By Alisha Staley
Medical students encounter death at a much higher rate than any other degree, except maybe nursing and mortuary sciences. We talk about dealing with this kind of experience a fair amount, but nobody tells you how to deal with a personal death as a medical student.
Grief is a terrible thing to go through as any kind of university student, but there are unique experiences associated with being a medical student. Normal students don’t have to learn about the disease that your grandma died from, normal students don’t have to talk to real patients suffering from the disease your father had, normal students don’t have to sit exams on palliative care. But we do.
It is an extremely difficult situation but I have some tips that may help you. Please be aware that this list is not exhaustive, and different universities may have different support systems in place.
1- The grief process
Grief affects everybody differently. Those who have not experienced grief often presume that grief is short and lasts about 2 weeks, then it is done with. For some people that is the case, but for others grief can last a lifetime and change them as a person.
There are a lot of symptoms associated with grief which can be surprising- for one; not being able to concentrate. Prior to my grief I had no problem with concentration, but now getting through the weeks enormous pile of work is a mental battle. I recommend not being too hard on yourself, recognising the change in yourself and asking for help from people. Offering yourself small rewards after a good study session can help. I also know that if I do anything too fun, then I cannot bring myself back to the work, so I save that stuff for once my work is finished for the day. Mental health can really deteriorate when you experience a loss. My recommendation is to rely on your friends and family for support. It’s not a weakness to be vulnerable and share your feelings. The university also has a counselling service and a grief support group. And the pastoral support team are always happy to help.
My mother died 2 days before I applied. This was an extremely difficult situation to be in, but also, I had to put my needs in the forefront of my mind. I had wanted to study medicine for such a long time, so I had to use my grief as a driving factor rather than a hindrance. Don’t be afraid to talk about what’s going on in your application. I talked for a good portion of my application about what I learned from my mother’s palliative care. It is important to remember that not many people your age applying to medicine have experienced death and disease in such a close proximity; in that sense you may be wise beyond your years. This can make you a better medical student, and a more empathetic and holistic doctor. Do be aware, however, that if you choose to discuss this in your application, you may be asked questions about it in the interview. This may be a scary prospect, but remember that your experiences give you a better insight into medicine.
Exams at university are usually in January and May/June. If you are experiencing a loss, it is not a failure to defer your exams, or even to defer the year. A death, or experiencing a terminal illness in your immediate family, is classed as a mitigating circumstance. This means if you choose to sit your exams and fail, you can resit them at a later date “at first attempt”. “At first attempt” means that the resit is classed as your first time sitting the exam. If you choose to defer the exams, as I did, you can resit them “at first attempt” in the summer. Don’t force yourself to go through more stress, there are processes in place so you don’t miss out.
Regarding OSCEs, I was worried that I would get upset if one of the stations involved death or terminal illness, hence I talked to my head of year. My head of year allowed me to be in the last group sitting the OSCEs meaning if I did need a break to clear my head, I could take one and not disrupt any other students. I recommend doing the same if this is something you are worried about.
PBL can be difficult at the best of times, it is even more difficult when you have to learn about what your loved one is/was experiencing. This happened to me in semester 4 of my 2nd year at medical school. The first thing I did was tell my PBL tutor before the case started. I just let her know that I may be quiet in this case and I may not come in if I do not feel up to it. That’s okay. Just do as much as you can handle. With regards to lectures, I decided to stay home and watch the podcasts in case I got upset. This allowed me to study the content at my own pace. Communication skills session can be a difficult one- I recommend just emailing your teacher prior to the session to let them know the situation.
5- Meeting patients
What I was most afraid of was meeting someone who had my mother’s disease. This came to fruition in the 3rd semester of 2nd year. Had my placement been on a cancer ward, I would have expected such a possibility, and been more prepared for it, but I was on a regular surgery ward. In 1st and 2nd years you generally do ECE (early clinical experience) visits with clinical partners. It is okay to rely on your clinical partner in this situation. I let my partner lead the consultation and I remained quiet for the remainder. After the consultation I asked my partner to continue the next discussion so I could take a breather. If you encounter a similar situation, I would recommend going to tell a member of staff on the ward to see if you can change wards. I also recommend getting in touch with whoever organises your ECE and your pastoral support team to try and come up with an action plan for the next time this happens.
Remember, you are not alone in this. Talk to people, consider your mental wellbeing, and don’t be afraid to ask for help.