Stigmas in MedicineI had a very insightful talk with a physician on friday. Among other things, we discussed how best to approach the fact that someone has an illness when applying to residencies and even when trying to get a license. As someone who is on the admissions committee for one of the residency programs here, he advocated honesty about any chronic illness, no matter how small. (This is actually in contrast to what many of my peers said, which was "just lie.")
His rational is that while disclosing an illness could put you at a slight disadvantage when applying to residency, the process is so subjective and full of prejudice that almost everyone will have some sort of "mark" against them, being personality or illness. However, disclosing an illness actually protects the resident. Think of the diabetic surgical resident. If his blood sugar drops during a long surgery, he needs to be able to take care of himself, and if his residency program is aware of his illness, he will probably already have mechanisms in place for such situations.
Although he was quick to point out that the analogy was not exact, he likened having an illness to being a foreign medical graduate. When reviewing residency applications, inevitably a new member of the committee will tsk tsk an applicant (no matter how qualified) for being a FMG. Of course, the doctor whom I was talking to was an FMG, and I must admit that I never would have known that, unless he had told me himself (he speaks better English than I do!). Even though all of his training other than medical school was done in the US (and he also got a PhD here in the states), the fact that he went to school in India still follows him around his career, though he's reached a point where his accomplishments should more than speak for themselves, and his colleagues are not questioned about their choices of medical school.
Unfortunately, biases still exist; someone with a mental illness will be more likely to be stigmatized than my diabetic surgeon. This is unfortunate given the high rate of mental illness and substance abuse in physicians, as one would think that reducing the stigma of having a mental illness as a physician would encourage more to seek treatment, which can only help the field of medicine.
My first suggestion for reducing this stigma? Reduce the potential career consequences for disclosing the fact that you experienced depression at some point in your life. When physicians in training feel comfortable disclosing the fact that they had a rough time in their first year in medical school, and don't worry that this disclosure will adversely affect their ability to get into a residency program, we will have made a major step.