Faculty Collaboration Database

The Impact of Mental Illness Disclosure in Applying for Residency. Acad Psychiatry 2020 Oct;44(5):554-561

Date

05/18/2020

Pubmed ID

32415458

DOI

10.1007/s40596-020-01227-8

Scopus ID

2-s2.0-85084989296 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

OBJECTIVE: Medical students have higher rates of depression than age-matched peers. Given the societal stigma against mental illness, students with depression often seek guidance on disclosing this in residency applications. This study aimed to answer whether disclosing a mental illness during the residency application process affects an applicant's success in the National Resident Matching Program. The authors hypothesized candidates disclosing mental illness would receive fewer interviews and would be ranked lower than those disclosing physical illness.

METHODS: The authors randomized program directors from residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) to receive one of two surveys. Both surveys included similar demographic information and three applicant vignettes, varying only in presence and type of illness disclosed (major depression or diabetes mellitus). The authors analyzed data using the Generalized Estimating Equation method for ordinal logistic regression.

RESULTS: Out of 3838 ACGME residency programs, 596 responded (16.9%). A total of 380 (10.7%) program directors (survey 1, n = 204, 5.3%; survey 2, n = 176, 4.6%) completed the survey. Applicants who disclosed a history of depression had higher odds of being in a lower category of receiving an invitation (OR = 3.60, p < .001 for a "perfect" applicant, OR = 2.39, p < .001 for a "good" applicant with leave of absence) and a lower category for match ranking (OR = 1.94, p = .01 for a perfect applicant, OR = 2.30, p < .001 for a good applicant with leave of absence) compared with the candidate who disclosed a history of diabetes. However, strong applicants who disclosed depression still fared better in the application process than an average applicant without disclosed illness (OR = 0.13, p < .001 for invite and OR = 0.04, p < .001 for rank).

CONCLUSION: Disclosing depression during the residency application process puts an applicant at a notable, however not insurmountable, disadvantage compared with applicants who do not disclose mental illness.

Author List

Pheister M, Peters RM, Wrzosek MI

Authors

Mara Pheister MD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Marika Inga Wrzosek MD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Disclosure
Education, Medical, Graduate
Humans
Internship and Residency
Mental Disorders
Students, Medical