A report on the mental health of students studying medicine was recently produced by the NHS Staff and Learners’ Mental Wellbeing Commission. Medical students struggle to strike a balance between their studies and clinical rotations; junior doctors are not the only ones who experience this difficulty. Students studying dentistry, pharmacy, and nursing are also expected to maintain their academic obligations while providing high-quality treatment in frequently uncomfortable working environments.

Support For Secondary School Students Seeking Careers In Medicine

According to the Commission’s study, there is a way to enhance the well-being of NHS personnel even before they begin their training or careers.

This section of the research examined the well-being of future healthcare workers during their formative years, with a particular focus on secondary school-aged youth who may be considering employment in the NHS.

The current NHS workforce can do more to promote an acceptance that everyone has a continuum of mental health.

The research emphasised that half of all mental illnesses in life appear by the age of fourteen, and that between 60% and 70% of youth do not receive the proper mental health interventions at an early enough age. In light of this, the paper offered suggestions meant to make pursuing a profession in healthcare “less stressful and more exiting”. These recommendations should have made applying for healthcare careers easier and less harmful to the wellbeing of young people. They include accurate information about which A-Level subjects are required for which degrees and publicising the wide range of different routes into NHS careers.

A couple things that were mentioned as influencing potential medical students are having a learning difficulty and coming from a home with few “contacts”. While students with learning disabilities typically face little to no disadvantage when receiving proper support from their school or college, they may find the move to higher education difficult due to concerns about finding the right support. Accordingly, the research recommended that UCAS (The Universities and Colleges Admissions Service) reconsidered its policies regarding learning-disabled applicants.

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All people would be able to gain work experience in healthcare if there were connections established between local NHS facilities, colleges, and schools. The NHS is able to offer a “bureau” service to give children work experience even if their family does not have the “contacts” to obtain such experience outside of school since it is the largest employer in most locations.

Undergraduate Medical Students Face Unique Challenges That May Compromise Their Mental Wellbeing

Although the likelihood of students disclosing a mental health disorder when they enrol in college has increased five fold, research indicated that undergraduates in the healthcare field, in particular, may have been significantly under-reported. There are a number of stressors that are likely to influence undergraduate students when they enter university, including living arrangements changing, adjusting to a new educational environment, and social and financial constraints.

An undergraduate student’s likelihood of having mental illness is increased by other cultural factors. Students that identify as LGBTQ+ (lesbian, gay, bisexual, transgender, or queer), female, disabled, Black, Asian, and minority ethnic (BAME), from less affluent homes, and BAME are more vulnerable.

Empirical evidence indicated that students pursuing healthcare degrees, ranging from nursing to medicine, exhibit elevated levels of anxiety, despair, burnout, and emotional suffering in contrast to their non-healthcare peers. Stressful clinical rotations, a heavy workload, moral dilemmas, and intense contact hours all contribute to the high stress levels experienced by medical students.

The research suggested that all medical students receive instruction on self-care, self-awareness, suicide risk and prevention, and how to identify when stress becomes a health issue. All medical students should also have wellbeing “check-ins” within two weeks of the commencement of their placement. Students would have a place to go where they can receive comprehensive help unrelated to the academic side of their degree if they had a personal wellbeing tutor.

Better working conditions are required for students participating in clinical placements. Comforts like clean restrooms, a peaceful space for unwinding, dependable Wi-Fi, and nutritious food would enhance what may otherwise be an uncomfortable and sometimes stressful event. “There is good evidence that happy staff are more compassionate and provide safer care” , the paper states.

It is imperative that medical students receive unambiguous instructions regarding the assistance protocols in place in the event that they reveal experiencing mental health difficulties. Information to “allay their fears of any detrimental impact of this disclosure upon future career prospects” must be given to students who may be afraid of the consequences of disclosure, according to the Commission.

Wellbeing Of Postgraduate Medical Students Is Yet To Be Sufficiently Researched

The Commission discovered a deficiency in research about the requirements of postgraduate students as learners and workers, despite conducting a thorough study of the literature.

Certain psychological characteristics that help postgraduate students succeed in the classroom and in clinical settings could work against them in terms of their well-being. Burnout and a “fear of failure” are associated with perfectionism, and being “conscientious, high-achieving, driven, self-critical, and obsessional” can occasionally work against you. The paper highlighted the high demands placed on postgraduate medical students in terms of “self-giving” and emotional involvement; being forced to control one’s emotions in order to ensure that only proper ones are expressed in public is also linked to higher levels of stress and burnout.

“Among some postgraduate learners, the term ‘resilience’ has negative connotations, implying that they are emotionally weak. There is also some academic contention regarding the term. Asking individuals to improve their resilience without acknowledging that the system they work within can seem almost designed to foster poor mental health may worsen the relationship between postgraduate learners and their employers”, the report said. “Resilience can be seen as having the tools to self-care. This can enable postgraduate learners to accurately perceive emotions, integrate emotions with cognition, understand emotional causes and consequences and manage emotions for personal adjustment”.

There is a “general atmosphere of ‘fear'” among physicians, and postgraduate students are afraid of being the subject of investigations by government agencies like the General Medical Council (GMC). The Commission observes that graduates who identify as BAME or who are not from the UK are more likely than their white or UK counterparts to receive warnings and sanctions, based on GMC findings. The research demonstrated that employers recommend a higher proportion of BAME and non-UK graduates to the GMC, and that employer referrals are more likely than patient complaints to have a lasting impact on a worker’s career. The GMC has commissioned an independent investigation to investigate this matter further.

Because they may have less experience than their colleagues, postgraduate students are more susceptible to bullying and harassment, which can cause stress, poor mental health, absenteeism, and presenteeism.

In Response To The Report, Sue Covill, Director Of Development And Employment At NHS Employers, Said:

“The NHS could not deliver quality care to patients without its staff. It is critical that we understand the needs of staff and learners and the NHS does all it can to support the wellbeing of its workforce. The findings and recommendations of the report continue to highlight the challenging environment in which our staff and learners work in but also the dedication and commitment of our staff to continue to deliver the best care they can to patients.

“We welcome the recommendations and the continued focus on key steps employers and staff can take to support and promote wellbeing.

“NHS trusts are working extremely hard to improve and support the wellbeing of their staff. Where this works well, organisations have strong leadership from their board to drive improvements, influence the culture of the organisation and engage with staff to provide the prevention, support and interventions needed.”

Conclusions

The Commission offered 33 suggestions in all for enhancing the wellness of NHS employees. A “Samaritans-style” programme to support NHS personnel, as well as more standardised processes to report bullying, demonstrate the need for pragmatic improvements to support individuals in what is, even in the best of circumstances, frequently an incredibly stressful job. The Commission’s report acknowledged that both undergraduate and postgraduate medical students face significant challenges in balancing their studies with clinical practise.

“The current NHS workforce can do more to promote an acceptance that everyone has a continuum of mental health” , the research states. In a poll of 3,500 physicians, it was found that 73% would rather tell friends or family about a mental health issue than a medical professional. Hopefully, this will change if the Commission’s recommendations are put into practise as soon as possible.

Read the full report here.