On the merits of intermitting

By Grace Scolyer & Meg Kent

It is always difficult for medical students to admit they are struggling or not coping with the demands of the course. But it is even more difficult to admit that is has become necessary or important to take time off. We as medical students struggle with self-care, vulnerability and perceived failure so very deeply; where possible, we take part in self-care provided it doesn’t come at the cost of our academic progress. In this piece, Grace and Meg discuss why, sometimes, it is okay to take a break from medicine.

Grace Scolyer

All year, I have been struggling through medical school: the bad days getting more frequent and severe, my enjoyment of the course dwindling into next to nothing, and my denial, through the roof. The truth is I never really acknowledged how much stigma I had internalised about taking a break from medical school. I kept thinking that I didn’t need to, that I was strong enough not to, that I just had to push through each hurdle, take it a day at a time, and I would be fine.

I think there was something really wrong with my internal monologue at this time, and it took me far too long to question it. It was only a few weeks ago that I started asking myself why I felt the need to push through the course when my mental health was not allowing me to enjoy it; when I was so clearly struggling, when it so clearly was not what I needed in order to recover.

The decision for me to take the rest of the year off was the hard decision, and definitely for me, the right one. However, it was also a decision between having my mental health, my enjoyment of medical school, and potentially my exam results suffer, or, letting myself breathe, giving myself a chance to feel like myself again, and hopefully, enjoy medical school again. This obvious answer was the most difficult decision to come to, and I think it’s because our culture celebrates overcoming obstacles, but without sacrificing your career progress — resulting in a huge stigma associated with intermitting.

The stigma, I think, comes down to a few things. Firstly, there is the fear that people will perceive you as failing. Really, the reason you end up repeating a year, the number of times it takes you to progress from year X to year Y, the total number of years it takes you to graduate with a degree, don’t matter in the slightest. Not just because the outcome is the same, but because the journey through medical school holds that much more significance, because it reflects the individual challenges you faced.

Secondly, there is the comparison between medical students (for a great look at this phenomenon, check out our article on the phenomenon of FOMOitis here). When I see the friends I started medical school with graduate before me, I suppose I will be a little jealous — but it’s a small price to pay for a well-deserved break, and a second chance at what I hope will be a much more enjoyable year of medical school when my head is screwed on a bit better. It can be hard to stop these comparisons, but it’s also incredibly important to, because we’re all so incredibly different in the challenges we face and how we choose to respond to them, and this decision at least, I’ve made for me alone.

And finally, there is the fear that deciding to intermit is a sign of weakness. That it means in a way, you have failed to push through and overcome the obstacles you’ve been faced with. Which couldn’t be less true. This is me dealing, finally, with the obstacles in front of me that I’m done ignoring. This is me realising that what is more important than keeping on track with my 18-year-old self’s five year plan is reflecting on my wellbeing at this point in time, and deciding what to do about it. I don’t think I will ever regret this decision, nor will I ever look back at this decision and consider it the easy way out.

Meg Kent

It’s really hard to admit you’re struggling in medicine: when you believe yourself to already be so far behind all the other brilliant people around you, when everyone else has life struggles and seems to be able to cope, and most especially, when you don’t even register your struggles and just keep trying to push through.

In January 2015, I got a letter from the Academic Progress Committee telling me that in light of all my struggles in 2014, they were automatically going to let me repeat. I didn’t even need to come in for a meeting to plead my case. This should have been my first sign that I had been dealing with too much. It turns out that even the APC could register that my circumstances were so extreme, but I couldn’t. I was just happy to be given a second chance to continue with the course.

Later in 2015, after some really awful living situations, a very quick move of house after those living situations became too much (if anyone wants to compare crazy roommate stories: I am free in exchange for a coffee), and then some significant neurological health problems (maybe make that tea instead of coffee), I was still powering through, not registering how hard my life had become. Walking out of my end of year exam I immediately knew I had failed. I felt like I had failed myself, and more than anything I had failed the faculty who had given me a second chance.

Early in 2016, I was back in Clayton in front of the APC. In front of the committee I told my story again, from start to finish. They didn’t look at me with pity but I could feel their respect for how I’d tried to cope with large obstacles that the medical student mentality had made me think were small. I ended the meeting stating to the committee before they made their decision that I did not believe I was mentally or physically capable of studying in 2016, and I could also recognise that I probably wasn’t in 2015 either. I take this degree seriously, and did not want to let anyone down, so I needed to (finally) take care of myself. According to the committee, this statement may have saved my career, and they let me repeat again, with the condition that I take at least twelve months off my studies and focus on getting well.

During those twelve months, I worked in different jobs, built my resume, had a break and reaffirmed that medicine is what I want to do with my life. I saw my specialists and got cleared physically, and I built relationships and actual support networks that I hadn’t had before to help me mentally. I travelled as well, like everyone does on a gap year, and came back a happier, more driven person.

I believe that a year off was the right decision for me, and while it may not be for everyone, I wish I had the courage to admit my struggles earlier. Maybe then my HELP-Loan wouldn’t be quite so insane.

Have you also taken time off medical school or been required to repeat a year? We’d love to hear your story at publications@mumus.org.

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