Should a student with psychiatric problems get a diploma?

A few weeks ago, something horrific happened in Rotterdam: two shootings, one of them at the Faculty of Medicine at Erasmus University. The suspect is a Medicine student who presents serious behavioural problems, such as animal abuse, extremist views, an excessively dirty house, and psychotic behaviour. The suspect fulfilled all requirements for getting his degree as a physician, but the Public Prosecutor’s Office warned Erasmus University about his problems, so he had to undergo a psychological examination to show whether or not he was suitable to work as a doctor. Chances are that this issue surrounding his diploma has played a significant part in his actions.

Complicated dilemma
This evokes the question of what universities should do when confronted with a student who is having serious psychiatric problems. These are complicated dilemmas. I once got involved in such a case myself. I was a PhD candidate and my supervisor told me that a student from a different faculty had visited him and talked about an interesting problem concerning a non-linear differential equation. He suggested that I started supervising him.

I made an appointment and thought he was very smart and kind. Programming was not one of his strong suits so I would help him with that. When I finished the programme, I asked him about the numbers I needed to use for the constants in the equation and what the boundary conditions were. He presented numbers that were completely impossible, if not ridiculous! He went from 1 to 100,000,000,000,000,000,000,000,000… So, I asked him: “How did you come up with these numbers?” And he answered: “That’s just how it is.” He didn’t speak to the supervisor at his own faculty. “He doesn’t get my work at all, he’s just too stupid. They all are. A bunch of idiots that are unable to estimate the value of my work.”

He hates us
When I called the other supervisor, he proposed to meet me right away. “He has always been a really good student, but something in his behaviour started to change slowly, leading him to cause more and more problems for himself and for us as well. He hates us, he thinks we’re stupid, he no longer wants to talk to us. He even scolded and threatened a colleague. Now he’s turned to you. His work is completely incomprehensible, which is a huge problem and now you’ve gotten caught up in it as well." The student in question turned out to have sky-high grades for all his courses, so the only thing left for him to do was hand in his thesis.

We decided to see whether I could guide him towards an acceptable thesis. A week later, I heard that he had made serious threats against his first supervisor and a few other employees. The police even had remove him from the faculty building. He didn’t say a word about that incident to me. Eventually, the cooperation resulted in a highly peculiar graduation thesis with an incomprehensible metaphysical introduction, a middle part with an analysis that was correct (mathematically and numerically) and a part with conclusions and recommendations that translated the model analysis results to his incomprehensible world again.

Can he graduate?
The big question was: can he graduate with such a thesis? This student clearly had psychiatric problems that became quite serious in the last year of his studies. That's incredibly sad but it is the harsh reality. The exam committee came up with two options: a failing grade, in which case the research conducted for his thesis would have to be repeated or giving the minimum passing grade, a six, with which he would obtain a Master’s diploma. The supervisor found the first option inadmissible, so we went for option two. The only problem was that the student considered his work to be brilliant, so he would not settle for a six.

And that's exactly what happened. His thesis defence ended up being a small gathering with just his parents, brother, sister, and brother-in-law. Many a funeral had a more pleasant atmosphere than the atmosphere in the lecture hall at that moment. What followed was a graduation assignment that was pretty much beyond reproach, except that it didn’t make any sense at all. Then came the moment which we all, except for the student of course – dreaded intensely: announcing the grade. The dean spoke and ended his speech with “… And that’s why the exam committee decided to assess your work with a six.” From what I remember, there was a long moment of silence. I saw him cringe and turn pale, after which he started shouting that he was going to send an army of lawyers after us to prove that he had been the victim of a big injustice. Then he stood up, nodded to his family and silently they left the room.

The wise thing to do
What is the right thing to do when a student with excellent grades develops serious psychiatric problems towards the end of the programme? Should the university deprive them of a diploma and send them away because they are ill? Or should it ask them to do everything all over again at a different institution? Or let them graduate with a passing grade? At a university, wisdom is expected but sometimes we ask ourselves what wisdom actually is. In Rotterdam, this issue happened at the Faculty of Medicine, which means that the candidate would be treating patients in the future, which is not the case of my student. Still, you have to make a decision and hope that everything turns out well. Unfortunately, sometimes it doesn’t...