The Student Service Centre (SSC) of the RUG has been contacted by various study advisers, student deans and student psychologists stating that they are worried about how often StudentArts prescribes ADHD medication Ritalin to students, says Jooske Doorenbos of the SSC.
‘Last year, we had a meeting with the practice, because we also had some questions about the prescription policy regarding Ritalin,’ Doorenbos says. She does not know the exact magnitude of the problem. ‘I do feel, however, as do my colleagues, that they are very generous in the prescription of Ritalin. And we have some reservations about that.’ Doorenbos says.
Ritalin is used to reduce the symptoms of ADHD. However, the medication that is closely related to speed is also used by many students to help them students better. The Dutch Institute for the Proper Use of Medicine (IVM) recently warned against the trade of this drug and the hazardous side-effects of Ritalin.
‘Naturally, there is a protocol for the prescription of Ritalin; there needs to be a diagnosis. We feel that the student doctors are very generous in setting this diagnosis,’ Doorenbos says.
According to practice manager Anne Visser this is not the case. ‘GP Maarten Goedhart has gathered a lot of experience with this in addiction care and has had good results with it. It is only prescribed to people who really need it; students who cannot do exams because they cannot sit still,’ he says.
Study pressure
StudentArts, a practice with about 14,500 registered students and seven (locum) GPs is also generous with issuing doctor’s certificates to students according to the SSC. The students need these statements to request an extension of the performance-related grants or a reduction of the standard for the binding study recommendation (BSA).
‘There is a huge need for these certificates,’ Visser admits. ‘But the system creates them,’ he says. ‘It’s actually the other way ’round. The pressure lies more with the study advisers, who ask the students for doctor’s certificates,because they need them to give them more time for their studies. We are quite hesitant in doing so; we only issue such a certificate if students are officially under our care. GPs actually hate those certificates; they say: that’s not why we exist, we’re here to make people better.’
Visser thinks that students ask for doctor’s certificates more because of the hard BSA standard the RUG has set and because of the lack of student counselling. ‘There are a lot of students who party hard. They do not have a sweet mother who checks up on them. They often come to the POH GGZ (GP practice nurse for mental healthcare, ed.) who goes through the process with them and says to them: if you continue like this, you will fail. I think there simply is a huge need for student counselling. The system is harsh and students who get stuck come to us to get a certificate.’
Evidence
According to medical association KNMG, doctors are not permitted to issue doctor’s certificates for their own patients. Visser states, however, that this rule only applies to matters such as driver’s license renewal medical check-ups. ‘In this case, it only concerns a certificate stating that a person is being treated by the GP, that’s all. It also doesn’t guarantee additional study time.’
Doorenbos admits that the problem regarding doctor’s certificates has been created partly by the university itself. ‘Students need to provide evidence for any exception to the current rules; mostly this concerns a medical certificate,’ she says.
However, worries about the generous prescription of Ritalin and doctor’s certificates by the practice remain, Doorenbos says. ‘You can’t do more than regularly discuss matters. It is their expertise and responsibility. We can only indicate the things we see and that this is not desirable. However, it they say that they have their own policy, handle this carefully and that we have to believe them, then that’s where things more or less end.’