The humble doctor’s note. A magical beacon of hope for the disaster-stricken student, who, on the day of their big exam finds themselves tragically struck down with a brief yet debilitating illness.
As per the University of Sydney’s special considerations policy, students who miss an assessment due to illness or misadventure have “no longer than three working days from the original assessment due date, the sitting date of the exam, the date of the missed class or missed placement” to submit their supporting documentation. This includes a Professional Practitioner Certificate, a medical certificate containing the same information, or a student declaration proving your exemption from a medical certificate in “extenuating circumstances.”
Sure, that may sound like a lot to achieve in three days, but we don’t want people faking sickness to get out of exams, do we? All in all, it sounds reasonable, right?
Well, not quite.
The doctor’s note works quite well if illness or misadventure lasts long enough that it’s not solved before you get a chance to see a doctor about it, but isn’t so debilitating that it prevents you from going to the doctor in the first place. Less fortunate are those of us with self-managed chronic conditions or disabilities which flare up unexpectedly — where consequences are infrequently serious enough to warrant going to the doctor, but serious enough that they may well cause you to miss an exam.
I’m type 1 diabetic, which at my age, level of independence and the level of subsidies on my medication and equipment means that most of the time, managing my diabetes is fairly easy and uneventful. But every now and then I have low blood sugars overnight and sleep through my glucose alarms, or I sleep at a weird angle that bends my cannula and I wake up to find I’ve not been receiving insulin all night. These things have simple fixes — sugar, insulin, and a bit of time — all of which I usually have on hand. This is the case for many chronic illnesses and disabilities. People experience flare ups of pain, bouts of depression or anxiety, episodes of fatigue things which to us are expected, manageable, and not warranting a doctor’s appointment, but temporarily prevent us from attending to our responsibilities. Even if I did want to go to the doctor, and I don’t mean this as a slight on the profession, General Practitioners (GPs) tend to know very little about diabetes. Sure, they understand that my pancreas doesn’t produce insulin, but they know very little about the day to day management.
It’s hard for non-disabled people to understand the day-to-day experience of living with a disability. The fluctuations, the good days, bad days. We see this in the inane and repetitive discourse about ambulatory wheelchair users. Despite the fact that one-third of all wheelchair users have some level of mobility, people struggle to understand how someone could need a wheelchair one day and not the next. Ambulatory wheelchair users face stigma and prejudice, often being accused of being lazy or faking it. Emblematic of a broader mindset, distrust of disabled people and our ability to judge and make decisions about our own needs is all too common — including when we need to go to the doctor.
Infantilisation when it comes to doctor’s notes is the tip of the iceberg. With a three day window, ‘just going to the doctor’ is easier said than done. For a start, it’s almost impossible to get an appointment within three days, especially with your regular doctor. This means calling around your local (or not so local) GPs, or sitting at a medical centre for hours on end, neither of which are particularly pleasant experiences when you’re sick. This problem has become even worse in recent years, with wait times for GPs steadily increasing, and bulk billing becoming an increasing rarity.
This leaves a space open for online telehealth doctors, who can promise you a sick note in 60 minutes for just $19.99! Yet for all the fears of people faking their illness, I don’t think these doctors investigate all that hard when you ask them for a sick note.
And to be honest, I don’t think face-to-face doctors investigate all that hard either when you ask for a sick note. At the end of the day, a doctor’s note isn’t proof that you were sick; it’s proof that you went to the doctor and asked for a sick note.
Yet, in the face of all of this, the university made proposals last year to reduce the three day window to zero — so if we felt this was a lot to achieve in three days, you now have to get sick, get better enough to make it to the doctor, find an appointment (or sit in a medical centre for hours), attend your appointment then submit all your documentation in the space of one day.
This is a direct consequence of refusing to listen to and consult with actual disabled people. The issue lies in the fact that many of these decisions are being pushed through university management by people who have never had to make an emergency doctor’s appointment, and if they did, would have no trouble paying out of pocket.
Of course universities need some level of assessment and standardisation. Courses and accreditations would fall apart if there were no standards to hold students to. But if universities fail to make reasonable concessions to people with disabilities, they fail an enormous portion of their student body. This ultimately excludes disabled people from accessing higher education, and means we are doomed to continue perpetuating social structures which routinely discriminate against and exclude disabled people. This is not to pin the blame of systemic ableism entirely on the doctor’s note — but if we’re looking for somewhere to start, it sure is an option.
