Aid for the Impaired Medical Student at Mercer (AIMS)
General Goals of the AIMS Program:
- To provide compassionate assistance to impaired students before they are irreversibly harmed
- To provide help in a way that fully protects the rights of impaired students to receive treatment in strictest confidence
- To assure that recovered students are able to continue their medical education without stigma or penalty
- To protect others from the harm that impaired students may cause
- Prevent future cases of impairment through school-wide interventions
This program is based on that developed by the University Of Tennessee Health Science Center, and much of this document is based on their published program. The University of Tennessee program was the first program of its kind in the country. It was developed to address the issues raised by the recognition that physician impairment, due to alcohol, substance abuse, or mental illness is a significant problem nationwide. Research suggests that 12-14 percent of all practicing physicians are or will become impaired during their careers. A large percentage of these impaired physicians report that the impairment began during their years of medical training. The purpose of the AIMS program is to reduce the number of impaired physicians by identifying, treating and preventing impairments that may begin during training at Mercer University School of Medicine.
What Is Impairment?
Many medical students experience medical education as seriously stressful. Most deal with the demands of academic and clinical workload, financial pressures, and changes in lifestyle using healthy coping mechanisms. Occasionally, however, students do not adapt successfully to these stresses and instead begin to engage in potentially harmful coping mechanisms, including the inappropriate use of alcohol and drugs. When these maladaptive coping techniques are relied upon heavily, a student may become impaired. We define an impaired medical student as one whose behavior violates the regulations of Mercer University School of Medicine, or the accepted standards of the medical profession. The behavior violation results from the temporary inability to cope with the stress of medical education, alcohol and/or drug abuse or dependence, or a major psychiatric disorder.
The Aims Program at MUSM
The AIMS program will be administered by the AIMS Council. The AIMS Council will be made of eight student members and four professional members. Two students from each class are elected by their peers in the winter quarter of their first year, and, ideally, are chosen for their integrity, maturity and discretion. Once elected, these students remain as their class representatives for four years, unless replaced by class vote. The four professional members of the AIMS Council are chosen by the Dean of the School of Medicine. Their selection is based up their expertise in dealing with problems of impairment, as well as their concern for the welfare of medical students. The professional members are not connected in any way with the administration of the School of Medicine, so as to assure the trust and confidence of medical students in the program. One professional Council member is assigned to each medical school class as professional advisor. The AIMS Council is co-chaired by one medical student and one professional member, both being elected by the membership of the Council.
Essential Elements of The Aims Program
We anticipate that some students will continue (as they always have) to recognize that they are coping poorly with stress and seek assistance before impairment occurs. The School of Medicine presently utilizes the structure of the Office of the Dean of Student Affairs to provide resources and facilitate referral for students in such circumstances. We anticipate that both student and professional members of the AIMS Council will augment those resources and provide information and assistance to students in seeking appropriate help when stresses are becoming unmanageable.
Assistance to the Impaired Student
The AIMS Program will have a unique responsibility at Mercer University School of Medicine; that is, where students are identified as impaired by others, but do not seek assistance. In this circumstance the AIMS Program will take responsibility for Identification, Early Intervention, Evaluation, and Monitoring of the impaired student.
Identification of Impaired Students
Research suggests that as many as eight percent of medical students may become impaired during their years of training. Most of these students will not voluntarily seek help, but their impairment may be detected by classmates, friends, faculty or staff. In this event, the reporting student/faculty member will relate the details of the situation to the appropriate class AIMS representatives. The representatives and professional member will review the facts of the situation to determine the accuracy of the information reported. Based up their review, they will decide that further steps are unnecessary, or that it is appropriate to intervene.
The Early Intervention process of the AIMS involves meeting with the impaired student to discuss the impairment in a helpful and supportive way. The interview will be conducted by one or both of the class AIMS representatives and an AIMS Council professional member. The purpose of the interview is to bring the student to the point of recognition that a problem exists, to express a commitment to help, and to explain the evaluation and treatment resources available.
The class advisor and AIMS representatives will assume an advocacy role for the impaired student, and help him/her choose a physician (from a list approved by Council) who will perform an evaluation of the student‘s condition.
The class advisor and AIMS representatives will also assist the impaired student in selecting a treating physician, who be responsible for the impaired student's treatment until the impairment no longer exists or until further action is taken.
A physician member of the AIMS Council will monitor the progress of the impaired student and will be responsible for ensuring compliance of the student with the treatment process.
Cost of Treatment
A student participating in the AIMS Program may seek treatment from any approved physician. Payment will be met by the student‘s individual health plan (insurance is required of all students enrolled at Mercer University School of Medicine), and by the Student Health Plan.
For hospital and other residential treatment programs, there may be substantial cost to the student.
Families of Impaired Students
Families can be an important part of a medical student‘s development into a competent and responsible physician. Students' spouses and families will be integrated into the evaluation and treatment process where indicated, and the costs of treatment addressed appropriately.
Failure of Treatment
In the event that a student is unsuccessful in treatment, the Council will meet to review the case. They may recommend a change in treatment program, especially if the student has been earnest in his/her efforts. If the student has failed to comply with the treatment program, or it appears that recovery continues to be compromised, the Council may decide to inform the Dean of the School of Medicine of the student‘s situation. This is the only circumstance in which the administration of the school will be aware of the student‘s involvement in the AIMS program.
Final disposition of the case, including dismissal of the student, is a judgment that resides with the Dean of the School of Medicine.
Advocacy for the Student
Where treatment is successful, the AIMS program will vigorously assist the student in assuring that previous impairment will not adversely affect educational and career opportunities. When treatment has interrupted medical studies, the AIMS Program will assist the student in making arrangements for resuming and completing his or her education. The AIMS program will also provide appropriate assurances regarding the student‘s recovery to educational institutions or employers to whom the student has disclosed his or her previous treatment for impairment.
The issue of confidentiality is CRUCIAL and of the UTMOST IMPORTANCE. The success of the AIMS program depends on student trust and confidence; a breach of confidentiality would compromise these attitudes, rendering the AIMS program ineffective and important. AIMS is designed to protect both the impaired student, and those who find it necessary to report an impaired colleague or peer. At no time during the treatment process will any uninvolved individual know of a student‘s impairment. The AIMS Council will review cases by number and anonymously. In an ideal case, only thetwo student representatives, the faculty advisor, the evaluating and treating physicians, the monitoring physician (member of the AIMS Council) and the chair of the AIMS Council will know the identity of the student in the program.
For additional information, see the Student handbook, talk to your AIMS representative, or the Dean of Student Affairs on your campus.