My Last Resort: Asking for Help

My parents visited this past weekend, and I finally tried talking to them about waiting another year before applying to med school and staying here to do a master’s program. Of course, things tend to not go as well as planned, and I wasn’t able to get my parents to understand or listen to my reasoning. Not knowing how else I could explain things to them, I figured it was time to ask my uncle for help. Hi Uncle,

TranscriptI know my parents have talked with you a few times regarding my situation in the med school application process, so you know that I’m “behind schedule.” I’m not sure how much you’ve been told beyond that, so I’m going to proceed as if you know nothing and give you all the necessary background information before explaining what I need help with. I’ve attached an excel sheet with my course history for further clarification.
In high school, I didn’t have to put forth much effort in order to excel, and I never had to deal with more than one or two difficult classes at a time. Freshman year quickly showed me that I’d be below average — and nowhere near competitive for med school — if I continued with the same strategy I’d had in high school. So I increased the level of effort I put into studies and experimented with various study strategies during sophomore year. I continued to have difficulty with time management and concentrating in lectures and when studying; I crammed for all my classes and learned little.
I’d occasionally entertain the thought that the cause of my struggles was from ADHD rather than a lack of personal effort and self-discipline. It wasn’t until towards the end of fall semester of junior year that I seriously considered it a possibility, which is when I decided to seek help from the campus counseling center. I was given a pamphlet of study tips at the end of my first visit, and began seeing a counselor regularly for stress management. Towards the middle of the spring semester, I decided to meet with the school’s psychiatrist when I continued having problems. The counselor thought I suffered from mild depression; the psychiatrist didn’t give any definitive diagnosis, but prescribed me Wellbutrin for mild depression and ADHD symptoms. It decreased my symptoms of depression, but did nothing for my problems with classes. I stopped going to the counseling center towards the end of the spring semester because the counselor I’d been seeing began working elsewhere, and the psychiatrist didn’t seem to care or take me seriously. I held off on finding another psychiatrist because, unlike with the school’s counseling center, I would have to pay for their services. I couldn’t be certain that I wasn’t just looking for an excuse, and since my parents provide the money for all of my needs, it felt wrong to spend their money for a psychiatrist. I spent hours researching ADHD and disorders with overlapping symptoms, trying to find something to completely prove or dismiss the possibility of having ADHD.
After realizing how much this conflict was affecting me, I finally talked to my parents about it to get their permission to see a psychiatrist. I had my first appointment this past November. He gave the diagnosis of inattentive type ADHD. We decided to try Adderall first, so I spent the remainder of the fall experimenting with dosages. I found an effective dose by the end of finals week. I’ve spent the beginning of this semester battling with the decreased appetite and insomnia side effects. I had trouble getting to sleep even when I’d taken the Adderall at 8 in the morning, and would end up sleeping in on the days I didn’t have class. Because I only have classes on Tuesdays and Thursdays, I got into a cycle where I only take Adderall on those days because I wake up too late the rest of the week. I’ve fallen behind in my MCAT classes and am barely keeping up with my regular ones.
Last week’s appointment with my psychiatrist was the first follow-up for the semester. He gave me a list of sleep hygiene tips and a prescription for Clonidine to help treat the insomnia from Adderall. If things don’t improve by my next appointment at the beginning of March, then I plan on switching to a different medicine for ADHD treatment. My pre-health advisor said that I should wait until next year to apply to med school, after seeing my transcript and being told the history of my struggles. It took me a while to come to terms with that, but I see now that it’s more beneficial to postpone my application to med school. I’m not ready to handle the rigorous curriculum or stressful atmosphere of medical school. I need to focus on figuring out the best way to treat my ADHD, improving my health, study strategies that work for me, and proper stress-management mechanisms that aren’t self-destructive. Since I won’t be entering medical school until fall of 2015, at the earliest, I’ve decided that I want to pursue a master’s degree at my university so that I can continue to work on studying skills and time management. It would also provide me with an opportunity to raise my GPA and give a better indication of my academic abilities.

My parents and I never established a relationship with open communication. Because of my sheltered upbringing, I didn’t develop very good social skills and didn’t have friends to rely on for emotional support. Social interaction doesn’t come easily and causes stress. Talking to figures of authority is especially nerve-racking, so I didn’t unless it was absolutely necessary. I tend to internalize my issues until I get overwhelmed and probably have low self-esteem. I tried talking to my parents about waiting another year before applying to medical school and that I wanted to pursue my master’s in the meantime. I told them that I wasn’t ready and needed more time to work on my ADHD issues, but I don’t think they were really able to understand. I feel that part of it is due to not knowing much about ADHD. My impression is that they think ADHD only affects performance in school, that the medication is a cure, and that improvements occur quickly. They also seem to think that postponing my application will decrease my chances of acceptance into med school. I’m asking for your help in explaining my situation to my parents. As a doctor and someone of their generation, I feel that you’ll have a better perception of their thought process and be able to explain things in a way they can understand. Your words would also have more weight than mine. I apologize for the lengthy email and for making such a big request, but I don’t know how else to explain things to them and can’t focus on improving until this conflict is resolved.

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