This is the original version of a piece I wrote in 2016 exploring mental health issues facing veterinary students. An edited version of this story was published in VetScript in September 2016 – you can view it here.
It’s a familiar scene. We sit in restless quiet in a too-hot room, pens shuffling against refill pads, laptop keyboards clicking, as we try to keep our notes coherent, notes that all too soon will be our lifeline for exam study, but right now are vanishing into the sleepy haze of afternoon lectures. The lecturer keeps talking, flicking through slide after slide, assuming we are paying full attention, because we are supposed to be young professionals now, supposed to be better, somehow, than we are. I check my watch every minute, because every minute feels like ten. When the lecturer finally closes down the PowerPoint and the familiar Massey logo appears on screen, we stumble to our feet, inertia replaced by movement as we try to be first out the door.
Biking home alone, I cry into the rain, wishing someone would see me, stop me, notice that something’s wrong. But no one does. Once I make it home, it’s a hot cup of tea, crackers, and I drag out the chocolate I have hidden in the back of the pantry ‘for emergencies’, choking on a slightly hysterical laugh-or-maybe-sob because there hasn’t been a single day this semester when the chocolate tin has not needed to come out. Collapsing into my desk chair, armed with food and drink, I pull out my books, laptop, pen, and prepare to work.
Sometimes before I can start I have to pace the room, restless and trapped, looking for a way out when everything that’s holding me is inside my head. Sometimes I collapse on my bed and stare at the wall, seeing nothing, with tears running into my hair. Sometimes I just sit hunched over the desk, head in hands, until that demanding little voice inside drives me up and to work. It always does, sooner or later. This is a normal day in vet school; there is always work to do, and I can never let myself rest from the constant squeezing pressure.
Vet is a five-year undergraduate degree only offered at the Manawatu Massey campus. Entry is competitive, with approximately two thirds of applicants being cut after one semester of general science papers. Only an A average will do – it’s a responsible job so we have to be the best. The part that no one seems to realise is how it is slowly crushing us, breaking us, driving us insane. The truth is, the student counseling service saw approximately 28% of the vet school last year. In comparison, only 9.5% of students from other degrees were in counseling that same year. This suggests mental health issues are a significant problem for veterinary students.
Consider also the warning that flashed up when we enrolled in our third year papers. Harsh, in your face, red type told us blankly that the workload for this course exceeds recommended levels. We don’t have the option to reduce our study load, but that red type is still there telling us we are being set up to fail. There is always work to do; so we tell ourselves just to do it, and we kid ourselves that if we just work a little harder it will all go away.
There is a constant struggle between the massive workload and never enough time to do it. A simple model for good life balance is the 8+8+8 rule: 8 hours study, 8 hours sleep, and 8 hours for nurturing yourself. The problem though, is that those last 8 hours have a way of disappearing. In vet school you spend 7-8 hours in class every day, but you still need a lot of time outside of class to study or work on assignments. Then there’s commuting to and from Massey, cooking meals, buying groceries, and running errands. Those eight hours rapidly get used up without you even noticing.
Of course this is true for many students, but the sheer volume of material covered in the vet degree makes it especially difficult to keep on top of things and stay healthy. As fellow student Anna says, “Vet school keeps moving like a freight train.” Her story is of multiple nervous breakdowns, inability to make simple decisions, and the feeling that her own brain was rebelling against her. After long experience with mental health issues, she knows exactly how to deal with them. The problem is having time to do the things she needs to do – cook healthy meals, go to the gym, even relax and watch a movie. “Time becomes a currency,” she says, “and you only have so much to give”. Often it feels that if we are to have a hope of getting through the degree, we have to sacrifice every other thing that matters.
One common misconception is that the vet degree is very competitive. Although the initial selection may be tooth and nail, once you make it, you generally stay in. As we were told more than once in our first days as timid and slightly shell-shocked ‘baby vets’: there is a degree for everyone, you don’t have to compete any more. Instead we were encouraged to form what the head of Massey student counseling service, Mark Rainier, describes as both the strength and the Achilles heel of vet school: the cohort. For the next four-and-a-half years, from selection through to graduation, a vet class stays together, and usually bonds strongly. We describe ourselves as family, share notes, and celebrate or commiserate together. It’s a support system that is perhaps the only way of making the long haul of the degree bearable; however these bonds can hinder as well as help. I struggled for half a year with the mounting feeling that I needed to take a break from vet school, always countered by the knowledge that taking time out meant losing my class.
I met with Jenny Weston, the dean of veterinary science at Massey, to discuss an issue facing many vet students: what might be described as ‘high achievers syndrome’. Sitting in Jenny’s office as she tells me about the suicide of a colleague and close friend, is like staring into a very bright light. You want to look away – it feels like this is something that shouldn’t be talked about. Jenny explains that she realised, “It could be anyone at any time” – access to lethal drugs means vets that attempt suicide are highly likely to succeed. Ever since then, the issue has been Jenny’s personal interest and concern and, after close to 15 years at Massey, she has her own theories on why vet students struggle with stress more than those in other disciplines. “I suspect that the population who gets into vet school are not “normal”… there is a tendency for them [these students] to be high-achieving, driven individuals who set very high expectations on themselves”. Vet students – having to be the brightest and best to make it into the degree – are often used to being top of their class. Suddenly in a class composed entirely of very bright students, most are going to come in middle or bottom. Some students may never have failed a test, and don’t cope well doing so for the first time in vet school. This environment leads some students to question their academic abilities, or feel they are frauds.
Policy at Massey requires grades for all students to be scaled on a bell curve, so while all students can potentially pass an exam or test, only a few can receive A grades. For some students this is a source of stress and frustration: “you study your butt off,” says Emma, “and you’re rewarded with a very underwhelming 68%”. Sarah confesses, “My ability to achieve highly has been a huge part of my identity… I do struggle with getting lower grades in vet”. For some, the idea of failing means more than getting a bad grade, or the threat of having to repeat a year: as Anna says, “…you realise you have spent so much time and given so much of yourself into this degree – it is so intrinsically entwined with who you are that failing … is failing yourself, your future patients, [and] your family who are proud of you.”
Vet school itself is not always the cause of students’ troubles of course. Often it is the combination of other, external problems on top of study that creates the ‘perfect storm’; that breaking point at which students can no longer cope. Although some of the students I spoke to have never experienced mental health issues before coming to Massey, others shared stories of depression during high school, unsupportive family backgrounds, death of someone close to them, and eating disorders. Other challenges that arise during the course of the degree – injuries, relationship breakups, bereavement, or other crises add strain to a person already dealing with enough. Jess explains, “There’s not much room for things to go wrong outside university, as everything is so stressful here … there’s not much stress reserve.”
“I’m not sure I can finish the vet degree. I’m not even sure I can finish this semester.”
I scrawled these words in purple pen across a post card: what felt then like the deepest secret of my soul. I posted the card through a thin mail slot to one side of the vet foyer, checking that no one was looking, and hoping that maybe someone was; hoping once again to be stopped and helped. I was one of many contributors to Vet Confessionals, a project set up by two vet students in 2014. One of the founders, Corey Regnerus, explains that their aim was to address potential issues for students before they became practising vets. The project started small, with a stack of postcards for students to write their secrets on. Submissions were shared anonymously on the Massey stream site for others to read and comment on. Since then it has expanded to a website and Facebook page, making it accessible to the wider vet community, including internationally. Corey explains that creating a connection between students and graduates was one of the major goals. “A key indicator in suicide risk is feeling alone and isolated… to say things in a safe environment and hear back from colleagues, even if they are unknown, is very important”. Mark Rainier adds, “There is lots of evidence that the best support comes from peers – and they themselves also gain so much from giving it”.
Halfway through third year I considered taking a year off. I explored the idea for the rest of the year, trying to reach a decision I could live with. Amongst the myriad fears and doubts competing for headroom, were grief at the thought of losing my class, and anxiety that I might be letting my loved ones down, countered by the fear that things would keep getting progressively, unbearably worse. Every day was endlessly long. I tried to concentrate in class but found my mind constantly drifting. Most mornings I forced myself out of bed only to end up on the floor in tears because even putting my socks on seemed too hard. I was just incredibly tired, in a way I’d never been before. I wanted to sleep, for weeks if necessary, until I could wake up and be myself again. In the end I did take the year off, my way of stopping the world from spinning on endlessly. It was the hardest decision of my life, but in the end it seemed the only one I could make.
Although this paints a very bleak picture of vet school, things are improving. While vet students may be under more stress than those in other courses, they tend to be better supported. The faculty is recognising and trying to address these issues, sometimes a difficult task to balance with teaching. Jenny Weston recently started ‘Wellness Wednesdays’; a series of informal talks related to improving wellness, and open to students and staff. Another recent action is to make “Spine”, the integrative studies paper, a pass/fail course, to encourage students to work cooperatively.
The defining
characteristic of my bad times was feeling alone. To quote Jess again,
“essentially all you need is someone who cares and gives a damn”. When I
announced my decision to take a year off, my classmates were understanding and
supportive, and some admitted that they were struggling too. High-achievers find it extremely hard to
admit they’re not coping, and perhaps my contribution was to make that slightly
more ‘normal’. Six months on, I am sure that taking this year out from vet
school was the right decision – but whether I will go back or not is yet to be
decided. The idea of returning is daunting, but I am stronger now, better
prepared, and ready to admit just how hard it is and not fall into that
high-achievers trap. I am still not sure what the future holds, but at least I
am beginning to feel like myself again.
Notes on sources:
The names of students Anna, Emma, Sarah, and Jess have been changed to protect the privacy of those students who contributed their personal stories to this project.
Information about the veterinary degree programme and selection process in the paragraph “Vet is a five year undergraduate degree…” is from the Massey University website: http://www.massey.ac.nz/massey/learning/programme-course-paper/programme.cfm?prog_id=92611&tab=plan
The statement ‘only an A average will do’ is based on conversation with Jenny Weston on 13/5/16, and information from http://www.massey.ac.nz/massey/learning/programme-course-paper/programme.cfm?prog_id=92611&tab=plan
Note the minimum GPA for selection is a B, however due to the competitive selection process the actual grade required is usually closer to an A- .
General statements containing the word ‘we’ in the paragraph starting “Vet is a five-year undergraduate degree…” are based on personal experience combined with statements from fellow students in the Massey veterinary programme as of 2016.
Statistics on numbers of students (Vet students and Other students) seen by the student counseling service for 2015 were provided by head of service Mark Rainier, in a Skype interview on 18/5/16. Calculations are based on the assumption that each class for 2015 contained 100 students, as is the norm. Information on student numbers at the Massey Manawatu campus that were used for these calculations was sourced from: http://www.massey.ac.nz/massey/student-life/about-our-campuses/manawatu-campus/manawatu-campus_home.cfm
The paragraph “Consider also the warning…” refers to an automated warning seen on the Massey Stream site (Moodle) on enrolling for third year vet papers at the end of 2014.
The “8+8+8 rule” is a healthy lifestyle concept mentioned in a confidential interview with a Massey vet student.
Quotes and descriptions in the paragraph “Of course this is true…” are from a confidential interview with a Massey vet student.
Description of the vet student cohort as both strength and Achilles heel is based on a quote from Skype interview with Mark Rainier on 18/5/16.
Quotes and information in the paragraph beginning “I met with Jenny Weston…” are from an interview with dean of veterinary science Jenny Weston, on 13/5/16.
Information on cognitive and personality factors related to suicide risk, including ‘high achievers syndrome’ as discussed in the paragraph beginning “I met with Jenny Weston…” was sourced from: Bartram, D. J., and Baldwin, D. S. (2010). Veterinary surgeons and suicide: A structured review of possible influences on increased risk. Veterinary Record. doi: 10.1136/vr.b4794
The paragraph beginning “Policy at Massey…” contains quotes from three separate Massey vet students, taken from confidential interviews.
Examples of problems facing students from the paragraph “Vet school itself is not always…” are all real examples taken from interviews with several current vet students. Quote in the same paragraph is also from a confidential interview with a student.
Information on Vet Confessionals project is from interviews with Co-founder and current committee member Corey Regnerus on 13/5/16, and professional patron Mark Rainier on 18/5/16, and from their website http://vetconfessionals.com/.
Information on Wellness Wednesdays and changes to Spine papers is from interview with Jenny Weston on 13/5/16.
The quote in the final paragraph is from a confidential interview with a fellow student.
Erin Marieke Maessen 
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