To summarize and characterize the questions on initial applications for medical licensure (nonosteopathic) as they relate to applicants' mental health and substance abuse.
Collection and analysis of applications for initial medical licensure (nonosteopathic) from 50 states and the District of Columbia.
Nonosteopathic medical licensure applications of 47 states and the District of Columbia (N = 48).
Number of questions per application relating to mental health problems and substance abuse, in addition to time qualifiers (e.g., current difficulty, specified number of years in the past, ever) and impairment qualifiers (e.g., functional impairment, treatment, hospitalization) per question or set of questions for each area.
Of 48 applications analyzed, 41 (85%) inquired about mental health problems and 43 (90%) inquired about substance abuse. Most explored periods between the past 10 years and the present; functional impairment was the most common inquiry.
Applications for nonosteopathic medical licensure most often inquire about physicians' recent history of mental health and substance abuse problems as well as related functional impairment. Variation of items across state applications may have important implications for some physician applicants.
[Show abstract][Hide abstract] ABSTRACT: To encourage treatment of depression and prevention of suicide in physicians by calling for a shift in professional attitudes and institutional policies to support physicians seeking help.
An American Foundation for Suicide Prevention planning group invited 15 experts on the subject to evaluate the state of knowledge about physician depression and suicide and barriers to treatment. The group assembled for a workshop held October 6-7, 2002, in Philadelphia, Pa.
The planning group worked with each participant on a preworkshop literature review in an assigned area. Abstracts of presentations and key publications were distributed to participants before the workshop. After workshop presentations, participants were assigned to 1 of 2 breakout groups: (1) physicians in their role as patients and (2) medical institutions and professional organizations. The groups identified areas that required further research, barriers to treatment, and recommendations for reform.
This consensus statement emerged from a plenary session during which each work group presented its recommendations. The consensus statement was circulated to and approved by all participants.
The culture of medicine accords low priority to physician mental health despite evidence of untreated mood disorders and an increased burden of suicide. Barriers to physicians' seeking help are often punitive, including discrimination in medical licensing, hospital privileges, and professional advancement. This consensus statement recommends transforming professional attitudes and changing institutional policies to encourage physicians to seek help. As barriers are removed and physicians confront depression and suicidality in their peers, they are more likely to recognize and treat these conditions in patients, including colleagues and medical students.
JAMA The Journal of the American Medical Association 07/2003; 289(23):3161-6. DOI:10.1001/jama.289.23.3161 · 35.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The authors assessed whether current methods of evaluating residency applicants and residents identify psychiatrists who later develop evidence of impairment.
Residency admissions and performance data for all physicians who were enrolled in a psychiatry residency between 1965 and 1994 and who were referred to an impaired physician program up to 35 years later were matched for age and gender with a nonreferred physician from the same class.
There were no significant differences between groups in admission interview assessments, performance ratings, or narrative observations by faculty during residency.
Standard approaches do not identify physicians at risk of later impairment.
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