I specialised at being a university student. I didn’t graduate from medical school until I was 30, for a variety of reasons, despite the fact that I first set foot in the hallowed halls at the age of 19. Only one of those years was spent recovering from illness. Aside from giving me the chance to grow up, meet my future wife, and learn how to be a junior doctor, it also gave me the opportunity to make lots of mistakes.
I was recently chatting to the lovely person who used to be the senior tutor while I was at medical school. She said that she had thought of me recently when she had had discussions with current students about their plans to do a risqué calendar to raise money for charity. Why near nudity would make her think of me is something of a mystery, however, I wonder if I would have actually made it through medical school in these modern days.
You see, nowadays medical students at my former university are subject to similar fitness to practise regulations as qualified doctors. At a time when the General Medical Council (GMC) has just ended a consultation on reviewing the fitness to practise process, I can’t help but wonder how this impacts upon the raucous sports teams, the satirical comedy shows, the debauched Freshers, and black tie events. Does it push bad behaviour further underground, and teach students how to hide these things from the very earliest stages of their careers?
Who knows . . . ?
On a more serious note, the first year I spent at medical school was after I had been misdiagnosed with unipolar depression on my gap year. I had weaned myself off antidepressants, which in retrospect hadn’t made any difference at all. What I didn’t know was that this year would be the year that I would have my first manic episode.
The build-up to my admission to hospital included a number of experiences that I can’t even begin to recount, just in case the GMC decide to retrospectively take action against me. Towards the end of the academic year I was disinhibited, ever the socialite, barely sleeping, and even left an exam early to get to a music festival.
Luckily, my interactions with patients at that stage were limited. Looking back, I had a complete lack of insight into my actions, not realising that my problems were exacerbated by reckless, teenage, risk taking behaviour. I suppose that I was somewhat fortunate that my behaviour didn’t become exceptionally erratic until just before my end of year exams.
However, I can’t help but wonder that if I had been subject to the same fitness to practise regulations as the current cohort of medical students are, I could easily have been thrown off the course, before I had even really started it.
I suppose there was an outside chance that my mental health issues could have been identified, but who would have made the thorny decision over whether I had been responsible for my careless, mania induced actions? I hope that if I had been reported to the medical school authorities, someone with more awareness of psychiatric illness than myself may have realised that I wasn’t just being rebellious—although I have always had a soft spot for rebellion—but actually needed help.
But it never came to that, and I only just managed to pass biochemistry, the exam I left early to get to a festival. Getting exactly 50% meant that I had passed the year and had a whole summer to myself to unravel completely. But that is a separate story, which may have to wait for some time to be told.
Tackling stigma in mental health is the aim of the Time to Change campaign. This article aspires to contribute to that.
Samir Dawlatly is a GP partner at Jiggins Lane Surgery in Birmingham. He combines clinical practice with being a part time house husband and an interest in social media, as well as publishing poems, essays, and blogs. He can be found on Twitter as @sdawlatly.
I have read and understood BMJ policy on declaration of interests and declare the following interests: I am a member of the RCGP online working group on overdiagnosis.