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‘Abundant’ mental health supports for TCD medical students – Deputy Head of School

By Catherine Reilly - 16th Feb 2024

Trinity College Dublin (TCD) has “the most abundant mental health supports of any third-level institution in the country”, the Deputy Head of the School of Medicine Dr Joseph Harbison has informed the Medical Independent (MI). He was responding to queries on concerns raised by students during a Medical Council accreditation process in 2022 and actions taken by the School.

In a written response to MI, Dr Harbison stated: “A welfare officer has been specifically appointed to the School to help coordinate student access to these [supports] and increased information has been provided to students on where and how to access help. All TCD clinical sites are within the Dublin region and student welfare support visits the main teaching sites every week.”

Fifth year students who met the Medical Council assessor team in February 2022 believed mental health support was “lacking” from the TCD School of Medicine, according to the accreditation inspection report.

“The year five students were eager to raise their concerns about the perceived lack of mental health supports. The students felt that there was an unfair emphasis put on them to recognise and report students who may be struggling but that there was no dedicated person to report these concerns to.”

The fifth year students stated it was “difficult” to get GP and counselling appointments and that they received a very limited number of counselling appointments each year.

“Students described the waiting list for appointments as ‘months long’. It was felt that the counselling service does not reach those who need it most. Students were unaware of the additional evening and weekend counselling sessions available for medical students. The students believed academic and mental health support is lacking from the School of Medicine.”

However, first year students who met the assessor team said they knew where to go if they had a mental health issue, and they received a lecture from Student Health on the supports available.

Stress levels were raised by a group of student representatives and second year students. The second year students said exam time was “extremely stressful” as performance was solely reliant on end of year exams.

In 2018, a Council assessor team also heard concerns from TCD medical students about mental health support. “A number of third- and fifth-year students reported, both verbally and in writing that they experienced a high level of stress. The supports provided by Trinity College and the School of Medicine for students were not effective,” according to a major finding from the Council’s 2018 inspection.

This report was approved by the Council in 2020 and TCD/the programme was accredited for two years. The School of Medicine was required to develop an implementation plan to address the Council’s recommendations.

2022 recommendations

The 2022 inspection of the TCD School of Medicine is the most recent of the Council’s undergraduate accreditation reports to have been published.  

The Council accredited TCD/the programme for five years without conditions. It issued 26 recommendations, including that the development of a renewed curriculum is taken forward as a high priority; that the School examines/reviews the balance of formative and summative assessments across all years; appoints student liaison support officers across all clinical sites; and actively engages with the student representatives in providing feedback on issues raised by students.

The programme was commended on eight specific grounds, including the “well-developed Global Health component of the curriculum” and the “impressive” number of students attending each of the meetings.

In regard to the curriculum review, Dr Harbison informed MI this had commenced and is expected to be completed in 2028.

A review of assessment is part of the process of curricular reform. An assessment group has been set up to review practices and assessment policy within the School.

A new discipline for medical education has also been established with academic staff appointed.

Commenting on academic support at clinical sites, Dr Harbison stated that all sites have either a tutor or a member of staff responsible for the Trinity students. “Some sites take as few as one or two students at a time and the provision of a full-time tutor would not be possible. Larger sites all have tutors.”

In regard to an issue raised by fifth year students concerning frequent cancellation of on-site tutorials, Dr Harbison said: “Tutorials in year five are predominantly provided by consultant staff who clearly have a multitude of responsibilities and must prioritise the care of patients. Where possible they will reorganise their tutorials if they miss them but that is not always possible. We note that the new consultant contract makes even less reference to the role of consultants in education than the prior contract.

“The school organises an excess of tutorials (eg, 20-25 hours/ week) to allow for the fact that some may be cancelled in the second semester of year five and it is explained to students at the beginning of the year that this is the case.”

‘Satisfied’

According to the Medical Council, TCD School of Medicine was asked to respond to recommendations made in the 2022 report via an action and implementation plan.

The Council’s spokesperson said: “The plan contains all recommendations detailed in the final report and the medical school was asked to respond to each recommendation, indicating how compliance with WFME [World Federation for Medical Education] standards will be maintained and/or improved. TCD medical school representatives were invited to present the plan to key personnel in the Medical Council. The Medical Council was satisfied with the progress made to date, and ongoing progress will be monitored via the annual returns process for the duration of the accreditation.”

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