Psychiatric Adverse Events in Medical School

Medical Students Face Extraordinary Pressure

Medical students are not immune from the pressures of a professional program. Indeed, medical students can face significantly greater academic and clinical challenges than students in other graduate and professional programs. Those extra pressures of medical and clinical studies and step and other exams can aggravate a medical student's underlying psychiatric disability or combine with other conditions and circumstances to trigger serious psychiatric adverse events. Despite their medical knowledge and studies, or even because of the pressure of those studies, medical students can have psychiatric meltdowns just as readily as or more readily than students in other graduate and professional programs. A National Library of Medicine journal article confirms, “Medical education and training can directly contribute to the development of psychological distress in medical students. This can lead to catastrophic consequences such as impaired academic performance, impaired competency, medical errors and attrition from medical school.” The American Medical Association urges medical school students to adopt remedial behaviors to avoid the seemingly inevitable medical student burnout that heavy study loads, heavy workloads, patient mortality, and separation from family and other social support networks can bring about. The message is to take care of yourself because psychiatric adverse events are not only possible but likely.

Typical Medical Student Psychiatric Conditions

As part of the general population subject to mental and emotional disturbance and disability, medical students can suffer the same psychiatric disabilities and adverse events as anyone else can suffer. Medical students can suffer depressive disorders, bipolar disorders, anxiety disorders, borderline personality disorders, and schizophrenia, just like other individuals from the general population. Medical school pressures may aggravate these preexisting conditions or cause these conditions' first development and manifestation. But the pressures of medical school can also combine with the natural tendencies of medical students to produce particular patterns of psychiatric symptoms with their associated adverse events. Driven and competitive medical students may, for instance, especially suffer from manic-depressive swings, obsessive-compulsive behaviors, cutting and eating control disorders, and self-medicating behaviors. The American Medical Association also recognizes how medical students may attempt to compensate for psychiatric conditions, such as isolating themselves, hiding feelings they would ordinarily express, and abusing substances to assuage their suppressed guilt and hidden feelings. Medical students can experience psychiatric adverse events, veritable meltdowns, impacting their ability to continue their effective studies.

Medical School Accommodations for Psychiatric Disabilities

Federal disability laws like Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973 require schools receiving federal funds to reasonably accommodate students with disabilities. Section 504, for instance, extending protection to qualified individuals with disabilities, protects students with a physical or mental impairment substantially limiting one or more major life activities. Medical school students with psychiatric conditions like bipolar disorder, borderline personality disorder, and schizophrenia can easily qualify for federal disability protections, requiring the medical school to offer the student reasonable accommodations. The Association of American Medical Colleges gives several examples of accommodations that a medical school may offer disabled students, including extending test times, adjusting schedules, and providing readers. But medical school procedures for determining what accommodations to provide can be just as important as the accommodations themselves. The Association of American Medical Colleges recommends these medical school accommodations practices:

  • Employ a disability services provider who knows accommodations and other supports
  • Ensure that disability services providers have training in accommodations and other supports specific to medical settings
  • Conduct an assessment of existing accommodations and support services through an outside expert in disability accommodations
  • Offer a clear process for requesting accommodations that does not involve disclosing sensitive personal information directly to a colleague, dean, or supervisor
  • Post disability policies and procedures for requesting and accessing accommodations on the medical school's website
  • Normalize help seeking behavior, including offering time off for regular mental health appointments

Diagnosing Medical Student Psychiatric Conditions

Medical schools may not always recognize and accommodate the student with a psychiatric disability. School officials may not believe the student has such a disability or needs the requested accommodations. Thus, when the question comes to getting the medical school's accommodation for psychiatric disorders, reliable diagnosis and documentation is key. When the medical student has a qualified clinician make a recognized psychiatric disorder diagnosis documented in a comprehensive report with accommodation recommendations, the medical school is far more likely to grant the accommodations. The University of Chicago, for instance, maintains a Psychological Disability Accommodation Policy. That policy encourages the school to recognize psychiatric diagnoses made by psychiatrists, other medical doctors, clinical psychologists, and clinical social workers. The diagnosis's documentation should include the methodology, relevant history, functional limitations, treatment recommendations, and prognosis. You are far more likely to receive psychiatric disability accommodations, while avoiding disciplinary issues, when you have such documentation.

Medical School Psychiatric Events and Disciplinary Issues

The problem, though, is not just that medical school can lead to psychiatric events and issues that the medical school should be reasonably accommodating. The problem is also that psychiatric events can trigger other medical school problems. The same National Library of Medicine journal article quoted above confirms that medical program stress and the psychiatric events it produces “can lead to catastrophic consequences such as impaired academic performance, impaired competency, medical errors, and attrition from medical school.” The medical student's stakes are that serious. Medical schools must maintain satisfactory academic progress (SAP) standards meeting federal regulatory requirements summarized by the Association of American Medical Colleges. Medical schools must also maintain student conduct, professionalism, and honor codes like the ones at UCLA's David Geffen School of Medicine. Impaired academic performance, errors in medical judgment, and unprofessional conduct caused or exacerbated by psychiatric issues can lead to disciplinary charges, findings of disciplinary violations, and resulting suspension and dismissal from medical school. Psychiatric events can not only lead to impaired studies, impaired clinical performance, and unprofessional conduct but also extended absences for recovery and treatment. Psychiatric events can cause or exacerbate medical school disciplinary issues.

Psychiatric Disability Defense to Medical School Issues

Given their federal disability law obligations, medical schools should be accommodating psychiatric disabilities, not using those disabilities to condemn, charge, and punish medical students. Psychiatric adverse events should, when properly interpreted, be defenses to disciplinary charges, not evidence of those charges. Medical school officials, though, may take substantial convincing for them to appreciate the role that the psychiatric disability and adverse event played in bringing about what those officials have charged as misconduct. The medical student must generally show the disciplinary officials the psychiatric diagnosis, how its expression contributed to the academic, professionalism, or other misconduct issues, and how reasonable accommodations can help the student come back into compliance with medical school policies and standards. Psychiatric disabilities and adverse events can be compelling defenses to disciplinary charges. But proving that defense takes skilled advocacy. Retain national student defense attorney Joseph D. Lento to make your case for a psychiatric adverse event defense. Don't let disciplinary charges ruin your medical education and career when skilled, experienced, and effective attorney advocacy can defend and defeat those charges.

Protective Procedures to Prove a Psychiatric Event Defense

Medical schools, like other graduate and professional programs, have disciplinary procedures for students to invoke to challenge false, unfair, or unsupported disciplinary charges. National student defense attorney Joseph D. Lento knows how to identify and strategically deploy those procedures for your best defense of disciplinary charges. Those protective procedures that a medical student with a psychiatric disability can invoke include:

  • Grade appeal procedures correcting subjective or unfair grades unduly influenced by an unaccommodated psychiatric disability
  • Satisfactory academic progress appeals to show the psychiatric event as a special circumstance for relief from those requirements
  • Informal resolution opportunities for behavioral, academic, and sexual misconduct charges relating to a psychiatric adverse event
  • Formal resolution investigations, reports, and hearings for misconduct charges, including witness presentation and cross-examination
  • Appeals of misconduct findings made out of bias, conflict of interest, or irregularity in the proceeding, or on newly discovered evidence
  • Alternative relief through oversight channels like ombuds offices, general counsel offices, and outside retained counsel

Premier Attorney Available for Psychiatric Event Defense

You have invested an extraordinary amount in your medical education, far too much to risk losing or impairing that education because of disciplinary charges relating to a psychiatric adverse event. If a psychiatric event has contributed to academic progression or misconduct issues in your medical school program, the best thing you can do is to retain a skilled and experienced student defense attorney to convince school officials to give you the special relief you need and deserve, and your medical school owes you. Retain national student defense attorney Joseph D. Lento and the Lento Law Firm for a winning defense of medical school disciplinary charges. Attorney Lento has successfully defended hundreds of students nationwide on disciplinary charges in all kinds of programs and at all levels. Call 888-535-3686 for a consultation now or use the online service.

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If you, or your student, are facing any kind of disciplinary action, or other negative academic sanction, and are having feelings of uncertainty and anxiety for what the future may hold, contact the Lento Law Firm today, and let us help secure your academic career.

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