Q. I am a 19 year old college student who is considering medical school and volunteers at a medical research facility. Specifically, I would like to be a psychiatrist or possibly a neurologist. I was also diagnosed with schizophrenia a year ago, and due to cognitive disturbance, I find it increasingly difficult to maintain the previous quality of my work. I have also been hospitalized several times for delusional violent ideation or attempted self injury. Because of all the time I’ve missed, I think my grades will start to suffer soon. Most of the time I can function very well, but despite medication, paranoia and what I am told are delusions sometimes take hold, and I require hospitalization. Assuming I can cognitively handle medical school, would it be ethical for me to become a psychiatrist considering I have what is considered to be a severe mental illness? Would I be required to inform anyone before being certified as a doctor? Also, do you think it is possible for someone with this disorder to handle the pressures of medical school? Everyone around me seems to want me to lower my standards and ‘do something easier’, and I admit that I often become very frustrated when I am unable to comprehend material which my classmates seem to absorb easily. It’s like written words have suddenly become a foreign language that I don’t know very well. I don’t want to give up, but I don’t know if I can actually do this, and I was wondering if you have heard of people being successful in the mental health/medical field despite having this condition. Thanks for your time.
A. I do not think there is anything unethical about becoming a psychiatrist and having a severe mental illness. It is not uncommon for people who previously suffered with a mental health disorder to find themselves in the mental health profession. It is possible, given you have lived with a psychiatric disease, that you would have an understanding and perspective that other psychiatrists might not have. This is not to say that either perspective is better than the other, but that your perspective will be especially unique. It is possible that your perspective will assist in understanding your patients a little better, especially when it comes to the issue of taking medication. I am sure not very many psychiatrists know what it feels like to take the medications they are prescribing. Having taken those medications, you may be more sensitive to how and what you prescribe as a psychiatrist. I have heard many clients say they wished their psychiatrist could experience what it is like to be “in their shoes”, and to have to take the medications they take, just to know how hard having schizophrenia can be.
Although not a psychiatrist, one example of someone with schizophrenia obtaining one of the highest degrees possible, a PhD in psychology, is Dr. Frederick Frese. According to his biography, Dr. Frese was diagnosed with schizophrenia in 1965 but went on to graduate with his degree approximately 13 years later. Despite having schizophrenia, he has worked as a clinician and a mental health administrator. In mental health circles especially, Dr. Frese is practically famous for his work in the mental health field. He has received many awards from groups such as the National Alliance of the Mentally Ill (NAMI) and the American Psychological Association (APA). He has also many published articles, edited a book and testified at Congressional hearings on behalf of the mental health field. For many, his story is inspirational, especially for those with a severe mental illness.
As far as I know, if you were to go on to become a psychiatrist, or any other kind of doctor, there is no mandate specifying that you have to reveal that you suffer with a mental illness. I believe there are laws written about this very issue. Also, I believe Boston University has a website discussing this issue (about revealing your illness to your employer) that I encourage you to check out. As a matter of personal choice, you may want to reveal this information, but I do not believe you would have to. However, if you were to have a psychotic or violent episode in which you were hospitalized, it is highly likely that your employer would find out.
Whether or not you should go to medical school is a whole new matter. It is a very difficult question to answer since there are many variables that could effect how you would do in medical school. Those variables may include whether or not you have a good support system, or if your medication is adjusted correctly, how often you have episodes, or how you handle stress, and the like. You mentioned that sometimes when reading, the words look foreign to you. This would certainly pose a problem for you given all of the reading and writing you will have to do (and are doing) in school.
Generally, school can be stressful but I have heard medical school is especially stressful. There is an enormous amount of work involved and I do not believe you can go on a part-time basis. One concern for you is that it is believed that stress exacerbates schizophrenia and in some people, too much stress does induce a psychotic episode. In fact, stress is one of the main culprits that can bring on a psychotic episode. You do not want to overwhelm yourself. Even after you have gotten your medical degree, you still would have to complete your residency. For their residency, most medical students work 60-80 hours a week, often working 15-18 hours a day. Some residents work days in a row without sleep. Even without schizophrenia, working that many hours is extremely taxing physically and emotionally.
I cannot answer the question of whether or not you should go to school to become a psychiatrist. I do not know all of the factors involved. That is a decision that you will ultimately have to make. It is not that you cannot intellectually handle medical school; I do not believe that is the case. But the stress involved with medical school could be detrimental to your psychological health and this fact needs to be weighed when you are considering medical school. It is not a matter of lowering your standards but recognizing that you have a disorder in which stress has the potential to cause you to get sick. This is a fact. That is the nature of schizophrenia. Dr. Carol Anderson, who co-wrote the book Schizophrenia and the Family, quotes a patient who says that people with schizophrenia have to “use a different yardstick.” What is meant by this is that you should not compare yourself to people who do not have a brain disorder (schizophrenia). It is not an accurate measurement. By using “a different yardstick”, you are not lowering your standards but using a more accurate measurement.
I extremely admire your goals. Most people do not have to live with schizophrenia but you do, and I am sure it is not easy. Having schizophrenia does not mean that you cannot pursue your career goals but when deciding what you want to pursue, you must factor in that you have schizophrenia. If you did decide not go on to medical school, you can pursue other options. Choosing not to go does not equate to lowering your standards. I hope I have helped elucidate some of the issues to consider when deciding whether or not to attend medical school. I wish you the best of luck and please, keep in touch.
What's Related
- Other posts by Kristina Randle, LCSW
- RE: schizophrenia and medical school
- Can I Become Pregnant if I Have Schizophrenia?
- Chances of getting schizophrenia
- Is Schizophrenia genetic?
- Worried about becoming schizophrenic
