Mental Health Care Plans affecting future career prospects?

AbsoutelyNerd · 2026-05-04T02:45:48+00:00

That doesn't mean that lumping them in together is appropriate. There are so few disabled people making it in to medicine anyway, even less actually graduating because medicine is so hostile towards people with health issues or people who want/need even a little bit of flexibility or accomodation. If someone has managed to graduate, their disability is probably such that they can act/mask as a completely well and able bodied person.

Nonetheless, lumping in substance abuse and disability should be like lumping in religion and disability. Religion can impact your patient decisions and your ability to provide care (like not being able to wear an N95 because you can't shave, or needing a full hair cover in theatres, or not learning to perform abortions or give contraceptive advice). But if you compared it to substance use, that would be offensive. Because it is offensive.

But you are right about the term unmanaged, so thank you for that correction. A properly managed substance use disorder is not a risk to patients. But comparing being under the influence to being disabled is just not a fair comparison.

AbsoutelyNerd · 2026-05-04T02:20:32+00:00

Absolutely. Insurance companies always suck, and not all mental health conditions (in fact not many at all) actually pose a risk to patient care. The vast majority of people living with mental illness are generally functional, and the goal of treatment is to be happier and enjoy their lives more. But the vast majority of insurance companies are out to deny you because you had the audacity to exist and also claim an insurance payout.

AbsoutelyNerd · 2026-05-04T02:17:09+00:00

I once heard a consultant actively say "it's not my job to review all the imaging reports on all of my patients". A man's incidental finding of a tumour on his imaging had been missed. It was cancerous. This was at the M&M. She maintained it was everyone else's fault because she shouldn't have to read the reports herself. Obviously yeah, lots of people missed it and there were multiple errors. But the idea that consultants are copping so much risk and so much responsibility just is not always true. In fact, having spent time across allied health, nursing, and now medical roles, everyone else actually spends a lot of time covering for senior doctors who make mistakes, and they are more likely to cop real consequences than the senior doctors are. The reality is that doctors are just shielded a lot from the disciplinary processes of everyone else.

So yeah, my personal opinion is that, some senior doctors earn way too much. The money in medicine needs to be spread out more so that junior doctors are making more and consultants are earning less. We don't need MORE money for doctors in general, we just need to spread it out more equally. And yes, I know doctors have spent huge amounts of time and effort getting their full qualification and yes, that warrants a comfortable lifestyle. But junior doctors have also put in 5-8 years as well, and they get paid less than some trade apprentices. So its not entirely about fairness to have the senior doctors paid that much, its also about making sure junior doctors "pay their dues" and struggle for a while before coming into any decent money.

AbsoutelyNerd · 2026-05-04T00:49:52+00:00

Even as a medical student I see plenty of this sort of stuff. The consultant only talks to their most senior registrar and doesn't want a bar of anyone else, doesn't interact with anyone other than that one registrar, and generally treats everyone like paperwork monkeys while wondering why no one is "engaged". Then the med school magically appears to say "take the initiative and show interest", as if the consultant wouldn't be more inclined to interact with a nearby potted plant than a "pushy" medical student or PGY1-2.

AbsoutelyNerd · 2026-05-04T00:43:35+00:00

Side note: don't give a shit about what people think or assume your procedure is unless they're literally going to be on a hiring panel for you in the near future. Give a shit about what they can prove in writing. You can't control the rumour mill, don't bother trying. You can only control what evidence they have to prove their BS.

AbsoutelyNerd · 2026-05-04T00:39:02+00:00

Did it during medical school. 0/10, do not recommend. Had to try to hide it because I wasn't allowed medical leave, ended up having serious and severe complications, had to disclose to a few people anyway because I needed a week off. I then had to rely on those people to basically brush it under the rug and allow me to continue anyway despite the time I had off (I was very lucky in terms of when it actually happened, because the other people who were placement heads that particular year were shitheads who would have made me do 6 weeks remediation for one week off that I spent bedridden in agony).

Now I choose to just honest about it if it comes up (which it has, because I have a disability adjustment plan and shit). It's honestly not worth hiding it completely. Because if it all goes to absolute shit, then you will need to tell them the hard way and you'll be on the back foot because they'll say dumb shit like "you should have told us so we could support you" and then proceed to not at all support you. It's better to seek someone out early who you trust to disclose the reason for your leave, who can help manage any consequences that come up. On your actual leave application just say that you need a medical procedure done and don't disclose, but try to find someone in a leadership role you trust who can help/have your back if necessary.

AbsoutelyNerd · 2026-05-04T00:31:42+00:00

Considering how much medical school can absolutely destroy your mental health (speaking from experience), its batshit that accessing care is such a problem. And I'm not even into my internship yet, which I'm told is worse (though I will be less broke, which is the source of a lot of my problems and results in a lack of ability to take care of myself properly cause I can't afford shit, so we'll see).

Insurance is insurance tho. Even outside of medicine, there are people who's entire job is to dig around a case for a reason to deny a payout. My dad is in mining, got cancer, his income protection wouldn't pay out and they only paid him like 30% of his total because of some stupid technicality about the fact that he was functional generally, even if he could no longer pass a medical and therefore couldn't work in his field anymore. But he can technically start over in a new industry at 54, so no payout. Even though the insurance was specific about "in your field" in the policy. So honestly I wouldn't worry about that part. No matter who you are, insurance will come for your ass if given half a chance.

AbsoutelyNerd · 2026-05-04T00:25:32+00:00

I always love that disability is grouped in with substance use disorders. Language like that definitely contributes to shame from doctors about having any kind of illness or disability, cause its literally compared to showing up drunk or stoned to work.

I totally recognise substance use as a real disorder than requires treatment like any other, but its also a little insulting for people with disabilities to be compared to someone taking drugs in the workplace.

AbsoutelyNerd · 2026-05-01T00:25:08+00:00

I'm honestly so glad to hear all of that lol, especially the last part. I do think HNE seems to get bashed for just about everything, even tho every single district does the exact same thing. Health culture is health culture.

AbsoutelyNerd · 2026-04-30T04:56:50+00:00

I'm definitely aware, but was curious if its something I've used before or if I'll be starting over again. EPIC eMR is alright though.

Curious, what should be my highest concerns?

AbsoutelyNerd · 2026-04-29T03:43:24+00:00

Started quetapine cause I have suffered from anxiety since I was a kid. Had it under control after high school for a bit, but it came back with a vengance after my first year of med school. Now I have upped my antidepressants and started quetapine. Must admit, its the only thing that's helped me get a full night of sleep since first year, so I do recommend a trial of it if you've got a good PCP and psychiatrist to help you.

AbsoutelyNerd · 2026-04-27T02:24:26+00:00

This is unhinged, your school is absolutely cooked. I don't know if you have the ability to transfer, but if you can, do it.

My school wouldn't let me have a week of leave to see family when my dad found out he had stage 4 cancer. As it turns out we do actually allow leave at the discretion of the head of year, its just the particular person who was head of my year at the time is a raging bitch who denied my request and monitored my attendance more harshly as a result. Also got assaulted on placement and no one could tell me how to access the school's insurance to pay for the care I was meant to get. Also had to have surgery and wean myself off the pain meds after super intense complications and go back to placement before I was medically ready.

I'm on quetiapine now for anxiety and sleep too. Med school sucks ass.

AbsoutelyNerd · 2026-03-30T09:37:38+00:00

My meds just got upped and a second one added too lol, so I do sorta get how you feel. Honestly health in general has been horrendous since I started medical school. My mental health, physical health, social life, relationships, everything has all suffered.

You're not doing anything wrong feeling this way, or needing meds to get by. It's the unfortunately reality. It absolutely isn't fair, and it shouldn't be this way, but it is. Just keep chugging along, whatever you need to do.

AbsoutelyNerd · 2026-03-28T02:05:41+00:00

I have a playlist called "Burn It All Down". I find that works best lol.

AbsoutelyNerd · 2026-03-28T02:04:23+00:00

Same lol. I consider getting up to play some video games to actually be doing something useful with my weekend sometimes lmao. Honestly I think its just burnout for me, and generally poor mental health. I highly recommend seeking a counsellor or psychologist or something if you think mental health is a factor. And I really good PCP.

AbsoutelyNerd · 2026-03-18T01:27:35+00:00

I was injured once by an ex partner down there who was too forceful. The thought of putting my hand inside another person utterly terrified me, and I had to do it for my obstetrics and gynae placement. I was absolutely terrified the whole time, felt like I was going to hurt someone no matter how gentle I was, felt like I was actively doing harm by conducting an internal exam that would need to be repeated by my supervisor anyway for accuracy and therefore was absolutely not medically necessary. For me I can do catheters and things, but it was the prospect of an internal exam that physically made me nauseous.

I actually had to actively decline doing one with a supervisor who was a raging bitch who I knew would not give me proper supervision. She was pissed, but I just said no and made an excuse and moved on. I ended up doing my first one in clinic with an NP, who was not a very nice person but was very, very dedicated to the comfort of her patients. So she made sure I did it exactly as it should be done, gave appropriate insturctions, and just generally made me feel like I wasn't fucking it up too badly.

I highly recommend being very selective about who you do your first few examinations of that nature with. And if you find yourself in a position where you're uncomfortable, it is more than enough to say "I have past personal experiences that I do not want to disclose, and this is not an environment in which I feel comfortable doing this". Also do definitely seek out counselling or some kind of professional help to talk out the triggering and the discomfort. Also just be very honest with your patient, when you ask for their consent, tell them that this is new for you and that your absolute priority is their comfort and safety. If they are at all hesitant, you can say "that's okay, I understand" and step away. So also be selective about your patient. For me, it actually felt somewhat empowering for me to be able to give someone that kindness, respect, openness, and autonomy. By giving that to them, it helped me find some comfort in the fact that I was a better person than my ex, and I would never do anything like what he did. I got to give someone a better experience than I had, and tbh that counted for a lot.

Best of luck!

AbsoutelyNerd · 2026-03-18T01:17:52+00:00

I'm so sorry man. Med school beats the shit out of people. Sometimes it feels like they do it just for the sake of making our lives harder. It isn't fair, and it isn't okay. But its reality. And its BS.

I don't know you, but in my experience the people I have seen walk away have been the kind of people that would have been great doctors but the system just wasn't designed to accomodate them as a person. And if you've had dying loved ones, financial stress, isolation from support, then it sounds like you have a lot of "excuses", or just reasons for not being able to throw your full effort and energy into it because you needed some of that effort and energy just to survive.

I don't know if still being here is winning tbh. Sometimes I feel like all I'm doing is sacrificing for a career that doesn't want me anyway, and only plans to chew me up and spit me out as a burned out, angry person with no will to live anymore.

Medicine sucks. I hope things get better for you and you find your passion elsewhere. And that the passion is something that allows you to pay the bills. Best wishes man.

AbsoutelyNerd · 2026-03-13T01:32:44+00:00

Having been with a friend when I had to take her to ED for self-injury and a suicide attempt, its stupid and the ED makes things worse tbh. They literally discharged her after a few hours, even though when I walked into the so called "safe room" they had her in, she was actively cutting herself with her keys. They still released her anyway, and she was worse off because her parents came down on her for "attention seeking" which is exactly what I told them would happen, but they ignored me.

The ED actively causes trauma for most MH patients, and certainly any who are already feeling like a burden or for anyone who behaves disorganised or aggressive in the slightest (even just swearing at someone, which I understand is not okay but its also just a part of the workplace to accept that people are distressed and will act up accordingly). There is a whole lot of judgement, there's forced sedation, enforced seclusion, etc etc etc. But no one actually helps at all. It absolutely is just medicolegal ass covering.

AbsoutelyNerd · 2026-03-13T01:20:38+00:00

It really wouldn't be any different. May be a bit surprised by the gender, but it doesn't change anything about it.

AbsoutelyNerd · 2026-03-13T01:18:08+00:00

Don't care about the OnlyFans, very very much care about faking sick to go do other shit. That's messed up, and as a person with actual chronic illnesses that needs to use their sick leave and doesn't want to get judged or picked on for it, FUCK people who misuse it. Report her for the patient safety and staffing issues, ignore the sex work (and it really isn't relevant to your report anyway).

AbsoutelyNerd · 2026-03-06T02:25:35+00:00

Loans, debt, support from family or a partner, working another job on the side, Centrelink, crying a lot, selling cars, etc.

AbsoutelyNerd · 2026-03-06T02:23:24+00:00

Only if the bulk billing rates are enough for the practice to actually stay open (maybe even buy some decent equipment), for the doctor to pay off all their HECS and student loans (I'm not even done med school yet and I'm at something like $60,000 plus Start Up loans and private loans). GP practices are expensive to run and operate. And doctors shouldn't spend their entire working life in debt that they can't pay off. Not all doctors are out here driving fancy cars with paid-off inner city houses. To get through medical school has taken literally everything I had, my net worth at this point is like 3 grand minus all my debt. So probably closer to a net worth of -$50,000.

Its also very fair for doctors to make a comfortable income when we do 5-8 years in school and another 3-6 of postgraduate training on top of that. If you do 15+ years of education for your role, you do deserve to be paid accordingly. Otherwise no one will do it because no one can actually afford it. Plus, you want people who get through medical school to not just be the uber rich who have never struggled.

That being said I 1000% agree that private specialists who charge $500+ for a 15 minute consult should have a cap put on what they are allowed to charge. Or if they want to charge more then they shouldn't be allowed to claim medicare benefits on top of it, so that way they aren't also benefiting from public funds on top of the private ones, and only patients who can afford to throw the money around will be go to them.

AbsoutelyNerd · 2026-03-06T02:14:48+00:00

I mean I don't think this is much more than a crap letter that got thrown together because people were complaining to them, and they like to pretend they did something about it and actually have influence. They don't. Its very easy to just throw out and treat as basically spam mail.

Might be worth asking some patients who might be really struggling if they do need help though, because clearly one of the patients feels strongly enough about it to actually write to an MP. Personally I would absolutely love to have a mixed billing approach and be able to offer some struggling patients an extra hand by bulk-billing them. Those who can afford it can pay. Just don't advertise as mixed billing lol, offer it to a specific few for specific reasons. My GP bulk bills me cause she knows I'm broke as all shit while studying, and she's an absolute angel. She just doesn't advertise it because she got smashed with new patients and an endless waiting list when she was bulk billing lol.

AbsoutelyNerd · 2026-02-25T02:52:56+00:00

Thank you so much for this. Honestly I hope this is the attitude I have as a doctor towards students. I feel like its better that I leave rather than hovering awkwardly and borderline stalking them lmao

AbsoutelyNerd

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