Lack of continuity in support after graduation

This anonymised account reflects the views of an individual, and not the General Medical Council.

A trainee doctor with dyslexia talks about how access to support has changed as they’ve moved through medical education and training and their fight for reasonable adjustments in postgraduate exams.

Support almost disappeared at postgraduate level

I am a doctor with dyslexia. I have been working for five years, currently in a fellow post in my field of interest but have been struggling with support in postgraduate training.

I was excellently supported throughout medical school. For instance, I had meetings with the programme leads from year one, who couldn’t do enough to support me. This was in conjunction with support from my university’s disability support office, who facilitated tutors and support to appropriate exam environments, taking into account my needs and reasonable adjustments.

However, I was shocked to find this almost totally disappeared at postgraduate level once I started working – in terms of accessing specific disability support, from reasonable adjustments in postgraduate exams to specific careers advice.

I successfully completed my foundation training but I started to run into issues during my core medical training, due to the need to pass postgraduate membership exams. I struggled with the format of these exams, and found the whole system very different to medical school. Yet unlike medical school, I had virtually no support to help guide me through it.

Battling consistent barriers to get reasonable adjustments

Issues with the lack of support at postgraduate training were compounded by the way the college fell short in meeting the needs of disabled candidates sitting their exams. From my experience, the delivery of reasonable adjustments for this can be woefully inadequate - I have had multiple appeals upheld over the years due to failures in delivery of adjustments. They have consistently put barriers and hurdles in the way and ignored professional advice on my reasonable adjustment requirements. The only way I was able to achieve acknowledgement and be offered adequate reasonable adjustments, as recommended in a professional Educational Psychology report, was through the support of a solicitor.

I feel very let down by the whole process. I believe there is an obstructive culture towards doctors with disabilities, with many unmet needs that prevent us from fulfilling our full potential, exacerbated by the fact we represent only a small percentage.

What I would change…

  • I think deaneries/HEE local offices would benefit from a disability support office type service for trainees to help provide continuity in support post-graduation.
  • There needs to be more specific advice and oversight in developing fair policies for disabled candidates at postgraduate level. Currently there is not a level playing field for doctors with disabilities in comparison to those who don’t.
  • Educational supervisors should be aware of what support is available through the Professional Support Unit (PSU) at the deanery/HEE local office. This was a fantastic service, helping provide elements of pastoral care for those struggling with training, and access to other services including exams support and other specialists.
  • Allow access to the PSU in specific circumstances, for ongoing, unresolved problems once a training programme has finished. I was unable to pass my membership exams, even with the permitted six-month extension. I am now no longer in a training programme and cut off from PSU support. I feel that there is nothing in place for the deanery/HEE local office to review this for disabled doctors who are facing difficulties that started during their training programme.