Working with doctors Working for patients

Returning to a course

  1. 108. When students take time away from the course, it is very important that their return is handled effectively. It can be very overwhelming and disorienting for a student to return to a completely different cohort of students. They are often worried about being stigmatised if people find out why they took time away from the course.
  2. 109. Medical schools should have a reintegration plan in place for each student, which should be discussed with the individual. The development of this plan should start early – well before the student is due to return or even at the point they leave the course. Setting clear expectations helps the medical school and the student to manage the reintegration process.
  3. 110. Medical schools should consider whether some students could complete the course on a part-time basis. This can be difficult for medical schools to implement due to the logistics involved in allocating appropriate teaching and placement opportunities to large groups of students. In postgraduate medical training (foundation and specialty, including GP training), however, there are some circumstances in which it is possible to train less than full time.* This means that it may be placing more pressure on students to expect them to study full time at medical school when they may not be expected to train and work full time when they graduate.

Footnote

* The UK Foundation Programme Office (2012) The Foundation Programme Reference Guide page 28; NHS (2016) The Gold Guide, sixth edition page 34.

Example: Student support team

Student support team at the University of Aberdeen

In addition to the medical school student welfare officer, Aberdeen has a student support team consisting of an ear, nose and throat surgeon with a wealth of medical school experience and a consultant psychiatrist with a background in medical education. This team is separate from the year lead and assessment teams.

The student support team offers to see students that year leads are concerned about. The team acts as a high-level screen for mental health and other problems – it does not treat students. The team can liaise with the student’s GP or mental health services to streamline the student’s access to care. This role is informed by the Royal College of Psychiatrists 2011 report Mental health of students in higher education (pdf), which highlights the barriers to mental healthcare that undergraduate students face.

When a year lead is concerned about the academic progress of a student, a student support doctor will join the year lead at a meeting with the student to identify whether there is an underlying problem. A student support doctor will also join year leads for handover meetings at the beginning and end of academic years to be vigilant for students who may be getting into difficulties.

All students who take time out from the course will be seen by the student support team so they can plan what the student can do to address their difficulties while out of the programme. The students will also be seen by a member of the team on their return to review their progress and decide what ongoing support is needed.

Aberdeen developed this team because some students with difficulties were identified at a late stage, even though the problems had been there for some time, and other students withdrew from the course before their problems became apparent. Furthermore, students were sometimes returning from periods away from the course after having achieved little progress with their underlying mental health problems.

The service has enhanced the care and support given to students in Aberdeen to make it more proactive. Students can speak to a member of the student support team in confidence, knowing that the doctor will not make decisions about their progression in the course. Year leads have the reassurance of knowing that a mental health doctor is reviewing the student and will suggest they contact their GP for treatment or referral to specialist services if appropriate. By having the student support team, students can also ask questions about mental healthcare and treatment. This can help to demystify and de-stigmatise mental health, which can encourage them to pursue treatment. The student support doctor can, if requested by the student, accompany a student to any progress or fitness to practise meetings to give support and act as an advocate on their behalf.