Using my experience as a vulnerable patient to become a better doctor
This anonymised account reflects the views of an individual, and not the General Medical Council.
During my fifth year of medical school I became acutely unwell and was diagnosed with psychotic depression. This led to me leaving my studies for 18 months whilst I received treatment and recovered.
I lost a lot of confidence during this time and was very fearful of returning, but once I decided to continue my studies the medical school supported my decision and aided my transition back. As part of this I have regular appointments with student support services. For the most part I’ve found these sessions useful and they’ve allowed me to voice any concerns I’ve had with my tutor. However, my tutor is often unsure of what adjustments can be made and getting help can be an uphill struggle.
Moving between clinical attachments can also be challenging. Every time we rotate I have to explain I have a health condition to a new tutor. As mental health issues are a hidden disability it can be difficult for others to understand the impact this can have on your life, so people don’t always understand, particularly if you have to take time away from studies due to mental health. Having any disability automatically identifies you as different and can make you feel inferior; good support from my tutor has helped me overcome this.
Stigma around mental health
The biggest challenge I’ve faced is stigma. Negative experiences have made me extremely cautious of telling others about my psychotic depression. The medical school has been very helpful in making sure that only those who need to know are aware of the details of my mental health issues, by providing me with a support card. I can show this card to my supervisor at the start of the rotation to explain that I have a known health condition that requires me to leave my placement on occasion to go to appointments. This has meant doctors understand when I’ve had to leave their clinic, and I’ve not been treated unfairly due to my absence.
I am using my experience of being a vulnerable patient to become a better doctor. I understand how lonely and scary being in hospital can be, and how you can be made to feel more like a bed number than a human being. Having empathy, asking a patient about their concerns, and good communication can go a long way. Most importantly, I have learned that my health comes above everything else, and I can only look after my patients if I look after myself first. I am extremely proud of returning to medical school, and I have come out the other side of my experience a stronger, better person.
As a result of my mental health condition, I moved back to my family home, meaning I have an hour commute to get to university. In order to make it easier to get to my clinical placements, the university arranged for all attachments to be at the hospital closest to the station. The medical school are also making special arrangements for my psychiatry placement, so that I will not come into contact with teams who were involved in my care when I was unwell. I am especially worried about this rotation as I had a very traumatic experience as an inpatient, but the medical school are doing their best to make it as stress free as possible.
What I would change…
- Help break the stigma around mental health. Universities and medical schools need to do more to encourage students to access support early. In my experience, many medical students and doctors seem to think they are exempt from mental health conditions. One in four people have mental health issues at some point in their lifetime, meaning that 75 students in my year of 300 will be affected. Furthermore, due to the competitive nature of medical school, students worry that asking for help can be seen as a weakness and an inability to cope. This means that when people begin to struggle they ignore their symptoms instead of seeking help; something I was definitely guilty of.
- Have a disability officer within the medical school who can work with students and staff to help suggest and arrange reasonable adjustments.
- Improve student support services – educate staff on appropriate reasonable adjustments for varying types and levels of disability, involving the disability support officer when appropriate.
- Have a clear pathway for getting help for those who are struggling, worried or have a concern, which both students and staff should be aware of.
- Remind students regularly to look after themselves and state that asking for support does not affect their ability to practise medicine.