Professor in Pathology Molecular & Clinical Microbiology, Nanchang Joint Programme in Biomedical Sciences, School of Biological & Behavioural Sciences
All students deserve support towards graduation, but this path may sometimes be difficult. In particular, mental health difficulties pose a great challenge when, culturally, they remain a stigma. According to the World Health Organisation (WHO), about 95 million people in China suffer from mental health disorders, becoming a UNICEF priority for 2022-25.
The Nanchang Joint Programme is one of the four transnational education (TNE) programmes run in China by Queen Mary University of London, in collaboration with different Chinese universities. The Nanchang Joint Programme in Biomedical Sciences is deployed with Faculty of Medicine of Nanchang University (NCU), in Nanchang, capital city of the Jiangxi province. The novelty of this programme is that it is entirely taught in English and, at completion of their studies, students are awarded with two degrees, one in Biomedical Sciences awarded by Queen Mary and another in medicine, awarded by NCU.
Getting two degrees, Joint Programme (JP) students have employability advantages. However, learning in a foreign language and adapting to the western educational system is challenging. In China the vast majority of students don’t openly declare mental health issues, for the cultural reasons previously discussed. Only about 2% of Nanchang students reported mental health issues that affected their studies, leading to interruptions and withdrawals, and none of them ever reached graduation. However, this figure might be largely underestimating the real magnitude of the problem, for the stigma associated with this condition and the very small percentage of students who openly share their condition.
‘Fighter’ (our pseudonym) was an extremely talented student who experienced periods of deep depression and anxiety, especially around the exam period. Despite hospitalisation and psychiatric interventions, anxiety still resulted in self-harming behaviours and posed serious threats for his life and wellbeing. This experience lifted the curtain on a story of mental health he was trying to cope with at his best not to be judged by others nor to cause pain to his parents. It started an in and out of hospital stays, the student interrupted to recover and got better. However, when exam time approached, because of his condition he could not handle the anxiety and attempted again at self-harming. Despite his talent, this student could not cope with the ‘normal’ exam anxiety as all other students, which triggered a relapse and a new interruption. It was clear to me that we needed to do something to support him and all the other students affected by similar conditions who likely did not have the strength to share their struggles.
As Subject Examination Chair (SEB) of the JP, I wondered if there was a more sensitive method of assessment. Taking advantage from literature, I proposed a change of policy for students with mental health difficulties to be assessed differently, introducing bespoke arrangements and oral examinations. It was not easy because I had to guarantee robustness and quality of assessments and faced resistance from Nanchang University, for which this approach was new. However, I strongly felt that, even if mental health problems affect a minority of students, I owed them a chance by being more inclusive, and I did what it took to change the policy. I discussed my idea with the Directors of the Programme, the Academic Registry and the DEB Chair, who were all keen to try this approach, initially trialled on my module.
‘Fighter’ did brilliantly and, with the collaboration of all JP staff, oral examinations became the routine for him. Little by little, he regained confidence and started to thrive, despite his condition. For his courage, strength, enthusiasm and determination to become a doctor he became our ‘role model’.
How did this journey end? ‘Fighter’ completed all the exams and recently graduated. Even more brilliantly, he recently started a post-graduate programme in London and is ready to embrace a new chapter of his academic life. This has given hope to other students affected by similar problems who can now see graduation as a reachable goal, not an impossible dream.
I am not only proud of him, but of the way all of us, academic and professional service staff, within the JP and at Queen Mary and NCU, joined forces. ‘Fighter’ (never a pseudonym was more appropriate!) proved that no two students are alike, and we should respect their diversities, while offering them the same opportunities. By being inclusive, we aim at not leaving a single student behind and supporting them in their journey towards graduation.
This experience has taught me to think outside the box and to always remember not a single student deserves to be neglected. It might not be straightforward to change policies, but it’s focussing on individual differences of students that we will be able to go beyond being educators, and to have a real impact on their lives.