By Nora Newcomb
General disclaimer: This is all based on my own personal experience. Please consult with someone in your program before making potentially life-changing decisions.
I’ve been sick since I was a teenager. At this point, I can’t remember what it was like before my disability or what life without it would look like. The labels have been swapped around. The symptoms have changed. That’s all part of life with a chronic illness; after a while, you just have to learn to adapt. And, for the most part, that’s what I’ve done. There’d be a flare or a new symptom, and I would change my world to go along with it. There was always something I could do to get myself back on track without losing sight of my goals or deviating from my path– until there wasn’t.
During my first semester of medical school, I had the worst flare I’ve ever had. It was a perfect storm: the pandemic had taken away some of my key health-management resources, I’d moved to a new state away from my support network, and, of course, I started medical school. The work kept coming. The pain was unrelenting. The more I tried to work, the more pain I was in and the more pain I was in the less my brain wanted to absorb the information I was trying to cram into it. It was a miserable, futile, vicious cycle. Suffice it to say, something needed to change.
So, I went on leave.
I say that like it was an easy decision; in some ways it was. I needed to provide myself with the opportunity to work on my health. It was evident that by being in school, I wasn’t able to devote the time or energy to myself that I needed to in order to get out of my flare. In addition to that– on a slightly more career-minded note– after all of the years I’d put in trying to get to medical school, I knew that I owed it to myself to give myself every opportunity to actually succeed. So, in those regards, the decision to take a leave of absence (LOA) was simple. The hard part came in knowing what to do in order to actually go on leave, and what I should do with myself and my time after I had.
A LOA is certainly not the answer to every crisis. What I did was right for me; it may or may not be right for you. That said, I thought I should take this space to talk about what helped me figure out my leave of absence. Hopefully it might help you too, whether you’re considering a leave or just need a way to think through a crisis.
This was the first thing I did, and I would wholeheartedly recommend it to anyone going through a rough time, regardless of the reason.
Once I knew that I needed to take a break from school, I talked to a wide range of trusted people to get support and advice about how to move forward. Friends, family, advisors, peers. Like many chronically ill people, I have my network of people that I can lean on when I need them. Everyone I talked to knew about my situation, and the conversations centered more around the LOA itself. Some of them helped to direct me to who I should talk to at the school to make it happen. Some of them provided emotional support. Even though, in the end, the decision was my own, I was empowered to make that choice because I had the space to talk through the logistics and the knowledge that my community was behind me.
Relying on a wide network of people might not be for everyone. That’s perfectly fine. I would still urge you to talk to at least one person that you trust. A LOA is a big decision, and no person is an island.
Please be aware that a LOA has the potential to have repercussions. When you are making the decision to take leave, emotions will be high. It is likely that you are already in crisis mode, and the idea of downstream effects of the LOA may be the last thing on your mind. If you can, though, I highly suggest taking the time to sit down and think about what those effects might be, and make sure that the LOA won’t create another crisis in and of itself.
Going on leave can result in you having to return your federal loans. If you rely on those, make sure you have a contingency plan. You may also have to start repaying your loans while on leave. A LOA can also cause problems with your access to healthcare, if you rely on student health. It may affect housing if you live on campus. Ask these questions (or others that you feel might be relevant to you) before you formally go on leave. Your school may have plans in place to address potential problems arising from a LOA or you may need to make your own.
Those are the more immediate potential consequences; one of the more looming ones is, of course, downstream career effects. As the people around you will often remind you, taking a leave of absence might hurt your match prospects. I truly don’t know to what degree that is accurate. I can’t predict the future. However, I know that, in my case, whatever those consequences might be, they couldn’t possibly be as bad as those from the track record I would have acquired if I’d tried to keep going through my health crisis. That said, more than anything, this is a concern that is going to look different for everyone. Every path is different, and so the outcome will be different for everyone.
It’s worth noting that you may be able to tell your institution that you are considering going on leave without immediately initiating that leave. It should always be a conversation, and, if you have any serious concerns, it’s important to have those addressed before formally going on a LOA.
Once you know for certain that you want to go on leave (or are at least very seriously considering it), try to press pause on the academics as soon as possible. Talk to the members of the administration at your school who can help you move forward in that process. Get everything moving to formalize your leave. In the meantime, take a step back. In my case, I made the decision to go on leave in the middle of an exam period. It honestly did not make sense for me to have to worry about studying in the midst of going through the process of initiating my LOA, so I contacted the appropriate people to make sure that I could be excused from my exams while this was all getting figured out. Pressing pause was the right call in that situation. I would encourage you to do the same with your commitments. Once the decision to take a leave has been made, you have now entered your time to focus on your health. That should be respected.
Obviously, this may not be immediately accessible to everyone. You may have duties or responsibilities that need to be attended to before you can take that step. However, be cognizant of why you’ve made your decision to take a LOA, and try to honor it.
“Oh wow, you have so much time now.”
“You should be doing research now that your schedule has opened up.”
“What a golden opportunity! You can get so ahead on your work for next year!”
“You know there’s absolutely no shame in your decision.”
“Why aren’t you studying? You’re wasting your chance!”
These are all things I heard from people when I told them I was on leave. They were not helpful comments. I learned to ignore them; I recommend you do the same.
You don’t magically get better when you go on leave. The health problems you had before are still there; all you’ve done is allow yourself the time to work on them. That takes time. A lot of time. So much time that you can’t even begin to explain to other people. Oh, and energy. Don’t forget the physical and mental energy it takes to go to your appointments and manage your care and adhere to your treatment plans. If you can do other things too, that’s okay. If not, that’s also okay. The goal here is to get yourself healthier. Save your spoons. Focus on you. Ignore the (usually) well-intentioned, but hurtful advice.
I’m aware that this sounds like weird advice. After all, a LOA is usually brought about by a crisis so what is there to enjoy? More than you’d think.
There’s something incredibly liberating and empowering about having a time that is specifically dedicated to working on you. This is a rare opportunity in life. Devote time to healing and recovery. Say no to unwanted commitments, and pursue the things that bring you joy (in my case, I took a ridiculous amount of online cooking classes, and had a blast). Have fun. Take a breath. As one of my mentors once told me, medical school will be there for you when you’re ready for it.
So, take your time. It’s not going anywhere.
