Medicine’s ‘stiff upper lip’ approach doesn’t help our mental health

Better support and a more open culture could make a world of difference for medical students with disabilities, writes Beth Dillon

Location: UK
Last reviewed: 10 May 2021

I assumed that when studying medicine with a chronic illness or disability, you would feel supported, as staff would understand. However, this hasn’t been the case. The profession has been slow to recognise that doctors and medical students can have health challenges.

This is due to the culture within medicine. It is only recently that the General Medical Council created a policy for supporting disabled doctors, and still only 4% of medical students identify as having a disability compared to 16% of working-age adults. Medicine adopts a very ‘stiff upper lip’ approach, where, despite all the talk about ‘reaching out’ the underlying message is to stay quiet, and if you do speak up, you’ll be treated as a nuisance. This decreases your confidence in every area, making you question whether you should even be there or should simply drop out.

Getting support requires a lot of resilience to keep pushing for what you need and are entitled to. This can severely affect your mental health. For instance, as someone with hearing loss, Zoom lectures were impossible, with me taking in perhaps only 20% of the words on a good day. Following numerous failed attempts to get support with Zoom lectures, I disengaged with the material, became increasingly frustrated and miserable, and found other means to learn the material.

Often when health issues are bad, it can be much easier to shut everything out and deny that it’s happening. When daily tasks are tricky anyway, it takes a lot of energy to psych yourself up to research potential support options or continue to advocate for yourself.

All these issues have been exacerbated by the pandemic. For example, referral times have lengthened significantly, with some taking over two years. Often these are the specialists that you need to see to obtain a letter of evidence to access support from disability services or disabled student’s allowance. Without these accommodations for exams and daily learning, education remains hugely challenging for an extended period. In addition, when not receiving medical treatment, you aren’t addressing the root of the problem. This makes you feel incredibly frustrated and miserable.

Other pandemic-related issues include one-way systems which often extend walking times in hospitals when this is already a difficult task. Masks are a significant, albeit necessary, problem, as many people rely on lip-reading or facial expressions which are hidden. This makes learning in a hospital setting more challenging and exhausting, leading to you hyper-focusing on hearing the words, and your brain then switches off interpreting what those words mean.

There are many ways to improve support for medical students with disabilities. For example, a mentorship scheme, where older students or doctors with disabilities mentor a younger student, or even just providing more support and training to advisors of studies. In the GMC and the BMA, there is a shift in representation but support just isn’t trickling down to medical schools quickly enough.

If you know that someone has a medical condition, acknowledge this and have a conversation about what is particularly challenging and how things could be made easier. This is individual as what might help one person might not help another. Remember, don’t ever be afraid to ask questions – nine times out of ten people love to answer them.