When Jai Sawkar was a freshman at Carnegie Mellon University, he slipped and hit his head.
He said his schedule was too busy to schedule a doctor's appointment, but suspected he had a concussion. He knew the common signs since he had three before: two from playing hockey and one from a car accident.
But it was the middle of the semester, he had a big project due, and he couldn't miss class.
“Because of how much work we had in all of our classes, I knew I couldn’t afford not only going to the doctor to get diagnosed, but I guess also taking take time to rest,” Sawkar said, who studies architecture. “I kinda just took some Advil and kept going through my work as best as I could."
He said he didn’t visit a physician because he worried his grade would drop from missing class. He and other students in the architecture program at CMU said they’ve spent up to 12 hours at a time working on assignments. Sawkar said it’s “frowned upon” to say home when sick or tired.
Looking back, Sawkar said that if he had sought treatment earlier, he would have saved himself a lot of time and frustration.
“It definitely could have just been two days rest and I could have been back to normal instead of two weeks of trying to keep up with the pace,” Sawkar said.
Many college students in Pittsburgh said whether they have time to go to the doctor has a lot to do with the demands of their coursework. For example, computer science and engineering students at multiple schools said they were commonly pulling all nighters, but language and history students generally had a little more free time in their schedules.
On top of balancing assignments, attending classes and trying to squeeze in a social life, many students don’t see a doctor’s visit as a priority.
“There’s nothing more disappointing to me than having a senior come in and they look around and they say, ‘Wow, I had no idea that I could’ve been using this,’” said Elizabeth Wettick, the medical director at the University of Pittsburgh’s Health Clinic.
About 1,000 students per week visit Pitt’s clinic for everything from upper respiratory infections to IUD insertions, said Wettick. She said she believes a school as large as Pitt should provide a robust and comprehensive care system, which includes an on-campus pharmacy.
“I always say that what we try to be is the primary care provider away from home,” Wettick said.
For many students in their teens and early twenties, college is the first time they’re required to navigate health care independently. Pitt tries to make it easier for students; the campus clinic is open six days a week, has evening hours and a low, $5 co-pay.
At smaller Point Park University, nurse Katie Leslie said she sees about 40 students a week. She said there’s an element of hand-holding for students who are just learning to take charge of their own health care.
Like Pitt, Point Park is trying to make it as easy as possible for students to access care. The school recently opened an online scheduling portal and new walk-in hours to allow flexibility in choosing appointments. But at first, students saw it as another barrier to getting care, Leslie said.
“[Now], they don’t run the risk of walking in and there may be eight people in front of them and they just have to wait, and then they either walk away untreated or they have to wait and miss class,” she said.
Many schools in the area also offer low-cost flu shots, access to doctors off campus and rides to hospitals so students don’t incur ambulance fees.
Leslie said colleges and universities are also trying to destigmatize mental health by offering treatment and resources like therapy and stress management.
“We’ll just continue to try to communicate that we’re here not only just for when you’re sick or injured, but also, you know, we have resources for health and wellness as well,” Leslie said.
In an e-mail, CMU spokesperson Julie Mattera said the university values access to care for all students. She said the University Health Services has evening and Saturday hours and strives to keep costs low for students.
But Sawkar said, while he knows his health is important, the rigorous academic culture doesn’t prioritize student wellness. He said students regularly attend class sick – getting other students sick in the process – too scared of their grades dropping to stay home and get well.
“At least in our major, and especially at CMU, school goes a mile-a-minute,” Sawkwar said. “So if you don’t go to class you’re probably hours and possibly days behind other kids.”
Carnegie Mellon University's School of Architecture did not respond to a request for comment.
WESA receives funding from the University of Pittsburgh.
*This story was updated at 2:50 p.m. on December 19, 2018 to include a comment from CMU spokesperson Julie Mattera.