[bipolarmedstudent]

So, last time I saw my psychiatrist, he said something that upset me a great deal. He questioned whether becoming a doctor is the right career choice for me. Basically, he said that my obsessive attention to detail (my mania/OCD combo) would be great in a career such as research, but he's not sure if I'm well-suited to becoming a doctor. He was saying that in medicine, you sometimes have only 5 minutes to spend with each patient, and you have to keep moving on, and he can't see me being able to do that.

He is also very much pushing me to take next year off to do a master's, because he doesn't think I can handle doing clinical rotations next year. Now I'm wondering if he just doesn't think I'm well-suited to medicine, period, and he's hoping I'll drop out of med school!

Well, I feel very upset about this. I think I'm great at what I do, and I think what I do is great for me. Helping people is how I stay sane. And I think I'll be a fantastic doctor one day.

How could he question that? I feel devastated that he thinks I won't be a good doctor.

[LiteraryLark]

Personally, I would not want to see a doctor with a mental illness. You trust your health and your life to your doctor. I need to see a doctor who can do more than just "function normally", I need a doctor I can count on 24/7 and be ready to handle any kind of situation. How can I trust someone who's secretly thinking "oh gee, feeling a little manic today, shouldn't have forgotten my pills". I'm sure their are doctors with mental illnesses, but when you're bipolar, there is no stability, you will always be experiencing BP symptoms, and the worst place to have an episode is on the job at a hospital.

That's just my opinion. I would not feel comfortable knowing that my doctor is mentally ill.

[EverythingNothing]

First off, this is one single person giving you their subjective opinion.

Now, I could see where your doctor is coming from as I know the deadly combo of mania/OCD fairly well.

But, have you not already learned how to adapt? And successfully so? I also believe that there is a great variance to the degree which OCD tendencies hinder or help what you are trying to achieve.

Your doctor is referring to the stereotypical mania/OCD tendencies. You have the ability to alter how you approach situations, you've already achieved great success, and you know yourself better than anyone else, including your doc, don't let anyone tell you otherwise.

In conclusion, don't take his stance to heart. If you really want it, and believe you are capable, then go for it. Furthermore, you seem to be on a stable med concoction geared towards progression and vigilant when it comes to your stability in general.

I hope I could cheer you up, you deserve it. If you don't mind me asking, why do you take iron supplements?

[bipolarmedstudent]

Originally Posted by DrSkipper

Personally, I would not want to see a doctor with a mental illness. You trust your health and your life to your doctor. I need to see a doctor who can do more than just "function normally", I need a doctor I can count on 24/7 and be ready to handle any kind of situation. How can I trust someone who's secretly thinking "oh gee, feeling a little manic today, shouldn't have forgotten my pills". I'm sure their are doctors with mental illnesses, but when you're bipolar, there is no stability, you will always be experiencing BP symptoms, and the worst place to have an episode is on the job at a hospital.

That's just my opinion. I would not feel comfortable knowing that my doctor is mentally ill.

Well, if I wasn't functioning at a high level, I would get kicked out of school/my job anyway. The fact that I am doing well in med school is proof that I'm functioning at least as well as my classmates. So it's not a matter of my performance being sub-par. If my performance ever does become an issue, I'll get kicked out or lose my job, for sure. So the patients are safe.

As for not feeling comfortable knowing that your doctor is mentally ill, the thing is you would never know anyway. Hell, your own doctor could be mentally ill right now and you would have no idea.

[BipolaRNurse]

I don't know, medstudent. I'm a registered nurse in a higher-level job and I've been told that I function well at work---in fact, both my boss and the two senior supervisors just below me were genuinely surprised to learn I'm bipolar. That could be because every bit of energy and sanity I possess have been invested in my work; even so, I know I've been extremely excitable and distractible the past few months and I actually have lost control a couple of times (behind closed doors, yes, but people did witness them, which is NOT good for the professional image).

Being a doctor, though, is a lot different. It's certainly a lot more responsibility, and if your illnesses aren't well controlled it's a recipe for disaster---not only for you, but for anyone unlucky enough to be in your care if/when you become acutely ill. I don't mean for that to sound harsh, but as a medical professional myself, I wouldn't be comfortable working with a physician who's impaired, whether by substances or mental illness. Believe me, I understand what it means to be mentally ill, and I would hope that anyone working or living with me would call me on it if I start showing signs that I'm getting sick again.

IF you can be stabilized and maintained successfully with medications and/or other treatment modalities .......IF you can develop some insight into the issues which make life so difficult for you......IF you allow yourself a few years to grow up a little more......then yes, you should continue your medical education. Your pdoc's concern is valid and I don't think he said what he did to upset you, or because he thinks you won't make a good physician. He is more than likely trying to get you to think about what you're doing and take things a little slower, because you are apt to decompensate as the pressure gets ratcheted up.

I wish you the best, hon.

[bipolarmedstudent]

Originally Posted by EverythingNothing

First off, this is one single person giving you their subjective opinion.

Now, I could see where your doctor is coming from as I know the deadly combo of mania/OCD fairly well.

But, have you not already learned how to adapt? And successfully so? I also believe that there is a great variance to the degree which OCD tendencies hinder or help what you are trying to achieve.

Your doctor is referring to the stereotypical mania/OCD tendencies. You have the ability to alter how you approach situations, you've already achieved great success, and you know yourself better than anyone else, including your doc, don't let anyone tell you otherwise.

In conclusion, don't take his stance to heart. If you really want it, and believe you are capable, then go for it. Furthermore, you seem to be on a stable med concoction geared towards progression and vigilant when it comes to your stability in general.

I hope I could cheer you up, you deserve it. If you don't mind me asking, why do you take iron supplements?

Thank you so much! Wow, you should be a motivational speaker. That was exactly what I needed to hear!

I take iron supplements because my ferritin (iron stores) is low. Low ferritin causes restless legs syndrome (which I have), because your brain needs iron to synthesize dopamine. Since my iron stores are low, my brain is not making enough dopamine, so I get restless legs syndrome. Restless legs syndrome wakes you up many times during the night, which leads to exhaustion and depressed/unstable mood during the day. Eventually, once my iron stores become even more depleted, I would also develop iron-deficiency anemia (I'm almost there, but not quite). I'm on high-dose iron supplements to help prevent iron-deficiency anemia, and also to replenish my iron stores and get rid of the RLS. Which should lead to better sleep and an improvement in my moods and energy level over all.

Did that make sense?

I'm also on vitamin D supplements, because my vitamin D is also low. Low vitamin D can lead to depression, as well.

Finally, I'm on omega-3 fish oils, simply because of the benefits shown in bipolar disorder.

Other than that, I don't take any vitamins or supplements. I'm a strong believer (and so is my doctor) in only taking supplements if a blood test has shown that you are deficient in a particular vitamin or mineral, or there are good studies to back up the use of a particular supplement in a disease that you are suffering from (e.g. fish oil in bipolar). Otherwise, it's better not to take vitamins or supplements, as some (such as folic acid which was recently linked to increased risk for colorectal cancer) can actually cause more harm than good.

[bipolarmedstudent]

Originally Posted by BipolaRNurse

Being a doctor, though, is a lot different. It's certainly a lot more responsibility, and if your illnesses aren't well controlled it's a recipe for disaster---not only for you, but for anyone unlucky enough to be in your care if/when you become acutely ill. I don't mean for that to sound harsh, but as a medical professional myself, I wouldn't be comfortable working with a physician who's impaired, whether by substances or mental illness. Believe me, I understand what it means to be mentally ill, and I would hope that anyone working or living with me would call me on it if I start showing signs that I'm getting sick again.

I wish you the best, hon.

If I ever felt that my judgement or performance was impaired (or someone else thought so), I would immediately take myself out of the line of patient care. One of the ways my OCD shows itself is that I am constantly checking and re-checking before I do or say anything to a patient, because I'm afraid of hurting a patient out of lack of knowledge/incompetence/an error.

That being said, I think my illnesses (although numerous) are compartively mild. For example, I've never been hospitalized or attempted suicide. My mania is more of the spending-spree and obsession-of-the-month type, rather than an emotional roller-coaster. I believe if I was truly that unstable, I wouldn't have made it as far as I have.

[Trippin2.0]

I believe you have great self-awareness, and from what I know from interacting with you, you'll be a great Dr. Personally, if I were to go the med route again, I'd PREFER a bipolar Dr. That way I know I'm being understood and cared for, and not just by someone who's going by what they read in some text book. I have HUGE problems with pdocs and their theories/case studies about bp, meds and what acceptable side effects are. How can they decide if they've never been subjected to these side effects? Beats the hell out of me.
.
YOU WILL BE AN ASSET TO YOUR PATIENTS

[moremi]

Originally Posted by bipolarmedstudent

So, last time I saw my psychiatrist, he said something that upset me a great deal. He questioned whether becoming a doctor is the right career choice for me. Basically, he said that my obsessive attention to detail (my mania/OCD combo) would be great in a career such as research, but he's not sure if I'm well-suited to becoming a doctor. He was saying that in medicine, you sometimes have only 5 minutes to spend with each patient, and you have to keep moving on, and he can't see me being able to do that.

He is also very much pushing me to take next year off to do a master's, because he doesn't think I can handle doing clinical rotations next year. Now I'm wondering if he just doesn't think I'm well-suited to medicine, period, and he's hoping I'll drop out of med school!

Well, I feel very upset about this. I think I'm great at what I do, and I think what I do is great for me. Helping people is how I stay sane. And I think I'll be a fantastic doctor one day.

How could he question that? I feel devastated that he thinks I won't be a good doctor.

I think oppinions are like assholes and everyone has one, follow your dreams. Yes he may be a good doctor but his word is not Gods word. I believe in you and you believe in yourself most importantly. Go for what you know to be best and dont let those who see negative in all bring you down. Your sick not stupid, I think you will be just fine and if it doesnt work out worry about that then. What an awful thing for him to try to destroy this for you. Im so sorry.

[dragonfly2]

Originally Posted by bipolarmedstudent

Other than that, I don't take any vitamins or supplements. I'm a strong believer (and so is my doctor) in only taking supplements if a blood test has shown that you are deficient in a particular vitamin or mineral, or there are good studies to back up the use of a particular supplement in a disease that you are suffering from (e.g. fish oil in bipolar). Otherwise, it's better not to take vitamins or supplements, as some (such as folic acid which was recently linked to increased risk for colorectal cancer) can actually cause more harm than good.

First, let me comment on the above quote. I also believe that the blood levels of vitamins should be taken before supplementing. One new area in depression research is the use of Vitamin D, which most people are low in (I'm a Medical Technologist and have seen hundreds of Vit D level results come across my desk). My levels are low and my pdoc has me on 4000 IU/d.

The other thing I want to mention is that they have found benefits of a form of folic acid called L-methylfolate in depression. A patient's folate level can be within the normal range, yet the availability of the folate to the body may not be optimal. This can be detected by looking at homocysteine levels, which would be elevated in a bioactive folate deficiency. There is a "medical food" (not a drug per the FDA) called Deplin that they are using to augment antidepressants in people with low levels of bioactive folate.

Here's a link to information on the benefits of L-methylfolate in depression:

http://www.cnsspectrums.com/aspx/art...articleid=1267

The other thing I wanted to bring up is that it sounds like your doctor's concern isn't with the bipolar, but the OCD. There are very successful doctors out there with bipolar disorder and it sounds like yours is not severe. My concern for you and the bipolar would be during internship and residency when you're working 36 hour shifts and not sleeping. I'm not sure what year of med school you are in, but you may have time to address the OCD to a point where it won't interfere with the pace you will need to keep up. Also, I'm not sure if you've chosen a specialty yet, but some areas with less patient contact (radiology, pathology, research) require going through things with a finer-toothed comb than others. Just some things to consider.

But, no, I wouldn't allow this guy to sway your commitment to your chosen career.

[bipolarmedstudent]

Originally Posted by dragonfly2

First, let me comment on the above quote. I also believe that the blood levels of vitamins should be taken before supplementing. One new area in depression research is the use of Vitamin D, which most people are low in (I'm a Medical Technologist and have seen hundreds of Vit D level results come across my desk). My levels are low and my pdoc has me on 4000 IU/d.

The other thing I want to mention is that they have found benefits of a form of folic acid called L-methylfolate in depression. A patient's folate level can be within the normal range, yet the availability of the folate to the body may not be optimal. This can be detected by looking at homocysteine levels, which would be elevated in a bioactive folate deficiency. There is a "medical food" (not a drug per the FDA) called Deplin that they are using to augment antidepressants in people with low levels of bioactive folate.

Here's a link to information on the benefits of L-methylfolate in depression:

http://www.cnsspectrums.com/aspx/art...articleid=1267

The other thing I wanted to bring up is that it sounds like your doctor's concern isn't with the bipolar, but the OCD. There are very successful doctors out there with bipolar disorder and it sounds like yours is not severe. My concern for you and the bipolar would be during internship and residency when you're working 36 hour shifts and not sleeping. I'm not sure what year of med school you are in, but you may have time to address the OCD to a point where it won't interfere with the pace you will need to keep up. Also, I'm not sure if you've chosen a specialty yet, but some areas with less patient contact (radiology, pathology, research) require going through things with a finer-toothed comb than others. Just some things to consider.

But, no, I wouldn't allow this guy to sway your commitment to your chosen career.

Thank you, I will research the L-methylfolate. It's always great to hear about new avenues of research. I'm one of those people who will obsessively look up stuff on pubmed (hah, can you tell?)

I had actually asked my p-doc about taking folic acid supplements because I had read that depakote depletes folate, so many people who are on depakote take folic acid supplements. He adamantly told me not to take (standard) folic acid, because my folic acid levels were normal (right in the middle of the normal range), and he mentioned the link with colorectal cancer as a reason not to take them unless absolutely necessary. He told me I should only take folic acid if I'm trying to get pregnant or if I become deficient in folate in the future (he said he would keep testing me).

I really like my new p-doc because the first thing he did when I came to see him was order a FULL panel of blood work (and I mean FULL...pretty much the only box he didn't tick was hepatitis serology!) He did a CBC, LFTs, fasting glucose *and* HbA1C, lipid profile, BUN/Cr, TSH *and* T3/T4, prolactin, FSH/LH, testosterone, ferritin, vitamin D...the whole gamut. Just to establish a base line and rule out any underyling physiologic causes. And he happened to disocover both my ferritin and vitamin D deficiency and my ****** lipid profile (at the tender age of 23 and normal BMI to boot...damn genetics!)

And next week....I'm having an EEG, just to rule out anything freaky happening there. How awesome is this doctor? I think every psychiatric patient should go through this whole gamut of tests at least once just to rule out any underyling physical illness that could be contributing to their symptoms.

My last p-doc never wrote me a single blood test in the 10 years that she treated me. Never!

ANYWAY.

As to your question. I'm in my second year. My clinical rotations (clerkship) start next year. That's why my p-doc is really pushing me to take academic leave next year and do a master's. He doesn't think I'm ready for clinical rotations, and wants me completely stabilized and at the top of my game before I start my third year of med school. Doing a (course-based) master's will give me some structure and something to do (and something to put on my resume) while I keep tinkering with my meds and fully recover and prepare for the stress of clinical rotations. And I think you are right that he was more concerned about the obsessiveness than about my moods. He kept saying that I'll only have a few minutes with each patient, and I won't have time to obsess. That I'll have to move on. The thing is, I think I actually do better in such an environment, because it FORCES me to move on, and doesn't allow me to keep ruminating and obsessing over one thing. Rather than giving my OCD what it wants (a bunch of slides and a microscope), I should give myself a structure that doesn't allow me to indulge my OCD. Something that forces me to live in the moment, and behave like a normal human being. Does that make sense?

As for sub-speciality choices, I would be devastated if I were to become a pathologist or radiologist. I definitely want a specialty with tons of patient care. I'm thinking internal medicine at this point. I know I'm good at connecting with patients -- I've volunteered with patients for years before med school. I think I am my best self when I am taking care of other people. It takes me out of my obsessive, ruminating mind and focusses me outward in way that I can make a tangible difference in someone's life. I do think that I would be better suited to a sub-specialty where I can spend a long time meeting with each individual patient. I would be terrible at something fast-pased like the ER or walk-in clinic, but good at something more leisurely like psychiatry or internal medicine with long appointment times. Something where I could really sit down and talk at length with my patient, and give him or her my undivided, unhurried attention for a good 30-minute block of time. Working in a teaching hospital would also be a good idea, because the pace is a lot more relaxed (as you are teaching residents, and everything takes 3x as long because you have to demonstrate and explain what you are doing).

As for research....I LOVE it, but it feeds my mania and obsessions, obviously. I don't think it's good for my mental health to get too involved in research.

Anyway, thank you. You have given me a lot to think about. And maybe I shouldn't have stayed up last night because I am maybe typing too much, hah.

[bluematador]

The discoveries in neuroscience and the research on neuroplasticity indicates that those experiencing mental illness can gain control over their behavior by engaging in learning activities that alter the structure of the brain. This level of recovery was previously thought impossible in the field of psychiatry. In one research study the neurocientists discovered that the frontal orbital cortex is overactive in individuals experiencing symptoms of OCD. The learning exercise that was employed to change this activity in the frontal orbital cortex was mindfulness meditation. This actually altered the function of the brain and removed the symptoms. I don't think we should limit ourselves because we have been diagnosed with a mental illness. I think we should be well informed and aware of the conditions we experience and by doing so know that there are many ways to gain control over these behaviors and manage our lives. Only you know what your limitations are. If I see a doctor it doesn't matter to me if the doctor has a mental illness. What matters to me is the doctors integrity and the quality of care I receive. Maybe your experience will give you more insight when dealing with patients experiencing mental illness. You won't treat them like demented children as I have been treated on more than one occasion by a doctor.

[dragonfly2]

It sounds like you have a fabulous pdoc. The bad lipid results may be from the antipsychotics you've been on and it's good to see that he did an A1c level. Fasting glucoses are good, but can be misleading in someone whose sugars they're monitoring.

It sounds like the Master's degree option may not be a bad one if you don't mind adding another year. Would you be guaranteed a spot in rotations if you were to take another year of didactic instead of clinical studies? It sounds like you've at least got some options and you're young, so you do have plenty of time to work on it.

Something else to keep in mind, just as a back up....if for some reason things don't go well in rotations, you could easily get into a physician assistant program, which I believe is a bit less rigorous in its clinical rotation work (ie: no sleepless nights). I may be wrong, but that was my impression when I was looking at PA programs. I'm certainly not saying to give up on the MD, but don't lose hope if things don't work out.

Oh, and yes, it makes sense to not feed into the OCD with an overly detailed field like pathology. I was just thinking it could be a good option to accommodate that if you were struggling with the frenetic pace of office-based managed care. Internal medicine sounds much more agreeable than emergency medicine or general practice.

[bipolarmedstudent]

Originally Posted by dragonfly2

It sounds like you have a fabulous pdoc. The bad lipid results may be from the antipsychotics you've been on and it's good to see that he did an A1c level. Fasting glucoses are good, but can be misleading in someone whose sugars they're monitoring.

It sounds like the Master's degree option may not be a bad one if you don't mind adding another year. Would you be guaranteed a spot in rotations if you were to take another year of didactic instead of clinical studies? It sounds like you've at least got some options and you're young, so you do have plenty of time to work on it.

Something else to keep in mind, just as a back up....if for some reason things don't go well in rotations, you could easily get into a physician assistant program, which I believe is a bit less rigorous in its clinical rotation work (ie: no sleepless nights). I may be wrong, but that was my impression when I was looking at PA programs. I'm certainly not saying to give up on the MD, but don't lose hope if things don't work out.

Oh, and yes, it makes sense to not feed into the OCD with an overly detailed field like pathology. I was just thinking it could be a good option to accommodate that if you were struggling with the frenetic pace of office-based managed care. Internal medicine sounds much more agreeable than emergency medicine or general practice.

Yes, if I do the master's program (I want to do it in biostatistics & epidemiology), then I would be guaranteed a spot in rotations. Basically, I would just be taking a leave of absence for one year (med students do this all the time for health reasons, or to do 3-year PhDs between 2nd and 3rd year). I would technically still be considered a student at my medical school, so I could still shadow doctors in my free time. Also, I would keep my student loans and keep my student drug plan coverage. There would be minimal disruption, really. One girl in my class took a year off between 1st and 2nd year to have a baby! Another girl took a year off because of illness. And several students in my class are taking 3 years off to do PhDs.

But, it's still scary to veer off course, you know? There is a well-defined plan in front of me that I thought I would be following. And deviating from the plan has me a little freaked!

As for my lipid levels....unfortunately, I think that's due to bad genes and a complete lack of exercise on my part.
I'm trying to convince my p-doc to put me on metformin and/or topiramate but he will have none of it! I was just searching on pubmed for some ammo for my argument, and found a bunch of articles suggesting that topiramate is useful in treatment of tics, trichotillomania, and OCD, all of which I have. I'm going to print them out and show them to him. Hopefully he will give in and put me on topiramate because I really want to lose weight and get my lipids back on track.

Originally Posted by bipolarmedstudent

He kept saying that I'll only have a few minutes with each patient, and I won't have time to obsess. That I'll have to move on. The thing is, I think I actually do better in such an environment, because it FORCES me to move on, and doesn't allow me to keep ruminating and obsessing over one thing... Does that make sense?...

Totally. I'm the same way.

Good thread. Firstly, though I understand his reasoning, it's not his decision to make. Or decree that you should make. I'm a proponent of the "give it a go" school of thinking. If it works out, great. If a particular aspect of it doesn't, there are alternate related paths. You know what might be problematic, you know what to watch for, so it's not as if you're going in unawares. Also, you are willing to take yourself out of patient care if impaired either by your own (and you do seem to very self-aware) or another's perception. That shows humility. Oh, if only that were more common in the field(!).... But I digress with a wish and a sigh...

Btw, because it's come up, I'll just mention that I would be totally fine with a Dr. with BP or OCD or ADHD. Heck, I've got them all and wouldn't want anyone holding it against me. So why should I them? Besides, it's not as if "normals" are not without problems that can influence their work -- family strife, substance abuse (more common that one would like to think in medical fields), what have you. Everyone likes to think they leave these things at the work doorstep. But in general, I don't think people are nearly as good at it as they think they are or think that they're functioning just fine with their substance abuse. Even if high-functioning, it doesn't mean unimpaired. This is not to freak people out with negativity, but to point out that humans are humans regardless of profession.

It sounds like you've thought this out well and have a plan. I think it's a good idea to draw up some alternate possible plans as well, such as those suggested in this thread --- not because of a presumtion of needing them. Only because sometimes, at certain junctures (and ironically, when we need it most), it can be hard to see other perfectly legitimate and worthy options, especially if we've really been focused on one very specific goal. If other options are written down it would be already there as a reference. Have a willingness to take in new information and reconsider things (a sign of intelligence) should it become relevant -- and it sounds like you're good to go!

I only want to say a few things quickly because I'm on my way out.

First off, the first pdoc I ever had suffered from his own mental ailments. He was an amazing pdoc, if he had not retired I would still be seeing him. He had one of the best reputations in my city in his field. Any one heard of Kay Redfield Jamison??

Second, not all doctors only spend 5 minutes with a patient. I would prefer a dr who paid attention to detail, my life is in their hands.

Don't let this one mans opinion sway yours. He is not the deciding person. Maybe he needs to pay a bit more attention to detail, like the fact that many people with bipolar are in fact dr's and some are quite successful, some even maybe more so than him. Kay Jamison is proof of that.

[venusss]

I can only echo what the others said. Having a condition does not mean you cannot do things in life. You seem well aware and you have plans for what-ifs. You are probably better prepared for this field than average person (many normals go to medical field to get burned out or overwhelmed quickly. Maybe you have advantage here, your own problems gave you much needed resielience).

Your pdoc seems one of the well meaning, but too narrowly focused people. Maybe it is his choice in life, staying safe and within a barriers you created yourself and he projects it into others. He should not be the person who decides about you, as he does not know you as well as you do know yourself.

[Merlin]

I've always been of the opinion that you should assume that someone is capable until they have proven they are not.

[interested2012]

Originally Posted by bipolarmedstudent

So, last time I saw my psychiatrist, he said something that upset me a great deal. He questioned whether becoming a doctor is the right career choice for me. Basically, he said that my obsessive attention to detail (my mania/OCD combo) would be great in a career such as research, but he's not sure if I'm well-suited to becoming a doctor. He was saying that in medicine, you sometimes have only 5 minutes to spend with each patient, and you have to keep moving on, and he can't see me being able to do that.

He is also very much pushing me to take next year off to do a master's, because he doesn't think I can handle doing clinical rotations next year. Now I'm wondering if he just doesn't think I'm well-suited to medicine, period, and he's hoping I'll drop out of med school!

Well, I feel very upset about this. I think I'm great at what I do, and I think what I do is great for me. Helping people is how I stay sane. And I think I'll be a fantastic doctor one day.

How could he question that? I feel devastated that he thinks I won't be a good doctor.

I think you sound level-headed and passionate about what you're doing. I do think that taking a year to do research will not hurt you in any way in the long term. You'll still reach your goals and when you're older you won't feel like finishing school at 30 was much different than finishing at 29. At the risk of sounding negative, I would also encourage you not to dismiss a career in pathology or radiology. Bipolar is often a moving target and you can't underestimate the difficulty of working as a clinical doctor when you're not at your best. It's also extremely difficult to "remove yourself" from clinical situations when things are not going well; the nature of this illness is such that we experience our moods and thoughts as entirely true, and it's not always easy to sense an episode at its onset. To this end I would encourage you to spend time in various specialty rotations before making your decision. Finally, if you do decide that internal medicine is the specialty for you, make sure that you know what the day-to-day work is like. I suspect most internists will tell you that they can't spend 30 minutes with each patient.

It sounds as though your psychiatrist has the best of intentions and his or her advice might be worth consideration. You might also consider that he or she is an MD and has some additional insight into life as a medical student and practising doctor. Just my two (or three) cents....

[Secretum]

My psychiatrist has told me multiple times that he treats several bipolar doctors. He knows that medicine is my career goal, and he encourages me to go for it.

Bipolar physicians face additional challenges; it is not an easy path to tread! We are passionate, however, and we are currently working on our mental health issues. I think that we both can do it. Best of luck to you.

[Merlin]

I am pursuing psych nursing, which is not the same as being a doctor, but patient care is my focus. I know that there is the possibility that I will become unwell again, but I will keep up my self-care and stay in communication with my pdoc. I will tell HR and my supervisor if needed and, if recommended, take temporary disability, up to and including hospitalization. I will always choose to work for a health service though, so I don't have to worry about continuity of care. Fortunately my pdoc is very supportive of me.

[bluematador]

Both my pdoc and my T have neurologically based illnesses and I am receiving the best care I have ever received in 25 years. I am thriving. They work with me like we are a team working together to accomplish my goals. I am a full time student. They cheer me on and celebrate my success.I feel like they really listen to me and understand what I am experiencing. They haven't disclosed exactly what their mental health issues are exactly but they have used themselves as examples of what I can accomplish. I've had a few crash landings but we don't dwell on it. It makes it easier for me to bounce back.

[Perna]

I would not necessarily take it "personally" (that he doesn't think you'd make a good doctor) but would realize that he is/has been where you want to get to and knows the routines. I see my doctor 4 times a year and have seen him 5+ years and bet he'd still have trouble coming up with my name if he met me on the street? I have certain chronic illnesses he treats. My meds have not changed greatly in 5 years, some tweaking and some additions and lots of tests (twice a year) to make sure everything is as good as it can be and nothing additional has gone right or wrong. It's not about "me", it's about my illnesses and the two of us work on them for different reasons; he writes prescriptions and reviews blood tests and I halfheartedly work at feeling the best I can feel; giving myself optimum health and caring for myself.

I don't know what you picture about being a doctor; but as "kind" as my doctor is, smiling very broadly when he enters the examination room and shaking my hand (no hesitation) and discussing (very very quickly, while he is writing out my next prescriptions -- which he sometimes gets my name or a detail wrong on, probably because we're also talking at the same time?) it's about the medical conditions, not the person. We wish it could be about us as persons, that they could see us and talk to us, but the costs of medicine and the time available just isn't there. If I raise a concern, if there's nothing to "see" (rash?) then it's being sent for more tests or having another prescription thrown at me with "try this".

I think a lot of the difference between 1950's doctors (I had one visit my home when I had the measles in 1956) and now is the same as the difference in "information" or "media". We just have access to so much and it is getting so much more complicated with opinions as well as "facts". Before, reference works were just "facts" and one didn't have to worry about whether it was true or not but now, the Internet and television has no "reference section" or librarian to help one out and we're forced to do a lot more thinking for ourselves.

Clinical rotation will mean heavy duty hours and a whole lot of stress; are you sure your body can hold up under that? I would do some research with bipolar doctors/students and make sure what I want and that I know how it might be:

http://studentdoctor.net/2007/10/hig...edical-school/

http://psychiatrist-blog.blogspot.co...be-doctor.html