Epilepsy and NHS junior doctor night shifts

[Jon1970]

Hi, just under a year into studying medicine my DD discovered that she has epilepsy after suffering two seizures in the space of 6 months. Her main triggers are lack of sleep and stress. Since she's known this, she's managed things well, been seizure free for two years now and thus far, without medication (she doesn't yet drive).

I'm wondering if anyone has any experience of NHS occupational health and how they would view the above. In a few years she'll get her first taste of doing night shifts, and I'm already concerned how she'll handle this. I am wondering if she may be exempt from having to do night shifts. She has a documented diagnosis per the above, from a consultant neurologist.

If she can get through F1 and F2 then I think she'd be able to specialise in something that doesn't typically require night shifts, but it's getting through those first few years that concerns me.

If anyone can offer any experience or qualified insight, I'd be very grateful. Many thanks.

It is very unlikely that she would be permitted to avoid doing nightshifts, especially since she has managed her condition successfully for two years without further seizures. And, to be honest, it would not be in her own best interests to be considering trying to do so without substantial reason - no matter what anyone says it will count against her and will inevitably annoy colleagues who have to cover for her.

There are ways of managing night shifts, and that is making an assumption that she will need to - people's reactions to stress, and the types of stress, can change over time and what she experienced two years ago may not ever happen again. When I was training I had a period of crashing migraines for a time - but I learned how to manage them and once I did I never had them again. It is stressful yes - but medicine is far from a stress free environment in any field.

In any case, this is a matter for her. If she has concerns that she won't be able to manage, then she needs to be the one posting. Third party advice is rarely helpful because it's her circumstances that people need to address, and she's the only one who can directly talk about them.

Thanks Moondust, for your reply. It's a good reality check and useful feedback. In fairness she has actually said that she wants to do night shifts as she recognises that it wouldn't go down well with colleagues if she didn't. She doesn't know I'm posting - I guess you could call me 'concerned parent' but I agree, at the end of the day it's up to her to decide and by the time she gets to F1 she will be 25. Pragmatically, I think the answer is for her to try medication again, which would reduce the risks at least.

A friend is a senior nursing sister with epilepsy and is exempt from night shifts. I think her seizures are well controlled, but not sure how often she has them now. Her triggers were also lack of sleep, changes in the time of day she takes her meds and stress.

An option might be to see how the first night shift placement goes, or start off with less nights in a row.

She really needs to talk to her neurologist about this. In Australia, she would be exempt from night shifts if her neurologist thought it appropriate. A JMO having a seizure in the middle of a code blue at 2am is not good for anyone.

I am aware of doctors that are exempt from night shifts due to to diagnosed health issues.

My colleague doesn't do night shifts as an anaesthetic registrar as they have epilepsy (was diagnosed a couple of years ago). I think occy health would let her do no night shifts for sure. Employment law says they have to surely?? She might not be popular with the rota coordinator but it would be agreed at a higher level than that.

I mean they have to let her NOT do them. Sorry if not clear. You can get all the same experience of nights by doing more long days and weekends so I don't think she'd miss out. I can see she would feel worried about letting people down but I think she should put her health first fwiw

I've know a couple of epileptic colleagues, both couldn't work at night/evening due to their condition and had regular hours.
Not sure how it works in the medical field but her health has to come first, if nights and irregular hours are going to bring on seizures then surely she cannot do them, she'll need to speak to her tutors who will have a better idea.

On a case by case basis it will be assessed but there are certainly staff who are exempt from night due to health conditions, it is the exception not the rule however.
She may be fine with nights, most people find the transition between student - F1-F2 very stressful in itself. It's probably better to have good coping mechanisms for these years (which she will be developing). But medicine is inately stressfull as pp has said whatever specialism.
Your obviously a worried parent but I'm sure with a plan in place through occy health, her supervisors and team she will be fine.

Thank you for the more recent replies - very, very helpful and I really appreciate you taking the time to reply

I know of a foundation doctor who has epilepsy and doesn't work night shifts - it's definitely possible

She will most likely be covered by the equality act given she has a long term condition and would be classed as disabled (appreciate she might not like the tag). If not working night shifts was a reasonable adjustment then the Trust would need to implement it. Given the nature of her role and sheer numbers if doctors in that grade it would be highly unlikely that they couldn't achieve that for her if she wanted to

Yes, I agree.

I can appreciate that she doesn't want to feel like she's letting colleagues down by not 'pulling her weight' but she didn't choose to have epilepsy, did she?

She should speak to her consultant and be guided by her/him.

I have a number of nursing colleagues who don’t work nights due to epilepsy or diabetes. So Occy heslth will give her dispensation. I haven’t known these colleagues get any grief from the rest of the ward staff even though yes it means we have to work more nights I guess.

If she can’t work night shifts and is signed off by a doctor she can’t, her health is more important ... colleagues won’t hold it against her
Not sure about stress though as long hours are typical in the profession... that might be an issue

She would need to apply for reasonable adjustments to avoid nights, IMHO her epilepsy is probably well controlled due to taking regular medication, her medication regime would be upside down on nights & potentially trigger a fit & consequently she would be back to square 1 re driving etc.
Ask her to liaise with her epilepsy nurse regarding this- they are fab & experienced in this type of support.

I was diagnosed with epilepsy when I was 15 been seizure free for 2 years now I work nights myself and to be honest the shift itself is fine but it’s the days of from work where I feel run down and no energy and sometimes it does feel like I’m gunna have a seizure personally don’t work the nights if you’ve got epilepsy I will be changing to normal hours once we have found someone to cover my nights while I do days no matter what always put your health first and make sure whoever your on shift with knows you have epilepsy that way they don’t get scared seizures are not a pretty sight