Some doctors need special careers advice

The new chronic illness matching scheme may help fill the gap

Ihave scleroderma. Eighteen months ago I was advised by an occupational health doctor to retire on ill health grounds. I was 30 years old. Determined not to let my medical knowledge and skills go to waste, I was left to find a niche which was more suitable to my health needs and allowed me to carry on working. My situation is by no means unique and in this month's Career focus article, some doctors who have chronic illnesses summarise their own experiences and give advice to other doctors who may find themselves in a similar position.

Unfortunately, doctors who have a chronic illness have a rough deal. Not only do they have to come to terms with the effects of their illness, they also find that their situation has implications for their career. Inflexible working patterns, poor contingency cover, and colleagues who are "sympathetic until it affects them" often add guilt to an already difficult situation and leave the doctors wondering whether they can continue working in a position which makes little allowance for their health needs.

If the doctors were classified as having a disability, it would be illegal to discriminate against them in this way, and employers would be forced to accommodate them.1 The BMA has supported meeting the needs of doctors with disabilities2 and Ian Bogle, chairman of the BMA council, has recently criticised the medical undergraduate course for not adapting to the needs of a student in a wheelchair.3 The BMA defines disability as "the end result of either mental, physical, or sensory impairments (and people can be healthy with such impairments) or long term ill health (which can limit functional ability). Either case can result in a loss or limitation of opportunities." The BMA says that part of the solution to tackling the problems faced by doctors and medical students who have a disability is to improve careers advice, increase general support, and help them to obtain reasonable adjustments to working conditions.² From the BMA's definition, this should include doctors and medical students who have a chronic illness but, unfortunately, with a few rare exceptions this is not the case. In addition, most doctors and medical students who have a chronic illness would never consider classifying themselves as "disabled."

I recognise the valuable support offered by the BMA's stress counselling line4; the Sick Doctors Trust (support for chemically dependent doctors)5; the Doctors Support Network (for mentally ill doctors);⁶ and the National Counselling Service for Sick Doctors, which advises sick doctors and their colleagues how to seek appropriate professional help for their health needs.^{7 8} I also recognise the need to regulate doctors whose own health is putting their patients at risk.9 But I am keen to fill the gap in providing careers advice for doctors and medical students who have a chronic mental or physical illness or disability.

This month sees the launch of the Career focus chronic illness matching scheme, which is a joint project between the BMJ, BMJ Classified, and the BMA. It provides the opportunity for doctors and medical students who have a chronic illness or disability to receive informal careers advice from another doctor. The concept is simple. You can request to be matched with a doctor or medical student who either has the same illness or disability as you or with someone working in a certain specialty. The scheme therefore relies on doctors from all different specialties, including general practice, who do not have a chronic illness to apply as informal career advisers. You can also request to be matched by grade and country.

The scheme is entirely web based and communication is purely electronic. When you complete the form at the following URL: http://web.bma.org.uk/public/chill.nsf, your details and preferences will be held in a secure database. When a doctor or medical student who meets your requirements applies, you will both be sent each other's email address. The rest is up to you. However, it might take some time for a suitable person to apply, so please be patient.

Career focus cannot be responsible for any advice that you may receive, but I hope that this service will provide doctors who have any kind of physical or mental illness or disability with some useful advice which will help them to find a career option which suits their health needs. I hope that it may also help another doctor to find an alternative from retiring on ill health grounds at 30 years of age.

Rhona MacDonald, editor, Career focus
Email: rmacdonald@bmj.com


studentBMJ 2001;09:171-216 June ISSN 0966-6494

1. Disability Discrimination Act 1995. London: HMSO,1995.
2. British Medical Association. Meeting the needs of doctors with disabilities. London: BMA,1997.
3. Bogle I. Disability no link to ability. BMA News Review 2001 Feb 10:25.
4. BMA counselling line. Tel: 08459 200169.
5. Sick Doctors Trust. Tel: 01252 345 163.
6. Doctors Support Network. Tel: 07071 22 3372; email: lizzie.miller@talk21.com
7. National Counselling Service for Sick Doctors. Tel: 0870 321 1753; www.ncssd.org.uk
8. Anderson W. Doctoring doctors. bmj.com/cgi/content/full/319/7205/S2­7205
9. General Medical Council. Helping doctors who are ill. London: GMC,1997.