Doctors With Disabilities: An Asset Not an Inconvenience 

Siobhan Harris

Disclosures

August 07, 2018

Doctors with disabilities and health issues should get more help and support, according to the General Medical Council.

The GMC is finalising its new guidance called Welcomed and Valued, which gives medical schools and employers advice on how to make sure that all students and doctors, including those with disabilities or health issues, can progress well and flourish.

Professor Colin Melville, the GMC's director of education and standards, told Medscape UK: "Addressing the challenges and barriers disabled medical students and doctors face is a key to encouraging more people to join the profession, giving them confidence that a disability is not a barrier and that they will receive the support they need to fulfil their potential."

Need for Role Models With Disabilities 

For many disabled doctors that's often not the case. Hannah Barham-Brown is a junior doctor in Leeds and uses a wheelchair. She has the connective tissue disorder Ehlers-Danlos syndrome. She's also deputy chair of the BMA junior doctors committee.

"The challenges start when you want to become a doctor. I've spoken to students with disabilities who've been told you'll never be a doctor, you won't get into medical school so don’t bother trying," she says.

"There are no visible role models for doctors with disabilities, you are often looked on as a novelty."

Prof Melville says: "It’s really important to emphasise that having a health condition or disability alone is not a fitness to practise concern. We know one challenge can be the attitudes of others towards their ability to be safe and effective doctors.

Practical Challenges

"Some students and doctors are hindered by the failure of universities and employers to make, or even recognise, the need to make reasonable adjustments for disabled doctors so they can practise medicine effectively," says Prof Melville.

Dr Barham-Brown has experience of this. For one placement the hospital didn't realise she used a wheelchair until she emailed them a week before to check they were aware. They were not. 

"Moving jobs is the worst part. You often have to act as a go-between for occupational health and clinicians over issues like special equipment," she says. 

"The practical challenges are hard enough even before you have to convince patients and colleagues that you are up to the job. There's often a look of surprise from patients, some have asked me if I'm a real doctor. Colleagues may make assumptions that I'll need extra help and won't be able to work as hard," she adds.

Dr Barham-Brown says: "Doctors don’t know what to tell and what not to tell. People probably push themselves harder rather than dumping stuff on colleagues. I'm lucky I'm [using] a wheelchair. You don’t have to justify your disability if people can see it and you have a prop." 

Mental Health Issues

Some issues aren't always visible, for example mental health.

Dr Caroline Elton is an occupational psychologist who works with doctors. She's the author of 'Also Human: The Inner Lives of Doctors'.

"Medical students and doctors suffering from mental health issues can face considerable stigma. As a result, students and doctors often wait until they are at crisis point before getting help rather than trying to get support earlier on".

She says: "Whilst there’s an acceptance that training as a doctor can be intellectually demanding, the way in which the training can be psychologically demanding often isn’t adequately thought through.

"Inevitably, confronting illness, distress and death can generate anxiety in the healthcare professionals caring for patients. If a doctor becomes ill it muddies the water and reminds colleagues that doctors aren’t in fact that different from their patients. This is very unsettling, and can end up with the sick or disabled doctor being made to feel very unwelcome in the profession," says Dr Elton.

Dr Adam Kay is author of the bestselling medical memoir 'This is Going to Hurt: Secrets of a Junior Doctor'. He gave up medicine after experiencing stress and depression.

"There's a cultural problem ingrained in medicine whereby we don't like to admit that the job carries an extremely heavy burden. 'We're bloody doctors and we'll bloody get on with it' is the militaristic attitude, the bad days at work met with a stiff upper lip and a stiff drink," says Dr Kay.

"Until we start to acknowledge that doctors are human, and that openness and honesty about our feelings and our struggles are a good thing, not something to be ashamed of, mental health issues amongst doctors will remain hidden and stigmatised. And until that happens, we won't be able to stem the flow of doctors leaving the system, and - tragically - we'll continue to receive the awful news of doctors taking their own lives," he adds.

What Can Be Done?

The GMC hopes its updated guidance will encourage more people with disabilities and health issues to become doctors.

"We want to see improved access to the profession for disabled students, greater support for disabled doctors in training, and better practical advice to education providers. Finally, we want students, and doctors, to know what support is available and how to access it," says Prof Melville.

Dr Elton thinks the issue needs looking at from three perspectives:

  1. Working with career advisors at schools so students with disabilities aren't initially put off going into medicine.

  2. Raising awareness of disability rights at medical schools and beyond so people are better placed to challenge what can sometimes be a hostile culture.

  3. Raising the visibility of doctors with disabilities, perhaps having disability champions who other doctors and even patients can come to for advice and support.

At the moment in can be a very ad hoc system where doctors need to be their own advocate when it comes to sourcing specialist equipment and expressing what they require to help them.

"People should feel confident talking about disabilities and what they need. There should be an emphasis on constant assessment of needs and offering ongoing support. There should be a better structure especially when doctors move jobs or trusts," according to Dr Barham-Brown.

The GMC has worked with key stakeholder organisations, doctors and students to update the guidance for medical schools and postgraduate educators. The new version Welcomed and Valued is still an advisory piece of guidance and the GMC is currently consulting on the draft.

It's keen to hear from anyone with an interest in this area or whose  experiences can help them. The consultation is open until 20th September 2018.

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