To Disclose or Not: Residency Application and Psychiatric Illness
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EDITORIAL
To Disclose or Not: Residency Application and Psychiatric Illness Rashi Aggarwal 1 & John Coverdale 2 & Richard Balon 3 & Eugene V. Beresin 4 & Anthony P. S. Guerrero 5 & Alan K. Louie 6 & Mary K. Morreale 3 & Adam M. Brenner 7
# Academic Psychiatry 2020
The process of applying for and being accepted into a residency program is the culmination of successfully negotiating all of the emotional, behavioral, and educational challenges accompanying medical education. Medical students usually perceive this process as very stressful because so much is at stake. Students worry about matching into a program/location of their choice in a specialty of their choice. In recent years, this process has intensified, with students applying to a much larger number of programs and accepting more interviews to increase their odds of matching successfully [1–3]. What makes matters worse is that this process comes at the tail end of a highly challenging medical education. This stress can be compounded when deciding whether or not to disclose a personal experience with psychiatric illness [4]. In the October 2020 issue of Academic Psychiatry, three articles examine different aspects of psychiatric illness in medical students and the residency application process. 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
* Rashi Aggarwal [email protected] 1
Rutgers New Jersey Medical School, Newark, NJ, USA
2
Baylor College of Medicine, Houston, TX, USA
3
Wayne State University, Detroit, MI, USA
4
Harvard Medical School, Boston, MA, USA
5
University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA
6
Stanford University, Stanford, CA, USA
7
University of Texas Southwestern Medical Center, Dallas, TX, USA
treatment from other medical students and their take on the stigma of psychiatric illness. These issues are all the more relevant given the findings that a substantial number of medical students and residents experience depression, anxiety, or burnout. In one large systematically conducted review [8], for example, rates of depression and depressive symptoms in medical students were about 27%, and the rate of suicidal ideation about 11%. Rates increased on entry into medical school, and only a minority with depressive symptoms reportedly sought treatment. Some medical students also suffer from burnout, although prevalence varies across countries [9]. Studies indicate that only a minority of medical students experiencing high levels of burnout seek help [10, 11]. With such high rates of psychological stress, why do so many medical students decide not to seek treatment? The article by Alfayez and AlShehri [5] in this issue suggests that de
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