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INTERNATIONAL MEDICAL EDUCATION German Med School Learns Local Lessons On Revamping Its CurriculumThe issues that face medical care, research, and education in this country—how to work across departments and disciplines, how to integrate and teach an increasing amount of knowledge, and how to find a place for industry and commercialization in research—are becoming international concerns. A group from Dresden, Germany, came to Boston during nine days in February to work through these same issues with HMS faculty to develop an innovative approach to education. The reforms in Dresden are part of a series of nationwide changes taking place in health and medical education. The German health system is overburdened, and Germany is looking at solutions such as managed care to reduce spending. New policies are trying to stimulate medical education reform and competitiveness in schools and teaching hospitals. Dresden, like many research universities in the U.S., is receiving an influx of state funds to develop a biotechnology hub with links between the academic and commercial worlds. The visit, coordinated by Harvard Medical International (HMI), focused on a combination of medical curriculum reform, working and teaching across departments, and initiating programs that link research and industry. Building a New CurriculumOne delegation of 15 medical faculty and staff members from the Carl Gustav Carus Technical University of Dresden (TUD) spent a week at Harvard with the goal of overhauling their medical curriculum. The group included the department chairs in pharmacology, physiology, and virology as well as course coordinators in the medical school. The program, developed by HMI, is an attempt to get people from different departments to work together as a team and think creatively about education.
Axel Rethwilm, department chair of virology at TUD in Dresden, listens as Ursula Ravens, department chair of pharmacology and toxicology at the school, debates an aspect of the medical curriculum with her colleagues. Photo by Steve Gilbert German medical schools have traditionally been highly regulated, public, and free. A centralized system assigns applicants to the schools, so they are not able to select their students. With an increasing amount of information to absorb in lectures, students find that they have difficulty connecting what they learn in classrooms to clinical practice. However, recent reforms have encouraged schools to develop new model curricula and are allowing certain schools to choose up to half of their students. The faculty of TUD wants to develop an innovative approach that will attract talented students. "Dresden is newer, not so settled," says Alexander Karmann, professor of economics at the university. "We feel the need as a new university to have our own profile." Tom Aretz, HMS associate professor of pathology and medical director for international education at HMI, coordinated activities for the group. "The program allows faculty members from different disciplines to spend time intensively together, reworking the medical curriculum from the ground up," Aretz says. Participants observe tutorials and rehearse mock tutorials, talk with HMS course directors, and hammer out a plan for their curriculum in teams. The Dresden group is interested in incorporating problem-based learning from the New Pathway and developing integrated classes that help make the transition from basic science to clinical practice. They would like to introduce economics into the medical curriculum, realizing that doctors in Germany are increasingly concerned with finances and cost-effectiveness. HMI led a similar course in 1996 with Ludwig Maximilians University in Munich, a program that won a national prize in Germany for educational innovation and attracted the attention of two other German schools, Ruprecht Karl University Medical Faculty of Heidelberg and TUD. "Medical care and medical education are really facing the same problems globally," says Gordon Moore, HMS professor of ambulatory care and prevention and one of the leaders of the sessions. "There are many more similarities than one would initially think, and much more to be learned from each other." Integrating Research and IndustryA separate delegation of faculty from TUD as well as the head of biotechnology in the Ministry of Economics in Saxony came to Boston for ideas and guidance on developing a biotechnology center in Dresden. The goal of the new center will be to integrate the university with other research institutes and the biotechnology industry to make Dresden a biotechnology hub in Germany.The center will have an innovative structure, housing research teams from the TUD as well as biotech firms and start-up companies. The research will integrate medical and engineering faculties with nearby laboratories and a planned bioinformatics center. The faculty was particularly interested in the Harvard–MIT Division of Health Sciences and Technology (HST) program, because they would like to offer cross-disciplinary academic programs tailored to the biotechnology center, with a master's degree in molecular bioengineering as the first offering. Such an integrated approach is unfamiliar to the TUD faculty, because it requires not only cutting across departmental and institutional boundaries but bringing industry into research. German education is traditionally quite structured, and the faculty does not have much flexibility to consult, start companies, or work for more than one institution. "There is a new philosophy, particularly in [the former] East Germany, that the faculty should be involved in collaboration with industry," says Richard Funk, dean for research and vice dean of TUD's medical faculty. One of HMI's goals for such visits is to create relationships between researchers in different countries. The faculty at TUD is hoping to continue a relationship with MIT and HMS with faculty exchanges and continued consultation. "Dresden is moving forward on one of the most innovative paths in medical education anywhere in the world," says Robert Crone, HMS clinical professor of anesthesiology and president of HMI. "We at HMS have a great deal to learn from participating in this leadership program." —Courtney Humphries |
