So, it’s not a secret, I’m applying for psychiatry residency and probably one of the oldest applicants due to being a 2ndcareer physician. I’m a former RN, Psych NP, retired Army, and now MD. All programs I reviewed, applied to, and interviewed at have some form of diversity statement such as follows:
“XYZ is a program that welcomes residents of all backgrounds including, but not limited to race, color, national origin, religion, sex, pregnancy, marital status, sexual orientation, gender identity, gender expression or perceived gender, age, physical or mental disability, genetic information, veteran status, parental status, educational background, or any other characteristics.”
I hope they mean it. When I retired from the US Army after 20 years and became a fulltime medical student, graduated, and now applying to psychiatry residency programs as a middle age man, I knew it would be an uphill battle. But agism in medicine? Yes, I figured it exists and did a quick literature search and found a number of citations such as https://khn.org/news/navigating-aging-a-doctor-speaks-out-about-ageism-in-medicine/ which states:
“Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.”
Most of the articles deal with treating older patients, but what about older physicians and other healthcare personnel? Do I even stand a chance at Matching next month? Agism is defined by the World Health Organization as “Ageism is the stereotyping and discrimination against individuals or groups on the basis of their age. Ageism can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices that perpetuate stereotypical beliefs (https://www.who.int/westernpacific/news/q-a-detail/ageing-ageism).” Another source, an article from June 2020 titled Ageism in Medicine: A Look at Medical Ethics, Laws, and Regulations reported “Ageism is defined as stereotyping, prejudice, or discrimination against individuals on the basis of their age. According to the American Medical Association (AMA), 43% of all physicians and surgeons are 55 or older. Specialists are, on average, older than primary care doctors. In addition, around 30% of the current U.S. population is older than 55, and that percentage is increasing thanks to the aging baby boomer demographic (https://www.enttoday.org/article/ageism-in-medicine-a-look-at-medical-ethics-laws-and-regulations/). It then goes on to report “Common ageism policies include requiring late-age testing for physician competency or skills without objective, evidence-based methods; making disability-related inquiries; or requiring an employee to undergo physical, medical, or cognitive examinations without the reasonable belief or justification that a physician cannot perform the essential functions of their job.”
An interesting article popped up in my news feeds today: Why Psychiatry Training Must Include Discussions on Structural Racism (https://www.psychiatrictimes.com/view/why-psychiatry-training-must-include-discussions-structural-racism). This actually had me thinking. You could easily add the word ‘agism’ to the title after racism and everything in the article would apply to that as well. I had plenty of residency interviews, so I’m feeling pretty good about Matching this year. I’d love to be the oldest intern at any of these organizations. I met a lot of wonderful people, residents, and faculty physicians. Why? Well, why not? Here’s my retort to agism:
1. Why would the football GOAT (greatest of all time) 43-year-old Tom Brady appear in his 10th Super Bowl? Why not?
2. Why would boxing GOAT 42-year-old Manny Pacquiao continue to be boxing’s great? Why not?
3. Why would Lou Ferrigno attempt Mr. Olympia body building titles at 40 and 41 years of age? Why not?
4. Why would surfing GOAT 49-year-old Kelly Slater attempt a 12th WSL world surfing championship title still beating everybody half his age? Why not?
5. Why would at 45 years of age, George Foreman make a boxing comeback and win yet another heavy weight world title? Why not?
6. Why would 30-year-old Vince Papale, with little football experience, walk on and try out and make the oldest rookie to the Philadelphia Eagles? Why not?
7. Why would 35-year-old Jim Morris walk on and try out for major league baseball and become the oldest baseball rookie to the Tampa Bay Devil Rays throwing fastballs better than he did in his college years? Why not?
Well, I may not be a GOAT, but I am seeking my own path in life and these people inspire me. Just like two particular mentors in my lifetime (1) 76 y/o male supervising psychiatrist carrying a full outpatient load with an abundance of vigor, passion, and energy, (2) 74-year-old inpatient psychiatrist female carrying a full inpatient load with a resident team who actually convinced me to go to medical school in the first place.
So, to answer why? Why not!!
Robert P. Duprey Jr MD
AAMC ID: 14820901
Psychiatry Residency Applicant