Introduction

Why do we need to talk about health in graduate school? To begin with, academia isn’t well known for being easy on your mental health, and physically aging throughout your degree can bring major changes, regardless of your age. Taking the time to invest in preventative care and learning to advocate for yourself in the complicated network of healthcare providers, insurance, and school policies will leave you better prepared to navigate the inevitable physical and mental challenges of graduate school. While it’s impossible to create a template for every challenge you might face, the topics discussed below touch on some common themes and unique aspects of managing your health as a graduate student in the United States.

 

Transitioning healthcare

Did you know that doctoral programs require incoming students to submit medical histories, ranging from documenting immunity to completing a physical examination? Here at the MIT-WHOI Joint Program, these forms are due well before arriving to campus, require a physician’s signature, and result in a registration hold (plus the corresponding late registration fee!) if not completed correctly. In addition, MIT has a minimum medical insurance requirement and students are auto-enrolled in an insurance plan and charged a premium unless they submit a waiver proving they have comprehensive coverage elsewhere (e.g. a parent or spouse’s plan). While not all universities have the same policies, planning ahead for both medical history and health insurance requirements is key to avoiding an unexpected fee, gap in insurance coverage, or even difficulties in enrolling for your first semester of classes. We recommend searching your academic institution’s website for information on medical requirements and timelines well before arriving.

Beyond these requirements, you should also transfer your medical records and establish care with a local physician when you arrive. Even if you don’t have any current health issues, you should always try to have a local primary care provider who you can visit for both preventative care, minor accidents/illnesses, and referrals to specialists. Ideally, your university’s health clinic will have mental and physical healthcare providers, and the new student paperwork you already completed would make this transition easy: just call and make an appointment. If you need specialty care, live far away from campus, or if your insurance requires you visit a different provider, you might need to find healthcare off-campus. As with everything else healthcare related, this will always require additional paperwork and time, so get started on a plan early, and don’t be afraid to call your previous healthcare provider, university, and/or insurance provider to clarify your plan to transition and get advice on where to find the care you need.

 

Insurance and paying for healthcare

Nearly all American universities require that their students carry health insurance and, as briefly mentioned above, you may be auto-enrolled in and charged for a health insurance plan unless you submit a waiver proving you have comprehensive coverage elsewhere! However, even if health insurance is not required for your program, you should strongly consider signing up for coverage regardless. It’s extremely expensive to receive medical care in the United States without insurance, and an emergency could easily become a major expense. Many programs, the MIT-WHOI Joint Program included, cover health insurance costs for their students. It’s worth looking into if your program provides health insurance or if you’ll have to cover the payments yourself when considering how to budget for graduate school.

So where should you get coverage and what level of coverage do you need? Unfortunately, there is no simple answer. Your first step should be to see what plans are offered through your university: general health insurance, vision insurance, and/or dental insurance may be offered at relatively affordable prices, and some level of care may be automatically included in your tuition. If you are low-income, have other insurance options offered through a parent or spouse’s employer, or otherwise cannot get healthcare through your university, you might want to shop around and compare. Check out this article “6 tips to help you pick the right health insurance plan” from NPR for help. 

You might find it is cheaper and provides better coverage to stay on your parent’s health insurance policy. This is great, but keep in mind you will age out and lose coverage at age 26, which may be mid-way through your degree! If your parents live out-of-state, you should also double check to make sure coverage behaves as expected across state lines and meets the minimum requirements for your location. Regardless of your insurance situation, keep an eye on enrollment deadlines and plan ahead to avoid issues.

Finally, even with health insurance, medical care can be expensive. Always be sure to clarify coverage before receiving care if you are worried about the cost. This can often be a frustrating and time-consuming experience, although transparency regarding insurance billing is improving. If you do receive a surprise bill, don’t panic! Check out this article “How to get rid of medical debt — or avoid it in the first place” from NPR for help.

Finding good providers

So, you’ve completed all your university’s required paperwork, have health insurance, and have an appointment to establish care with a provider – what else is there to know? Well, not all healthcare professionals provide the same quality of care, and for many of us, graduate school may be the first time selecting our own providers. What should you look for in a healthcare provider?

First of all, do they make you feel comfortable, listen to your concerns, and answer your questions clearly? A good provider respects your opinion and makes you feel heard. Empathy and compassion are important to your care and you should never feel like a burden or rushed out of the office.

Secondly, how long does it take to get to their office, how easy is it to contact them, and do they respond in a timely manner to your needs? A good provider is readily accessible and easy to get ahold of. Consider if you are able to easily access your medical records and test results online, get same-day appointments, quickly pick-up prescriptions, and follow-up with your doctor on the phone. If you aren’t able to see or communicate with your doctor, it doesn’t matter how good they are! 

Don’t be afraid to switch providers if something doesn’t feel like a good fit. Check out this article “Thinking of Changing Therapists? Here's How to Switch” from Psych Central, and this article “How To Pick A Doctor (Or Break Up With One)” from NPR. 

Preventative care

This topic is here to remind you to take care of yourself! You need preventative care, regardless of your age. In addition, a lot of preventative care is fully covered by insurance at no additional cost to you, so put those insurance premiums to good use and see your doctor. For a detailed guide explaining what preventative care is recommended for you, visit My Health Finder at health.gov. If you are having symptoms already – don’t wait until it gets worse to schedule a visit.

In addition, your university likely offers many community resources to help you care for yourself, usually at a reduced cost (or even for free). Check out classes, support groups, and take advantage of events and resources like flu shot clinics and free contraception. Find what works for you!

Sick leave and parental leave

Regardless of if it is planned or unplanned, or short-term or long-term, at some point during your graduate degree we can guarantee you will need to take time off for your health. So how much time can you take off, will you still be paid, and who do you need to notify? As usual, policies vary by university, so your university’s website is your best resource. Generally, we would expect for short term illness (like a cold or the flu) you can simply contact your teachers and advisor and let them know you’ll be out sick for a couple of days and then continue on with no impacts to your funding or education. If you are sick or injured for a longer period, you may need to reach out to your student dean to verify your medical issue and coordinate with them to resolve missed coursework or other requirements while still remaining enrolled and in good academic standing (i.e., still eligible to be paid). Finally, if your health requires a significant amount of time off of school (e.g., several months), you may need to submit a formal request for medical leave that would result in you temporarily leaving school while remaining eligible to re-enroll at a later date once your health has improved. In this situation, you would likely lose or (in the case of funding from an outside fellowship) need to formally defer funding until returning to school. For all health issues, going to the doctor to receive documented care and contacting your teachers and advisor to let them know you’ll be missing some work is the first step. Don’t feel obligated to provide personal details to your advisor or university – just letting them know you are sick should be enough.

Parental leave policies also vary across universities and once again can be complicated by outside funding situations. The amount of leave can vary depending on if you are the birthing or non-birthing parent (at MIT the birthing parent receives two months childbirth accommodation and one month of parental leave, while the non-birthing parent receives only one month of parental leave). While your academic deadlines will most likely be extended, you will probably still need to coordinate with your advisor and department to accommodate your time off. If you or your partner are considering childbirth during graduate school, I would recommend reading up on your institution’s policies well in advance to ensure that they meet your needs.

Advocating for yourself

Last but not least, how should you treat yourself in graduate school to maintain your mental and physical health? Take a moment and consider the sustainability of your approach to your health. Graduate school is not a short period of time, and you need to set boundaries with yourself and those you work with (e.g., your advisor) that are reasonable and support you.

A personal note from the author: As an undergraduate, I did not have a sustainable approach and was burnt-out by graduation. I tried to learn from my mistake when applying to graduate school, and I recommend you do the same. I made sure to speak with my advisors about their expectations for work-life balance. I also spoke with other students about the workload and stresses they experienced in graduate school. I tried to make an informed decision about how graduate school would impact my mental and physical health – but of course you can’t plan for everything (see: COVID-19). 

Don’t feel obligated to sacrifice your mental and physical health for your work, and if your advisor or department has unreasonable expectations, search for a solution that maintains your health. Solutions could include taking a lighter course load, switching advisors, or even switching departments or programs if needed. Consider seeing a therapist, speaking with an Ombudsperson (a professional trained in workplace issues and conflict resolution who is, critically, entirely confidential) or reaching out to a trusted peer, mentor, or loved-one for advice. Ideally, you should be able to communicate openly and honestly with your advisor about when you need a break and set realistic goals together to accomplish your research without sacrificing your health. If you are managing a long-term illness or disability, don’t be afraid to ask for accommodations, and understand your rights. Schools generally have an office specifically for disability accommodations (Disability and Access Services, at MIT) from testing aids (distraction-free locations, extra time, etc.) to assistive technology and mobility services. Don't hesitate to contact your institution if you have needs they can meet. Your health is your priority, so please advocate for yourself, and enjoy your time in graduate school!