The Impact of Mental Illness Disclosure in Applying for Residency

To Disclose or Not: Residency Application and Psychiatric Illness

“…While program directors may consider an applicant's fitness for future practice, the question remains as to whether all psychiatric and nonpsychiatric illnesses are judged by the same standards or whether psychiatric illnesses are unduly stigmatized. Although Pheister et al [6] did not find evidence for such parity, their study cannot answer whether program directors prefer applicants with non-psychiatric illnesses over psychiatric illnesses. Moreover, in one, now dated, multi-institutional study [20], students appeared more concerned about the potential impact of illnesses such as depression, substance use, cancer, anxiety, and HIV than diabetes or arthritis, so diabetes may not be an optimal comparison.…”

“…Alfayez and AlShehri [5] examine the prevalence of anxiety and depressive symptoms in medical students in Saudi Arabia and associated perceived stigma. Pheister et al [6] examine the impact of disclosure of psychiatric illness on the residency selection process. Goldenberg and Wilkins [7] provide a glimpse of how educators think through the process of protecting the privacy of a medical student receiving inpatient treatment from other medical students and their take on the stigma of psychiatric illness.…”

“…Are medical students correct that disclosure of a psychiatric illness puts them at a disadvantage in the application process? Pheister et al [6] attempt to answer this question by examining the effect of disclosure of major depressive disorder (MDD) during the residency application process on the chances of being invited for an interview and the eventual ranking. The 380 program director respondents, which constituted an 11% response rate, were given vignettes with some applicants disclosing MDD, others disclosing diabetes mellitus type I, and some without either.…”

“…A program director's decision to not rank an applicant with a disclosed illness-psychiatric or not-might stem in part from a concern about the resident's future performance during residency. Pheister et al [6] found that some comments by residency directors indicated a concern about an illness causing unexpected leaves of absence and the resulting impact on the program. The authors speculated whether this concern was true only for programs with limited resources in that should training need to be extended, there may not be adequate call coverage and monetary resources.…”

In This Issue: October 2020

“…Another question is whether to disclose a history of psychiatric illness in an application to psychiatry residency [3]. This decision has always been a very thorny one, and Pheister et al's report "The Impact of Mental Illness Disclosure in Applying for Residency" [4] is a valuable contribution to our literature. Unfortunately, their data suggest that applicants may still pay more of a price for disclosing a psychiatric illness compared with a medical illness.…”