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How My Medical School Reacted To My Mental Health Issues

Discussion in 'Medical Students Cafe' started by Ghada Ali youssef, May 28, 2017.

  1. Ghada Ali youssef

    Ghada Ali youssef Golden Member

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    All I needed to do was click a button. The button that said “Send.” Surely that wouldn’t be too difficult? I just needed to move my hand a little, and press the cursor.

    But I was nervous.

    I had written a long email to my personal tutor explaining that I had been diagnosed with severe depression, and that I had been struggling badly. If it weren’t for the seriousness of the situation, perhaps my difficulty in plucking up the courage to press the goddamn button would have been funny.

    I have said it on this blog before and I will say it again – many Medical Students, including me for some time, are scared to disclose any mental health issue to our Medical School. Not necessarily unreasonably either – we can thank the stigma for this. What if our fitness to practice is called into question? What if our Medical School think that we are cannot cope with the demands and pressures of the medical course?

    Eventually, I did press the button.

    What would be the reaction?

    The Reaction
    The next challenge came very soon. It had been less than 24 hours and already, my tutor had replied to me. I was sitting in a lecture at the time, and was now ridiculously scared to open the email. I remember feeling very angry with the stigma as I sat there in my predicament. It wasn’t fair. Why was it that this stigma still existed? Why did it even exist at all? Why was there even a stigma amongst the medical profession, given the nature of the role?

    I opened the email. After reading it, my heart relaxed very quickly. The reply of my tutor was not only understanding, but it was also extremely supportive. Like me, he too seemed annoyed that such a stigma existed. “The stigma is bullshit and shouldn’t exist,” he wrote. “I know you must be worried about your exams but we will make them work. But actually, the most important thing is yourself. You’re far more important than these exams so we must firstly think about how best we can look after you.”

    I remember thinking at the time, and am still thinking: Wow.

    After reading all the horror stories of some other tutors from past medical students or current doctors, I was so very pleasantly surprised.

    The Next Step – Seeing the Senior Tutor
    After me and my personal tutor met up to discuss things, we both agreed that it would be in my best interests to speak to the senior tutor at my medical school. The senior tutor had the power to help me with any reasonable adjustments that could help me when I was sitting my exams. My personal tutor said that he would email him himself and that I didn’t need to worry.

    Once again, it had been less than 24 hours since I saw my tutor before the senior tutor replied. My first reaction to his reply was – wow, he is very laid back! With senior tutors or top professors at a university, you expect them to be very formal when emailing you. This especially becomes true when you realise they’re all doctors. His email, however, went a bit like:

    “Dear [name]

    ur tutor told me there r some issues with ur mental health. How do u feel about meeting up so we can decide how best to support u?

    Best,

    [name]”

    I’m not even joking. In many ways, however, it reassured me. He was unlikely to be the ‘strict’ type of person and would likely be much more understanding than everyone else. I wasn’t disappointed either when I did go to see him. He explained things very clearly to me, and when I mentioned that I was worried about my exams, he literally went: “Pfft, seriously, you’re worth way more than they are so don’t worry about those stupid things for now, we can help you with them” while waving his hand.

    Perhaps his best question, after asking me what had happened and taking notes on everything, was: “How would you like us to help you?”

    Finally, I could explain what I wished my medical school could do to support me. Instead of them deciding what was best for me, I had a say in what I thought was best. And this was invaluable.

    Mitigating Circumstances
    Although both tutors made it clear to me that exams were nothing to worry about, it was natural for me to still be concerned about them. After all, I didn’t want to get kicked out of medicine!

    To counteract this, the senior tutor suggested that I apply for mitigating circumstances. I just needed to produce medical proof for my issues (which was very easy to obtain from my psychiatrist, GP and mental health support team) and write a brief summary explaining why I was applying for them. “They’ll only consider your request if you fail your exams and then it’s up to their discretion as to whether or not they award them to you,” the senior tutor said to me. “But I’m the head of the mitigating circumstances board and I can tell you that I would be very surprised if you didn’t get them,” he added with a bit of a wink.

    The way exams worked at my medical school was that in summer, everyone who was able to had to sit them. If you failed that, you would have to retake the papers you failed a few months later. If you then failed the retake, you would be kicked out. You could appeal if it came to that, but it was unlikely to amount to much unless you had an exceptional reason.

    With mitigating circumstances, things changed quite a bit. You could choose to have a go with everyone else at the first attempt in the summer but if you failed that, you could retake a few months later with the retake being seen as your ‘first’ attempt. That meant that if you failed the retake, you would still be allowed to retake again. If you failed that and your mitigating circumstances were still on going, you would be allowed a break from medicine for a year and then return when things got better.

    “Just imagine your attempt in the summer is a mock,” the senior tutor said to me. “If you pass, you don’t have to do the ‘real’ thing. If you fail, it’s nothing to worry about.”

    Reasonable Adjustments
    Reasonable adjustments are something else that are offered to medical students who have any health issues, be it physical or mental. In my case, the following adjustments were made:

    • I was allowed either a separate room in exams or to sit near the back of the hall should there be an acute mental health issue. I chose the latter.
    • I was allowed to take time off teaching time for things like mental health appointments.
    • I was allowed to take some time off if I found it difficult to come in because of mental health issues, although I was encouraged to talk to my tutor should this happened.
    • If worst did come to worst, I was allowed to take a ‘leave of absence’ – that is, a year break from medical school to make a recovery before coming back to continue.
    Final thoughts
    Opening up to medical school was probably one of the hardest things that I have ever done. It was made so much easier, however, by how understanding everyone was when I told them. Not only that, but the head of our medical school sent the whole medical school an email telling us how important it was to look after those with mental illness. It wasn’t because of me (he didn’t even know of me at the time) – it was just a general email he sent everyone.

    “We must ensure that we do not discriminate against those struggling with mental illness,” he wrote.

    I am extremely glad that I opened up, and would suggest other medical students in a similar issue to give it a try too. It seems like we’re moving on from the bad days of the past.

    [​IMG]

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