My career in medicine has had its challenges and dips. I remember there was a period during my training when I was transiently depressed, and it wasn’t particularly clear to me why that was. I stopped enjoying work and the pressures of delivering a service in parallel to achieving my training goals, was psychologically, just too much.
Through a friend I’d discovered that the London Deanery offered a support service for doctors which involved journeying to see a psychotherapist every few weeks or so. The journey itself was inconvenient, however, the talking helped to an extent. I’m not sure whether it was a success, but I managed to get out of that slump (and subsequently out of the country for a while!)
Doctors have characteristics that sometimes preclude presenting to healthcare services for these types of problems, including altruism, presenteeism, narcissism, feeling a failure and fear. We forget that we’re all human beings, and as doctors, we suffer from the same problems that our patients do.
Research indicates that the taboo of developing a mental health problem whilst working as a doctor, is diminishing, however doctors feel that the standard services available to them are insufficient for fear of lack of confidentiality, threatening their GMC registration and perhaps feeling that they know more than the healthcare professional they would be seeing.
Other factors that may contribute to the development of stress, anxiety or other mental health problems include;
- Competition within specialties
- Feeling forced to choose a specialty early within one’s career
- Barriers to changing specialties after a few years (ie. having to start from ‘scratch’ again)
- High service delivery, understaffing, training requirements
- Wondering whether one made the right career choice
I’d thought I would list a few services that may be of use to doctors who are experiencing difficulty in their lives. Many of which are either independent or government funded;
Support for Doctors – run by the Royal Medical Benelovent Fund, they help doctors with all sorts of problems from careers to financial advice.
Practitioner Health Programme (PHP) – Self-referral service for doctors who suffer from mental health concerns. Strictly confidential service with access to Psychiatrists, Psychotherapists, Mental Health Nurse and GP. They prescribe and specialise in several areas including addictions to drug and alcohol, mental health illnesses, adjustment disorders of varying complexities. NHS funded. Unfortunately it is only available to doctors who have a residential address in Greater London. They’ve written several articles in BMJ Careers based on their experiences of doctors using the services, and they boast up to 88% abstinence rates in alcoholic doctors within 5 years, which is incredible when comparing it to 20% in the general population.
Doctor’s Support Network – charity forum and resource for doctors who need advice.
Employment Assistance Programme – many organisations subscribe to this initiative. They can provide counselling and advice for anything within your lifestyle remit.
Mednet – A London Deanery funded confidential consultation service for doctors based at the South London and Maudsley and Tavistock Centre in Camden. Similar structure to PHP, but offer up to 6 counselling sessions for doctors with mental health problems.
These are just a few options. I wanted to highlight that as doctors, we needn’t be alone, and inevitably we will have to make lifestyle and career changes or choices depending on our health, situation and/or preferences. There are always several options available for you, and sometimes you need someone impartial to guide you to the right one for you.