Continuing the conversation on mandatory reporting: from a medical student seeking help
BY JESSICA YANG, PRESIDENT, AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION
In February, medical students were disappointed to see the Queensland Parliament reject recommendations to the Health Practitioner Regulation National Law which would reflect the WA model of exempting treating practitioners from mandatory reporting. While the adopted changes were a step in the right direction, I would like to reflect on a personal experience which reminded me of the reality for vulnerable medical students and doctors attempting to seek help.
Several months ago, I relocated to a new area in Sydney. New suburb, new GP, same old medical history. While I still have a regular GP, now about half an hour away, a practice down the road from my new abode was too convenient to turn down. The consultation was friendly enough and conversation flowed easily as we bonded over our experiences in the medical field (albeit mine being far earlier in the path than hers).
During my long-winded history, I recounted my experience with (what I still assume was) stress-induced fatigue last year during a particularly brutal rotation which required a reasonable 35 hours per week of clinical contact. Then, I added the 20 hours per week studying for the end-of-placement exam, and the 20 hours I worked part-time on weekends to support myself. Taking days off, even for illness, would mean having to remediate those hours on a weekend and having to forgo my weekly income.
To make matters worse, I was placed at a satellite hospital an hour commute away, with only one staff member of our medical school trying their hardest to support the dozen students on the rotation.
A month into this placement, I went to the only local GP available after hours. I was convinced I had developed narcolepsy as I frequently found myself on the verge of falling asleep throughout the day, most worryingly during my hour-long drive to and from the hospital. I never had the time to go back to confirm a diagnosis, or the money to follow up with the sleep physician he referred me to. By the end of the rotation, I had developed acid reflux symptoms, daily headaches and sleep paralysis.
I recounted this to the new GP, partially to vent my frustrations to someone who had certainly gone through the same experiences during their medical schooling, but also seeking some sort of retrospective medical validation for a level of fatigue that profoundly impacted me during that time.
Instead, the GP scolded me: “You should have followed up. If I had seen you last year and you were as fatigued as you say, I would have been required to report you, you know!”
I cannot fully describe the incredulous mix of emotions I felt when she said this – surprise, anger and mostly, shame. I thought I had been forming a rapport with a new GP, lamenting over the barriers of time, money and social pressures which stop many medical students from seeking help. Instead, this GP put up another barrier for Me – fear.
Just a month before I had seen this GP, AMSA had sent a focus group to consult with AHPRA to identify the best way to positively communicate to medical students that they are able to seek help without fear following the mandatory reporting reform. I remember leaving this focus group feeling positive and ready to encourage my peers to reach out when they needed to.
Despite feeling significantly more deflated following my consultation, I reflect on this experience with a hopeful outlook which requires action. While this positive communication from the top is vitally important, it is just as important to educate those who will be interacting with vulnerable medical students and doctors on their reporting obligations. All the positive messaging in the world is for naught if vulnerable medical students, so early on in the medical careers, are being turned away when they seek help due to ignorance.
Published: 13 Nov 2019