From lecture hall to NHS front desk

For many psychology students, the classroom is only one part of their education – the rest takes place in corridors, offices, and clinics across the NHS. As a psychology undergraduate working in outpatient services in an administrative and clerical role, I've found myself positioned between theory and practice in a way that few textbooks prepare you for.

Each day, I manage appointment scheduling, patient queries, clinical correspondence, and waiting lists, often under tight time pressures. While I don't deliver direct care, I'm a point of contact for patients navigating complex systems, some of whom are distressed, vulnerable, or living with chronic mental and physical health conditions. These interactions have made abstract academic concepts feel vividly real. I've observed the biopsychosocial model in action. I've also seen its limitations – when systemic delays or resource shortages create obstacles to holistic care.

This role has also given me firsthand insight into the resilience of both patients and healthcare professionals. It's deepened my understanding of psychological constructs like stress, burnout, coping, and support systems. Crucially, it's highlighted the gap that can exist between academic understanding of mental health and the realities faced by service users and NHS staff alike.

From theory to practice

Studying psychology has provided me with a robust early understanding of key theoretical frameworks, such as the biopsychosocial model, behaviour change theories, and concepts around stress, coping, and health beliefs. These ideas form the foundation of how we understand health and illness from a psychological perspective. However, working in an outpatient setting within the NHS has shown me that applying these theories in practice is not always straightforward. 

For example, the biopsychosocial model emphasises that health is influenced by a combination of biological, psychological, and social factors. This model is heavily referenced in lectures and academic texts as a holistic approach to care. In theory, it seems comprehensive. But in practice, I have seen how psychological and social factors can be overlooked due to systemic constraints. A patient may present with clear emotional distress, but if the clinic overstretched and clinicians are under pressure, their mental wellbeing may receive limited attention. Emotional needs can be unintentionally sidelined when the priority becomes managing time and resources.

This is particularly evident in the administrative role I hold. I often speak to patients who are anxious, frustrated, or overwhelmed – sometimes due to delayed appointments, miscommunication, or simply the emotional toll of managing a long-term condition. While psychology highlights how stress can impair health outcomes and coping abilities, it rarely accounts for the compounding effects of system-level stressors, such as long wait times or limited continuity of care. These factors can significantly influence patients' trust in services and engagement with treatment, yet they are often treated as logistical rather than psychological issues.

Moreover, witnessing the impact of systemic pressures on healthcare staff has deepened my understanding of concepts like role strain, compassion fatigue, and resilience - not as abstract ideas, but as lived experiences. While academic theory outlines coping strategies and interventions, the reality is that staff often have little time or support to implement them. Working closely with both administrative and clinical teams, I have seen how chronic understaffing, IT issues, and increased patient demand can erode morale, potentially affecting the quality of patient interactions. 

Finally, engaging directly with patients and observing their emotional responses has given me a more personal, grounded understanding of psychological concepts. Health behaviours, for instance, are often influenced by far more than knowledge or intention. Fear, stigma, cultural beliefs, and previous experiences all shape how people interact with healthcare services. These are difficult to capture fully in classroom discussions but are evident every day in practice.

Overall, my work in outpatient clinics has bridged the gap between theory and reality. It has made me more critical of assumptions in academic models while simultaneously reinforcing the importance of psychology in improving patient experiences and outcomes.

Towards resilience

One of the most important lessons I've learned is that mental health support must be accessible, ongoing, and tailored. Many patients attending outpatient services are managing chronic conditions, navigating difficult diagnoses, or dealing with uncertainty about their health. These experiences understandably take a toll. Patients often share their frustrations, anxieties, or sadness with me as admin simply because I am available and present. Administrative and clerical teams work under significant pressure, managing appointment backlogs, cancellations, and distressed patients – all while trying to uphold compassionate communication. This has made me aware of how essential it is that all NHS roles – not just clinical ones – are trauma-informed and empathetic, as even brief encounters can influence a patient's sense of being heard and supported.

I've developed my own coping strategies to manage stress while balancing my studies. These include maintaining strict boundaries between work and study, practicing mindfulness and reflective journaling, and seeking informal support from colleagues. I've found that even small actions, like preparing for the week ahead or taking regular breaks, help build a sense of control and reduce feelings of overwhelm.

From a psychological perspective, I now view resilience not just as the ability to 'bounce back', but as something dynamic and context dependent. Some of the most resilient people I've met are patients who continue attending appointments despite enormous personal challenges, or who navigate their treatment journey with determination despite fears, delays, or setbacks. Similarly, healthcare professionals and admin staff often demonstrate quiet resilience – showing up every day despite fatigue, emotional strain, or limited resources. However, I've also learned that resilience cannot be expected without support. Systems must enable resilience through realistic workloads, mental health support, and open conversations around burnout.

Studying theories such as Lazarus and Folkman's transactional model of stress and coping has helped me understand the mechanisms behind how people adapt to stress. But it is the real-world exposure – seeing what helps or hinders this adaptation in practice – that has enriched my understanding. This frontline experience has shaped how I view psychological theory, not as something separate from daily life, but as deeply relevant to the everyday realities of those who give and receive care.

Support from University

I have come to appreciate the richness of learning that occurs beyond lecture halls, but balancing demanding NHS shifts with academic expectations is often challenging. Universities and supervisors have a key role to play in recognising and supporting students who contribute to healthcare systems while also pursuing their education.

Firstly, universities should acknowledge the unique value that frontline students bring to their studies. We witness firsthand how psychological concepts play out in real settings – a grounded perspective that can enhance class discussions, assessments, and critical thinking. Creating formal opportunities to incorporate real-world insight – such as reflective coursework, placements, or practice-based modules – would allow students to integrate this learning more effectively.

Flexibility is another vital form of support. Juggling shift work, unpredictable rotas, and coursework deadlines can lead to significant stress and, at times, burnout. Offering more adaptable options, such as extended deadlines, hybrid learning, or part-time study routes tailored for working students, would allow those in healthcare roles to succeed without compromising their mental health. Greater understanding of fluctuating schedules – particularly for those in patient-facing roles – could also reduce feelings of guilt or failure when academic demands feel overwhelming. A simple shift in institutional mindset – from penalising lateness to fostering dialogue about workload – could make a major difference in student wellbeing.

Supervisors and academic advisors should also play an active role in this support. Regular, empathetic check-ins can provide not only academic guidance but also emotional validation. Sometimes, it is enough to simply be asked, 'How are you managing work and study this week?' That recognition alone can counteract the invisibility that many working students feel. Mentorship and peer groups specifically for students working in health or care settings could also be helpful, providing shared understanding and collective coping strategies.

Finally, universities could explicitly incorporate reflective practice on frontline work into the curriculum. This might involve journaling, facilitated discussion groups, or assignments that encourage students to link their job experiences with theoretical frameworks. Such reflection would not only promote deeper learning but also provide a space for emotional processing – a crucial part of supporting students exposed to the emotional demands of healthcare.

In conclusion, students balancing frontline healthcare roles and academic studies occupy a unique position. With the right institutional support – through flexibility, recognition, and integration – these students can thrive and, in doing so, help bridge the gap between theory and practice in psychology education.