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Mental Illness and the College

Mental illness in physicians is a highly charged subject. It’s something we just don’t talk about for fear of stigma, but also due to fear of professional blowback from our regulatory body, the College. We’ve all heard stories of the doctor whothat had to jump through incredible hoops to be able to get back to work. What we often don’t often hear are the success stories, the positive experiences with the College. 

Let’s be honest: the College’s mandate is to protectthe protection of the public. As a self-governing profession, maintaining that public trust is critical, and to ensure that, the College needs to exercise discretion in who is deemeddetermined fit to practice. But that phrase, “fit to practice,” can mean so many different things. When it comes to mental illness with its broad-ranging spectrum of phenotypes, that ambiguity becomes even harder to navigate.

My struggles with mental illness and interacting with the College have thankfully been a positive one. I have been practicing for about five years since graduating from a family medicine residency in 2017. Due to working in a toxic workplace, I found myself severely depressed and unable to work for about nine9 months. The College became involved early on during my deterioration. I had reached out to the Physician Health Program around the same time I needed to take time off work. At first, I thought I just needed to get away from that particular work environment. However, the amount of stress and trauma I had endured left an indelible mark. I was experiencing symptoms of anxiety and depression, including nausea, muscle aches and panic attacks. The worst was the insomnia because the worse that I slept, the more my mind suffered.

It became apparent that I needed to be off work. I was encouraged to put my license on hold while I struggled to get my mental health in order. The Physician Health Program connected me with a local psychiatrist who had a large practice of physicians struggling with mental health issues as well. Over a period of nine9 months, we worked together to optimize my medications while I took time away to heal and develop better coping skills. During this time, the College was not involved much. 

By the time I was ready to go back to work, the only thing that the College required was a report from my family physician andas well as my psychiatrist attesting to my fitness to work and my compliancethat I was complying with treatment recommendations. I was eager to get better as soon as possible from the very beginning. That it took me nine9 months to get back to work had nothing to do with the College and everything to do with the treatment plan devised between my physicians and meI. The College’s health monitoring department strives to be as non-intrusive as possible with the reports required. Once I was back at work, they asked for reports every three3 months. I also followed up with my physicians withat the same frequency, as well which made things easy. The monitoring period varies based on the diagnosis, but for me, it was set at five5 years, given that I had suffered from severe depression and at that time, there was a question of bipolarity at that time. I was thriving dDuring my time back at work, I was thriving at work, managing very sick patients and participating in multiple continuing education and leadership opportunities. I completed my period of monitoring in the fall of 2023. 

A perfect storm of factors led to my second deterioration. With my PTSD triggered, I began losing sleep to the point that I developed a brief psychotic episode and was finally diagnosed with bipolar disorder. This led to an ER visit and a 14- day stay at a short-term psychiatric facility. I self-disclosed this time around, knowing full well that I had suffered a mental health emergency and needed time away. The College looks favorably on registrants whothat self-disclose and demonstrate a willingness to openly participate in the monitoring process. I was off work this time for two2 months while my medication regimen was optimized. Getting back to work again requiredwas a matter of my psychiatrist and family physician writing a brief report to the College attesting that I was safe to practice and compliant with treatment recommendations. 

Now why does sharing this story matter? One of the biggest reasons physicians are afraid to ask for help is because of fear of having their license pulled. This means that even when we have the opportunity to seek help early on, we won’t. To take care of our patients, we need to be healthy ourselves. At a time, when more than over half of Canadian physicians are burned out and approximately just about half have screened positive for depression, it becomes even more critical to intervene before it is too late. There are several stories about physicians interacting with the College. My hope is that sharing mine takes away some of that fear that keeps physicians from seeking help.