Does your hospital/postgrad dept have a counselor you can speak with? Many medical schools and residencies offer such mental/emotional support for students and residents who go through these types of difficult situations.

 

[CambieMD]

You need to choose a specialty that really suits your personality. More than that you need to figure out how you learn.

cambie

 

[dragonfly99]

I agree with cambieMD.
I am an IM doc, and I'm thinking it might be better to avoid fp and IM. Though they have a rep. for being easy to match into, they involve a lot of juggling different things and multitasking, plus you get patients who crash, etc. There aren't many times an ophtho resident has to code someone...

Agree with considering pathology or psych. The OP needs to think about whether he/she REALLY wants to do residency, though. If he likes research that might be a way to go. Could consider occupational medicine, too, but that might require a medicine prelim year first.

Not sure I'd tell PD's about the ADHD, especially if you're not applying to psych. Just try to get in on your merits and NOT based on what you cannot do.

There are shared residencies, but they are extremely rare. And as mentioned above, they aren't really 1/2 time, it's probably more like 1/2 the time on, 1/2 the time off.

 

[Pinkertinkle]

Path or psych problem solved

 

[AthensBeth]

Shared residencies, in theory, are a great idea; however, there isn't a good forum/site for finding a partner. I wrote a post in June looking for someone in psych or IM to share a position with me and still have not received a reply. One big problem is demonstrated in the earlier posts-- people think it doesn't exist when in fact, 41 psychiatry programs support part-time tracks (and similarly high numbers for peds and IM). It's hard to find interested partners for a shared spot when people don't know it is an option!