Students and medical professionals require additional support from time to time. Long shifts, experiencing traumatic events in the workplace and staff shortages, further exacerbated by the Covid-19 crisis, have meant more staff and students are finding the workplace stressful. How can we best support students and medical professionals?
Support and welfare provision is essential for medical students, to ensure they get the most out of their clinical course and their time at the University of Cambridge Clinical School. Students may encounter many different stressful and upsetting situations, both on the ward and during placements, for example, seeing patients in an Intensive Care Unit or individuals coming through Accident & Emergency with multi-trauma injuries. The pressure of studying medicine on top of the normal everyday stressors mean it is important to ensure students are well supported with their mental wellbeing, as well as physical health.
There are different levels of support available and it’s important for students to know who they can turn to if they are struggling, as there are many pathways of care. Students may wish to speak to a member of staff who individuals may be more familiar with or there is the option to self-refer to some of the services.
At the University of Cambridge, students belong to a College, and may wish to speak with a College tutor to help with pastoral and financial issues. In addition, students have a Director of Studies to help with the academic side of things and they have access to all the other support networks within the College, such as College nurses, counsellors, study skills advisors and the College chaplain.
At University level, there are support services such as the University Counselling Service and the Disability Resource Centre. The University Counselling Service aims to provide counselling to staff and students dealing with mental health issues such as anxiety and depression, as well as running workshops and groups. The Disability Resource Centre provides learning and education support to students with a range of issues, including registered disability or specific learning difficulty. This ranges from providing students with a disability mentor to making reasonable adjustments to exam conditions.
Additionally, there is also the Clinical Student’s Mental Health Service, which is separate from the clinical school and completely confidential. This is unique to Cambridge and was started by Clinical School staff with the aim of supporting clinical students with mental health issues throughout their studies, as well as issues that may arise from their clinical placements. Students are assessed by a consultant psychiatrist and may be prescribed medication if it is necessary. If required, students can then be put onto a waiting list for psychological assessment and therapy, which is a significantly shorter wait than local NHS services. Crucially, the support is run by doctors and psychologists who understand the pressures of clinical studies, as well as some of the traumatic experiences students may have experienced or observed on their clinical placements.
It is recognised that even after students finish medical school there is still a need for support. There is often a perception within the NHS that doctors need to carry on with poor mental health, because if they presented with such issues, it may be perceived as a sign of weakness or lead to other problems.
Health professionals working at Cambridge University Hospitals NHS Foundation Trust have access to a specialist support service called ‘Doctors For Doctors,’ dealing with professional wellbeing and clinician support. This service is for clinicians working at the hospital and run by doctors with a background in General Practice who understand the system and its pressures.
Whilst the doctors providing support in this service work within the NHS, they are not direct hospital colleagues which is integral to the ‘Doctors For Doctors’ approach. The clinicians facilitating the service are not the people who will be writing appraisals or involved with their career pathway in any way, the service aims to create an environment where clinicians feel they can seek confidential support and advice.
The lead for the service periodically sends out emails to all doctors working in the Trust, informing them that services are available if needed. Doctors then make contact with the service, and an assessment appointment is scheduled, either in person or via video conferencing. Crucially, the service provides an opportunity to guide, signpost, and seek advice from elsewhere if needed.
As well as the specific support avenues we have identified above, medical students and qualified doctors can also seek guidance and support from a range of other avenues, such as their GP, local NHS mental health trusts and local counselling groups. It is important to highlight that providing a doctor has insight into their problems and is taking appropriate action if their health is impacting their behaviour and performance, then this would not be considered a fitness to practise issue.
What is most important is that help is sought and whilst we recognise it cannot always be easy to access general NHS mental health services, we hope this article has identified some of the specific support mechanisms in place at the University of Cambridge and Cambridge University Hospitals Foundation NHS Trust.
To learn more about the some of the systems in place, there are two podcasts that relate to these issues. Please see: https://www.cumeg.cam.ac.uk/podcast/student-welfare-and-support/ and https://www.cumeg.cam.ac.uk/podcast/clinician-welfare-and-support/.