The stigma of taking a year out from medical school
I have never felt as nervous as I did when I requested my year out from medical school. I’d never met anyone who had taken time out, and I wasn’t sure it was possible. You are supposed to put your head down and get on with it, aren’t you?
My first reason for taking time out after my second year of medical school was financial hardship. I had a job throughout the first two years of medical school, but as the third year approached I knew the spare time to earn some cash would get shorter, and my student loan would get bigger. I had overdrafts, no savings, and did not want part time work to hinder my clinical studies. I thought that a year out would enable me to earn and save enough to get through the final three years without working or building up any more debt.
But there was another reason—burnout. By the end of my second year I was exhausted and not sure whether I had chosen the right course. It was interesting, but I felt out of my depth and unsure of my abilities. I didn’t want to drop out completely, but I needed some time to reassess and to make sure medicine was what I really wanted to do. The dropout rate at UK medical schools is around 5-6%, and in a recent study half of the medical students who were asked reported feeling burnt out, and 11.2% reported suicidal thoughts.
Medical schools will generally allow time out for major life events such as childbirth, illness, or bereavement. But if medical students are experiencing such stress, should medical schools be more open to students taking time out for other reasons? To my surprise, my medical school was incredibly helpful. I met the sub dean of medicine and explained my request. He admitted that it was unusual, but he was supportive and talked me through the headings under which people are permitted a year out. These included: illness, parental responsibility, professional commitments, study abroad, compassionate grounds, and financial hardship. He then guided me through the application process. It was approved.
I had another reason for wanting a year out. I wanted to travel while saving money, and my year out turned out to be the best decision of my life.
I went to New Zealand and got a full time job as a phlebotomist, which was a brilliant skill to have gained. It is invaluable now that I am in my clinical years. This job took me closer to medicine. I was able to get involved and learn about the reasons for the tests I would be requesting as a doctor. I also gained a better understanding of colleagues in a multidisciplinary team and their role within the hospital. This re-ignited my passion for medicine, and by the end of the year I was reading Kumar and Clarke just for kicks.
Coming back was difficult. It was hard to return to the routine of studying for long periods, and I didn’t know anyone in my year group. Word of my year out travelled fast around the medical school. Some people seemed interested, but I also felt there was some disapproval about my decision. This predominantly came from consultants, but some junior staff too. I heard words to the effect of “that shouldn’t be allowed.” The implication was that I was not serious about medicine. I find this outrageous. I am more mature, more experienced, and more committed as a result of my year out. The idea that you will fall behind academically comes up repeatedly on blogs and discussion groups,  but I found it no harder than returning from a summer break. My third year exam results were my best yet. Since getting back I have been contacted by several of my peers who want advice about doing the same thing. After medical school there are opportunities to take time out. The General Medical Council allows you to take up to two years out between graduating and starting the foundation programme. Later on you can do an accredited foundation year 2 abroad, take a year or more out after foundation year 2 or after core training, or take a sabbatical during registrar training.
So, why is there less flexibility at medical school? It seems disgraceful that at a time when my fellow students are feeling lost, burnt out, and in need of a break, the options available to them are not widely known. My year out was invaluable—I am now fully committed to my career choice. There should be no stigma around taking a year off medical school.Bethan Conrad, fourth year medical student
1University of Cardiff, UK
Correspondence to: ConradBA@cardiff.ac.uk
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
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Cite this as: Student BMJ 2014;22:g4735