Neurology:
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Metabolism:
Cellular Stress Appears to Link Obesity, Diabetes

Structural Biology:
Interdisciplinary Team Yields High-res Clathrin Model

Pathology:
Blood Flow Mechanics Affect Genetics in Vascular Cells

School History
Book and Forum Recognize Achievement of African Americans at HMS

Medical Education:
Education Reform Aims for Longitudinal Clinical Experience

Muscle Loss Pathways Proliferate

Fine-particle Pollution Linked to Blood Pressure Boost

Human Cell Therapy Center Created at CBR Institute

Lieberman to Head Faculty Affairs

Five Faculty Members Become AAAS Fellows

Ground Broken for New Fenway Housing

Grant Funds HSPH Initiative for Preparedness Against Terrorism

Long-term Care: Averting a National Crisis

Front Page

Education Reform Aims for Longitudinal Clinical Experience

Four overarching goals are shaping the new curriculum, said Malcolm Cox, HMS dean for medical education: the need to introduce students to all the sciences relevant to medical practice, including the population and social sciences as well as basic biomedical science; integrating the teaching of science and clinical medicine across all four years of medical school; promoting interdisciplinary teaching and team- and systems-based approaches to medical practice; and enhancing student mentoring, especially by senior faculty.

"This is a tall order," Cox said, "but one that has been enthusiastically embraced by the Harvard community."

In September, faculty came together at a retreat to discuss a draft blueprint of the new curriculum and other recommendations presented by 11 working groups. HMS dean Joseph Martin outlined five challenges that the School faces in transforming medical education: deciding on the core content of the new curriculum; finding means to alleviate the crisis in the cost of medical education and the impact of student debt on the educational experience; embracing and implementing culturally competent care; compensating clinical teachers; and finding a way for students and faculty to work together in the chaotic atmosphere of modern academic health centers.

"There are four converging lanes in Building Bridges: education, research, clinical care, and community service," Martin said. "We need to energize each of these components as part of our mission."

"This blueprint allows us to integrate science within the teaching of clinical medicine throughout the four years of the curriculum."

The centerpiece of the new curriculum is the principal clinical year, an alteration of the current third-year clinical experience. The proposed changes extend the third-year rotations to a full year at a single institution, with the start moved to January of the second year. This longitudinal experience facilitates greater continuity for students and more consistent mentoring and assessment by faculty.

The advantages to the principal clinical year are that it avoids fragmentation, encourages faculty continuity, requires faculty ownership, and encourages innovation, explained George Thibault, HMS professor of medicine at Brigham and Women's Hospital and director of the Academy at HMS. He said it also enables meaningful assessment, focuses on students' educational needs, and builds on the School's strengths by using HMS faculty and the resources of the hospitals, both inpatient and ambulatory settings.

"This blueprint allows us to integrate science within the teaching of clinical medicine throughout the four years of the curriculum," said Jane Neill, associate dean for academic programs in the Program in Medical Education.

In the blueprint, first-year students will attend a new course, Introduction to the Profession, in which the curriculum will orient students to HMS and equip them to embark on a medical career. It has also been proposed that students be required to pursue an in-depth experience or concentration in an area of their own choosing. The blueprint has a block of time throughout the four years for such a concentration

"Medical education should be both broad and foundation-building, but there is also a great deal of value in pursuing something in-depth during medical school," said Neill.

Following the retreat, five new design groups are being appointed. They will focus on planning the Introduction to the Profession course; the fundamentals of medicine, comprising all components of the first three semesters; the principal clinical year and site-specific planning at hospitals; the advanced clinical and science experiences for third- and fourth-year students; and the in-depth educational experiences. Planning for pilot programs in the affiliated hospitals will begin this year, in addition to the integrated clinical year already under way as a pilot program at Cambridge Hospital (see Focus, June 4, 2004).

To view the blueprint, log on to eCommons, click on Shortcuts, choose M, click on MER, and choose Sept. 24 retreat.

--Leah Gourley