I’m OK-You OK? Best Efforts to Watch Over the Wellness of the Learners in the Three Mass Chan Gradua

Michael Hirsh, MD

I have been involved with the UMass Medical School since I first took a job as an academic pediatric surgeon there in 1986. Although I did take a nineyear break to hone my skills in Pittsburgh from 1992 to 2000, I returned in large part to Worcester because of the wonderful relationship that I always had with the medical school and its students.

A lot of what I imparted to medical students was based on the negative role modeling that I had experienced as a trainee and later as a young attending. There was no focus on wellness or work/ life balance, or any of the catchphrases that one uses nowadays to show that there is a world outside the four walls of the hospital.

I suppose the philosophies and approaches I took to both my work life and my home life did play a big part in what I shared with the students. They were always very receptive and always asked me how I continued working hard when there were so many obstacles in my way – i.e. short staffing; poor subspecialty representation to support multi system critically ill/ injured patients; inadequate administrative support for pediatric services. My standard answer was if you pick a career that you love, it doesn’t feel like work, so you can work like crazy, which I think I did.

The generation of medical students coming up now, are not willing, (justifiably so), to make the same imbalanced life part of their future. Despite the imbalance that I represented, Dean Terry Flotte tapped me in 2019 to start an Office of Health and Wellness Promotion within the Office of Student Life of the UMass Chan Medical School.

At the time that I was opening this office, there was a great deal of concern about the level of pressure being put on students with the Step One and Step Two exams, and how they greatly detracted from the level of enjoyment that the students had in their med school experiences.

The first approach I embarked on in assessing the situation was partnering with an expert focus group leader, Dr. Kristin Mattocks, to evaluate representative students from all three grad schools about what stressed them and when. We also talked about what distressed them too.

We have recognized financial stress detracts from overall wellness so we work closely with financial aid to assist students. We also work closely with Coaching services and Student Counseling Services to make sure that students who need extra help with coping skills or a safe place to speak freely about problems can get on board with these services promptly.

One of the overarching themes that came from those focus group sessions was that students felt very isolated in the time that they were studying for their Steps, going for their nursing licensure, or completing a set of experiments in their lab, particularly if their lab work wasn’t going well. The isolation was something that I felt we could mitigate by establishing group experiences outside of a hospital.

We therefore took the budget that was allotted to us and bought tickets for various events in Worcester and surrounding towns that might give the students an experience of calm, no-pressure fun. We had tickets that students could sign up for in groups to go to the Woo Sox, Mechanics Hall for Music Worcester, the Worcester Art Museum, and Tower Hill Botanical Gardens in Boylston. The rate that these tickets were gobbled up convinced me that we were on to something. We then planned welcoming ice cream socials and picnics and tried to emphasize the 3-school participation in these events.

We also worked out a deal with the City of Worcester, where I serve as the Medical Director for the Division of Public Health, to rent out the ice-skating rink behind City Hall, called the Oval, for our three school students to enjoy for free. This included music, food, and skate rental. Nearly 200 students participated each year we did it.

When the Pandemic arrived, the isolation became much more profound. But here an old maxim I have touted came mightily into play- “Advocacy prevents burnout”. As the word we were getting from Washington was that

Operation Warp Speed would produce vaccinations by the end of 2020, I realized that we were going to need an army of capable vaccinators to meet the demand of a mass vaccination program against COVID-19. I dialed up my dear friend Professor Jill Terrien of the Tan Chingfen Graduate School of Nursing (GSN) who had helped teach med students how to administer vaccinations using her GSN students as trainers during the H1N1 outbreak in 2009 and in subsequent school-based flu clinic campaigns. She was completely on board with doing this once again for COVID-19 vaccinations. In the space of approximately five months, we had collaboratively trained approximately 800 vaccinators to be part of the Vaccine Corps. They were mobilized in January of 2021 and never looked back. Many are still involved today. With 68% of our community successfully vaccinated we owe a huge debt to these students. But they too saw how giving to others in this way made their own feelings of isolation or malaise diminish if not disappear all together.

Taking a similar approach of using our students to help the community as a way of lessening their own feelings of sadness, we employed students to work with seniors at the Worcester Senior Center by connecting with them and giving them support when the Center was closed. We called these students Elder Buddies, and they made thousands of phone calls, navigating food and medical problems for their seniors.

In the Worcester Public School System, there were many students who did not handle remote learning on computers well. We started a buddy program for those students that the school adjustment counselors identified as worrisome. With some training with the counselors, our three schools provided support for hundreds of students helping with tutoring, pep talks, or just playing video games to ameliorate the situation. This program continues today.

These activities not only got the students to see themselves as part of the Greater Worcester Community, but to feel they were fighting off the Pandemic that had so radically altered their own educational pathways and experiences.

Now that the Pandemic is over, there is a certain malaise that we have observed amongst the medical community at large. Despite the dangers and hassles of the Pandemic, there was a unanimity of focus and a collaborative spirit that made us feel like we were pulling the oars together. That spirit has dissipated.

So moving forward, our office will have to continue to find ways to increase the sense of wellness, camaraderie and belonging in our student body. The health inequities that the Pandemic highlighted give us an opportunity for advocacy that could play a huge role in getting our students to feel that sense of common purpose once again. I will do my darndest to push this agenda forward. I know I will find many willing collaborators in this endeavor. +

Michael Hirsh, MD

Assistant Vice Provost for Health and Wellness Promotion Medical Director for the Worcester Division of Public Health