As medics we are notorious for sometimes failing to look after our own physical or mental health. It’s important to get into good habits while you’re at medical school. By putting your own wellbeing first, you’ll also avoid putting patients at risk.
IMC guidance is clear that you should not try and assess your own health or rely on another student’s or colleague’s assessment. Seek independent and objective advice from your GP, your university’s occupational health department, or both, if you’re worried.
Medicine is a stressful career, and this can begin at medical school. It’s best to get help early, if you can. Keeping quiet, or ignoring the problem, can cause things to escalate and lead to more serious problems. While it’s not always widely acknowledged, depression and anxiety are common amongst doctors and plenty of clinicians develop drug or alcohol dependency as a result of mental health issues.
As a society, we’re becoming far more aware of our need to be open about mental health. There’s no reason this should be any different for doctors.
James was a medical student on a graduate course. He had already completed an English degree and had always excelled academically.
However, he found the first year at medical school different, struggling to adapt to the more scientific way of approaching his studies and finding it difficult to make friends.
In the lead-up to the summer exams, he found himself becoming increasingly unhappy and withdrawn. As his mental health became harder to manage, he began to drink more regularly. This escalated quickly, and his attendance at lectures and tutorials started to drop. His pastoral tutor asked James to meet with him, but he missed several appointments.
Towards the end of the first semester, he was called to attend a formal interview with the dean of the medical school. When James arrived, there were noticeable signs that he had been drinking that day, which he explained by saying he’d been at the pub with friends.
As a result of ongoing concerns, formal fitness to practise procedures were instigated at the medical school.
James contacted Medical Protection for advice and support. We were able to show that his poor attendance and perceived attitude problems related to an underlying health issue. He acknowledged that he was struggling with depression and alcohol use, and the medical school allowed him to take a break from his studies and provided him with help and support through occupational health.
Health issues can arise at any time in your medical career, from the early days at university to the final years of clinical work. It is always important to seek help, the sooner the better.
Sometimes things can get out of hand, and occasionally formal investigations or procedures will be the first point where issues are picked up. Even at this stage, as the above scenario shows, getting appropriate advice and support can help to get your health and career back on track.
Tackling stress as a new doctor
Hospitals are challenging places, full of demanding individuals who openly confront the staff that run them. In the face of this, medical students and junior doctors must maintain a calm, well-presented and attentive demeanour, while multi-tasking in an often-frenetic environment.
Working as a junior doctor can be one of the most stressful periods of your career, but if the avenues to support services are well signposted and explored, stress can be managed, to the benefit of both staff and patients.
Tips for managing stress
• Put up boundaries – learn to say no
• Take time out – particularly when you start to feel stressed
• Keep a stress diary – to identify what things are causing you stress
• Acknowledge your limitations – work within your competency
• Talk to your GP – see them when you are not well and listen to their advice
• Hold regular meetings – we’re all human: working at the ‘coal face’ leaves little time for this, so organise time for reflection with colleagues
Medical Protection members have access to a range of wellbeing resources including a confidential counselling service.