Clinical MSW grad says social work was perfect foundation for medical school

Originally published in fall, 2019

It’s been a busy few months for Jamie Hickey. After her June convocation from medical school last spring, the former MSW grad is packing up and heading to the University of Ottawa Hospital where she recently began her residency as a psychiatrist. She’s taken a few minutes from packing and preparing to reflect on the road that’s taken her from an MSW to Ottawa and a new career as a physician.

“The push to apply to medical school actually came from one of my practicums, which was in medical social work, during my MSW,” says Hickey. “I'd continued to work casually at the Children's Hospital and kept running into really oppressive things in the medical system that I was unhappy about. It turns out it's very hard to get people to listen to you unless you have the right kind of letters after your name. So I decided to go get some letters.”

The path to an MSW

In case you’re wondering Hickey isn’t one of those people who always wanted to be a doctor. In fact, out of high school she went to school to become a photojournalist, because, as she says, “she liked hearing people’s stories.”

However, she soon felt she needed to change careers because a journalist’s job is to get the story – not to help – and that really bothered the future social worker. “As a journalist you often show up at the most heartbreaking moments in people's lives,” she says. “And it isn't to do anything useful or bring anything helpful. It’s as a voyeur and I just wasn't okay with that anymore.”

Somewhat disillusioned Hickey moved on and tried on a bunch of different hats as she tried to figure out what to do next. So, she did some accounting, even tried construction, before deciding to go back to University where she took a degree in psychology. She actually had her sights set on a PhD in psychology, but life intervened, and she wasn’t accepted. That’s when she discovered the profession of social work and applied to do her Master of Social Work in clinical social work.

So, what do social workers do, anyway?

Like many people, Jamie admits she didn’t know much about what social workers did, outside of vague notions from TV shows and child welfare roles. However, as she investigated the careers she was interested in, she discovered that social work was another pathway into “this really cool world” that she wanted to get into. Reflecting on her degree Hickey says she’s grateful that she ended up in social work, because it gave her a valuable set of tools.

“I really got an appreciation of how social structures, power structures and things like that act in ways that we don't see unless we're looking for them,” says Hickey. “Social work taught me how to think about things like power and oppression in a way that's much more critical and much more present in my day-to-day thinking about the world.”

Following her degree and practicum in medical social work, a friend convinced her that she could do a lot of good inside the health care system, but to do that, she’d have to apply. The rest, as they say, is history. Interestingly she didn’t give up on social work when she entered med school. Amazingly, she continued to work as a social worker, pulling 12-hour overnight or weekend shifts, which, as she says was deliberate.

“First of all,” she says, “when I initially got in to medical school I kept working because I fully expected I would fail. I had no science background and was in a room full of absolutely brilliant people – so the imposter syndrome was very strong. Besides being a safety net for my own anxiety I realized I kept working because I truly loved the work. It was an absolutely vital reminder about why I decided to pursue medicine. Honestly, if I could have continued to practice social work while in residency I probably would have.”

“In medicine it is extremely easy to get sucked into your own world and get lost in the science of physical medicine where the person you are treating becomes a lab value or an ECG printout,” she says. “Staying connected to social work kept me focused on finding those same opportunities for connection in medicine. On a professional level it also kept me very grounded in thinking about the world from a perspective that included power dynamics, privilege and systems and it was incredibly important to me that I not lose that as I moved into medicine.”

Changing the system from the inside out.

Jamie goes on to point out some of the many ways being a social worker grounds her perspective as a doctor and provides a strengths-based holistic view of the patient. For example, telling someone who is food bank reliant to eat a FODMAPs diet just sets them up to fail or understanding that medication is unlikely to help if someone's sadness is rooted in loneliness.

“In medicine it is extremely easy to get sucked into your own world and get lost in the science of physical medicine where the person you are treating becomes a lab value or an ECG printout,” she says. “Staying connected to social work kept me focused on finding those same opportunities for connection in medicine. On a professional level it also kept me very grounded in thinking about the world from a perspective that included power dynamics, privilege and systems and it was incredibly important to me that I not lose that as I moved into medicine.”

Keeping a strengths-based approach

Hickey also says that patient interactions are often rooted in how often a patient has failed on their treatment path. For example, slipping on their diet, or forgetting to check their blood sugar. She says being a social worker allows her to “flip the script.”

“Frankly,” she says, “I'm much more interested in all the times someone didn't fail. [Telling patients] ‘Somehow, even when things really sucked, you rallied your energy, leaned into hope and tried a new strategy. When you realized that wasn't going to be enough you still refused to give up and made a decision to keep yourself safe by coming to seek health care. Even though life has kicked you in the teeth you keep standing up and you continue trying. That's not failure. That's the very definition of courage.”

As she takes the next step Hickey is careful to point out that social work isn’t “something she used to do,” rather it’s part of who she is, personally and professionally.

“Social work didn't just give me a perspective that I value,” says Jamie, “It gave me a professional identity that is meaningful and worth bringing into medicine. Social work came into my life at a time when I really needed to learn the lessons it had to teach me. The people I met in my social work journey truly changed my life for the better and I will always be thankful for it.”