September 21, 2001

Medical School program among first in U.S. to counsel peers

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Volunteers are needed again this year for the VUMC-sponsored Habitat for Humanity house. Last year, medical students Andrew Zwyghuizen and Lisa Andrews were among the many volunteers who helped build the house. (photo by Dana Johnson)

Medical School program among first in U.S. to counsel peers

Medical student wellness programs will someday be required at all of the nation’s medical schools. It’s a national effort to help future physicians maintain balance in their lives and develop healthy life habits and positive coping skills.

But Vanderbilt University School of Medicine, long known for its focus on students and its strong student-faculty relationships, is jumping on the bandwagon early. The medical school has a new wellness committee and a series of events and programs geared toward helping students deal with the stress that occurs in a busy medical school setting.

“Vanderbilt has always been very proud of our student community and our student-to-student relationships,” said Dr. Bonnie M. Miller, associate dean for Medical Students. “This will only strengthen that community.”

At one of last year’s meetings of the Group on Student Affairs of the Association of American Medical Colleges (AAMC) meeting, the Liaison Committee for Medical Education (LCME) presented information on the need for student wellness programs. The presentation suggested that it would soon become mandatory for medical schools to organize such programs. Miller and Dr. Deborah C. German, senior associate dean for Medical Education, who attended the presentation, decided that VUSM would become proactive by developing a student wellness committee. The medical center also offers a Center for Professional Health for physician wellness for its residents and faculty.

“We want to help our students develop healthy life habits that they can use when they are physicians,” Miller said. “We want them to maintain balance and positive coping mechanisms throughout medical school.”

“We’d like them to maintain an even keel – exercising and eating right and not getting stressed. The best way to deal with stress is to not become overly stressed to begin with,” she said.

Last year, the wellness committee surveyed all students about their needs, printed laminated cards with important campus phone numbers for crisis situations, sponsored a mandatory first-year retreat and hosted several brown bag luncheons. The topics included medical relationships, substance abuse and depression.

This year, the committee will again hand out the phone numbers as refrigerator magnets to all students. In addition, the medical school, which has long paired first- and second-year students in a student-to-student advisory program, will now have organized student peer groups – groups of 16 (four from each class) – who will be encouraged to meet at least once a month for an activity. The groups will receive funds from the medical school to carry out their activities.

“We’re doing something we’ve always done, providing a lot of support for our students, but this is in a more active, formal fashion,” Miller said.

Miller said she hopes the younger students in each group will talk to the third- and fourth-year students about their concerns.

“It’s difficult to be a first-year student,” Miller said. “Medical school may seem very rigid. There’s little flexibility in the curriculum for the first two years. Classes begin at 8 a.m., whether you’re a morning person or not. There’s a great deal of coursework, and it may be a huge adjustment for some students.

“Most of our students are super achieving people who have never encountered stumbling blocks. When they encounter the challenges of the first year, they may feel inadequate, like they are the only ones to ever have trouble. We feel it will be helpful for new students to talk to senior students who have faced the same challenges and who have thrived.”

The first-year class will again attend a retreat in October with their spouses, partners or significant others. The retreat focuses on team building, relationships and coping skills.

“The timing of the retreat is excellent,” Miller said. “It’s a good way for classmates to interact outside of the lecture hall. They will have taken anatomy and biochemistry tests and should be eager for advice. At orientation, students may not yet be ready to hear about study skills, time management and positive coping, but after the first several weeks of class, they are.”

Stein Bronsky, a fourth-year VUSM student and student wellness committee member, has had first-hand experience with first-year medical student stress.

“At the beginning, medical school was personally very difficult for me,” Bronsky said. “I was not handling stress well. I literally thought I was one of the only people in medical school who was having difficulty transitioning. This is a wonderful medical school, and we’re supposed to be the best of the best. Nobody wants to expose his or her weaknesses,” he said.

But Bronsky believes stress led to back problems. He soon found himself addicted to painkillers and had to take a year off from medical school while he rehabilitated from the addiction.

Bronsky and a classmate who has suffered from depression were two of the featured speakers at last year’s brown bag luncheons. They will speak again this year.

Bronsky said he believes the student peer groups will help relieve some of the worry and stress of the first and second years of medical school.

“In the past, third- and fourth-year medical students would be lucky to even be able to identify a first-year student because they are so busy in the clinical part of their education,” Bronsky said. “It has been nice to pair first- and second-year students at the beginning of school, but maybe one of 10 pairings goes on to have a relationship that lasts four years. The peer groups are a major expansion of that program.”

The peer groups will stay together throughout the first-year class members’ four years in medical school. Each year, as the fourth-year students graduate, a group of incoming first-year class members will be added to each group. Each group will have three leaders, a second-, third- and fourth-year student.

Bronsky said he hopes the students will feel comfortable opening up to others in the group. “Many of our students go through the first couple of years feeling like they are the only one dealing with certain issues. And upperclassmen here are willing to openly talk about the difficulty of going through those two years.”

“Vanderbilt is a very student-focused school,” Bronksy said. “I have friends at other medical schools, and Vanderbilt is definitely much more student focused. The stuff we take for granted here, students at other medical schools would love to have.”