Editorials

Career advice for doctors with a chronic illness

The Career Focus matching scheme may help fill the gap

Career Focus bmj.com/content/vol322/issue7295/#CAREER

I have scleroderma. Eighteen months ago I was advised by an occupational health physician to retire from the NHS on grounds of ill health. I was 30. Determined not to let my medical skills go to waste, I was left on my own to find a niche for myself which matched my health needs and allowed me to carry on working. My situation is not unique, and in this week's Career Focus (BMJ Classified p 2) some doctors who have chronic illnesses summarise their experiences and give advice to other doctors who may find themselves in a similar position. This week also sees the launch of Career Focus's mentoring scheme for doctors with chronic illness.

Doctors who have a chronic illness have a rough deal. As well as having to come to terms with their illness, they also face problems in 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 ill doctors wondering whether they can continue working in a position that makes little allowances for their health needs.

If they were classified as having a disability the Disability Discrimination Act would make it illegal to discriminate against them in this way, and employers would be forced to accommodate them. The BMA has supported meeting the needs of doctors with disabilities,¹ and it has recently criticised the medical undergraduate course for not adapting to take account of the needs of a student in a wheelchair.²

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." It wants improved career advice and support in obtaining reasonable adjustments to working conditions for doctors and medical students with a disability.¹ The BMA's definition would include doctors who have a chronic illness, but with a few rare exceptions (see Career Focus next week) doctors with a chronic illness do not get the support owing to disabled doctors. Moreover, most doctors with a chronic illness would not classify themselves as disabled.

Valuable support to many ill doctors is offered by the BMA's stress counselling line, the Sick Doctor's Trust (for chemically dependent doctors), the Doctor's Support Network (for mentally ill doctors), and the National Counselling Service for Sick Doctors (which advises ill doctors and their colleagues on how to seek professional help).* However, there is a gap in providing careers advice for doctors who have a chronic mental or physical illness or disability.

The Career Focus chronic illness matching scheme, a joint project between the BMJ, BMJ Classified, and the BMA, is designed to help fill that gap. It provides an opportunity for doctors who have a chronic illness or disability to receive informal careers advice from another doctor.

The concept is simple. Doctors can ask to be matched with a doctor who either has the same illness or disability or with someone working in a particular specialty. The scheme therefore also relies on doctors from all specialties and general practice who do not have a chronic illness to apply as informal career advisers. Doctors can also ask to be matched by grade and country. The scheme is entirely web based, with individuals' details and preferences held in a secure database. When a doctor who meets the requested requirements applies I will send both doctors 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 the advice provided, but I hope that this service will provide doctors who have any physical or mental illness or disability with useful advice that will help them find a career option that suits their health needs. It may help another doctor find an alternative to retiring on ill health grounds at the age of 30.

Rhona MacDonald, Editor, Career Focus. 

BMJ

Acknowledgments

*BMA Counselling Line 08459 200169; Sick Doctor's Trust 01252 345 163; Doctor's Support Network 07071 22 3372 or email lizzie.miller{at}talk21.com; National Counselling Service for Sick Doctors 0870 321 1753 or www.ncssd.org.uk