Counseling service helps students deal with stress

By Leila Gray
HS News & Community Relations

For many of the young adult students attending the brown-bag medical ethics discussion groups led by Dr. Thomas McCormick, most of the talking was still theoretical. They had not yet been through the death of a patient or other critical turning points in becoming health professionals.

A couple of years later, one of these students is training in his first hospital rotation. He participates in a failed attempt to save a child’s life. The nurses and doctors around him are busy, and he needs someone to talk to about what has just happened. His first thought is to pick up the phone and call Tom McCormick. He would listen and understand.

Because health professional students were naturally turning to McCormick and his colleague, Margy Anderson, for advice during difficult times, in 1977 the medical school formally appointed them as the first two counselors for medical students.

Tom McCormick, at left, meets with medical student counselors Joanne Estacio-Deckard and Mark Wicks

Over the years, the counseling program has expanded to include a number of programmatic services. The counselors have a get-acquainted meeting with every new medical student to let each one know that the door is open if problems arise. Counseling is available during all four years of medical school, at the student’s request, with no fee for service. All of the counseling is private and confidential within the boundaries of Washington State law. In addition to two part-time counselors and the director, the program has a consultant from the UW Department of Psychiatry faculty. Dr. Ed Walker, a former UW medical student, has served in this role for the past 13 years.

The counseling program also has support groups for medical students who are parents, for the spouses or partners of medical students, and for gay, lesbian or transgendered students. The program also offers stress management workshops.

Each year of medical school brings personal changes to medical students, McCormick explained. The first year is one of adjusting to medical school. The second year is generally a time of difficult coursework and an eagerness to move on to hands-on patient care. The third year brings a whole new set of issues as students begin their clinical rotations. At the beginning of each clerkship they find themselves back at ground zero after feeling that they were just beginning to gain competence in the previous clerkship. During the fourth year students must make choices about their field of practice.

“At an age when many of their friends are working in computer companies, in offices, or teaching in schools, medical students and other health professional students are studying diseases and taking care of the very sick,” McCormick said. “The emotional demands of training in the health professions are different from other fields.”

McCormick said that many medical students struggle with the desire to become as competent a physician as possible, with the realization that they can never be infallible and all-knowing, and with the fear that they will make mistakes. Most come to terms with this by understanding their own limitations, and by learning how to work with others on a team where different strengths are shared.

McCormick talked about other qualities that help medical students with the demands of medical school. Having a network of supportive friends, both in and out of medical school, can help ease some of the pressure.

Families can be a mixed blessing: some students give and receive loving support from their relatives, others find that combining medical school with family responsibilities, such as caring for older parents or young children, can be overwhelming. Sometimes the stresses a student is experiencing can exacerbate family, friendship or marital problems.

“One of the services we provide is to assist students in resolving conflicts in their relations with others, and in creating healthy relationships,” McCormick said.

Some of the internal strengths needed in medical school are the ability to delay gratification and to be self-disciplined - to work while others are out having fun, McCormick said. Also vital is a strong sense of mission and purpose that keeps the student going through rough times.

“Of utmost importance,” McCormick said, “is a sense of wanting to serve people and of believing that the more you learn, the more skillful you become, the more effective you will be in helping others.”

The counseling service is also there to “help the helper.” Some of the more common occupational hazards of the helping professions are burnout, depression, anxiety and stress-related illnesses. The counselors try to stay tuned into the signs of these silently painful conditions. They guide students to potentially useful solutions and serve as their allies and advocates.

McCormick, who retired in January after nearly 25 years as a medical student counselor, said that one of his greatest rewards has been “helping students to develop a deeper self-understanding and to develop practices of self-care that can sustain them, not only in medical school, but in the arduous years of residency training and actual medical practice in the future.”

McCormick will continue to teach part-time in the fields of medical ethics, human sexuality, spirituality and medicine, and death and dying. However, he said he will miss the close connections of students sharing their life struggles and talking about what really matters most to them.

“Getting down to brass tacks and working with students on the real issues they are facing is the most gratifying reward of being a counselor,” McCormick said.