The Envelope, Please

Nearly Half of Fourth-years Choose Massachusetts

On the 54th annual Match Day, March 16, 152 HMS fourth-years discovered where they will do their residencies. Almost half of the students will remain in Massachusetts, with another 17 percent heading to California and 8 percent to New York.

Forty-six percent of the residencies will be in primary care, most of which are in internal medicine. The second most popular residency was pediatrics, which 9 percent of the graduates will be entering. Compared to last year’s fourth-years, emergency medicine, family practice, and general surgery saw a decrease while radiation oncology and urology saw an increase.

Photo by Liza Green

From left, Daniel Guss, Dzifa Kpodzo, and Medell Briggs rejoice at what four years of medical school has brought them—residencies at Massachusetts General Hospital, Brigham and Women’s Hospital, and UCLA, respectively.

Women’s Work Is at the Bench and Bedside

HMS celebrated International Women’s Day this year with its second annual Diversity Town Forum, which focused on the status of women in biomedical careers.

Photo by Steve Gilbert Vivian Pinn (left) and Evelynn Hammonds described the hurdles faced by women in biomedical careers, as well as the progress they have made.

In recent years, the face of biomedicine has changed markedly. In 2003, more women than men applied to medical schools for the first time. Since 1980, the ranks of women have grown in every health-related profession, with the exception of nursing. Yet for all that, said keynote speaker Vivian Pinn, much remains the same.

Pinn, director of research on women’s health at the National Institutes of Health, noted that the barriers women face in biomedicine have not changed significantly in the past 20 years. Women are more likely than men to be primary caregivers for children or ill parents, and reconciling work and home presents a challenge for them, as does the lack of female role models and sex discrimination. Because of family demands, women are more likely to take long leaves of absence and to need assistance reentering biomedical studies and careers.

In addition, rates of female faculty are not growing at a level similar to that of students. The percentage of female faculty grows at less than 1 percent a year, and female faculty occupy primarily junior-level positions, suggesting that a glass ceiling might exist in academic settings, Pinn said.
Inconsistencies between men and women’s experiences in medical careers extend beyond admission and hiring rates. Women, on average, receive about 80 percent of the funding their male colleagues do, Pinn explained, although this is probably because female applicants request less money in their proposals.

Pinn’s talk was not without optimism. “At least we’re not seeing a decline,” she said, pointing to the steady increase in female enrollment in science and MD programs and growing resources.

Evelynn Hammonds, senior vice provost for faculty development and diversity at Harvard University, agreed. “Barriers have always been high for women in the sciences,” she said, “and they’ve remained high for African-American women.” But referring to the work her office and Pinn’s office, among others, have done, she said, “We have the opportunity to make substantial changes. ”

—Rebecca Tinkelman

Proceedings of the HMS Faculty Council

At the Faculty Council meeting on Feb. 8, Mortimer Litt, HMS associate dean for educational programs, presented a motion to disband the Committee on Elections, a standing committee that he chairs.

The committee was established in 1978 and charged with conducting the annual election of members to serve on the Faculty Council. The committee chair is responsible for addressing any academic issues that might arise and reporting them to the council. The Faculty Council voted to disband the committee and to require that Litt continue addressing and reporting academic issues to the council. The annual Faculty Council election will be managed by the staff in the Office of the Dean.

Ronald Arky, the Charles S. Davidson distinguished professor of medicine at Brigham and Women’s Hospital, and Stan Finkelstein, HMS senior lecturer on health care policy, presented an update on the progress of the MD–MBA program, which was launched in November 2005.

The program requires students to spend their first two years at HMS taking three policy or management courses. The summer between the first and second years will include a six- to eight-week management internship. The third year will be devoted to core medical rotations with the addition of a management-oriented integration seminar. The fourth year will be spent at Harvard Business School, with management-oriented clinical electives being taken in the summer. In the fifth year, the students will have an HMS–HBS integrated curriculum.

Nine students were accepted into the program in the spring of 2005, three from Harvard College, four from the HMS first-year class, one from the HMS third-year class, and one from the HSDM third-year class.

Information is available at: www.hbs.edu/mba/academics/mdmba.html and www.hcp.med.harvard.edu.

Joan Miller, co-chair of the Medical Education Reform Initiative’s design group on the advanced clinical experience (ACE), provided an update on the group’s work. The ACE would, essentially, be the fourth year of medical school with the following timeline:

• April–June: Subinternships and electives;
• June–October: Clinical areas of concentration and auditioning electives;
• November–January: Thesis completion, USMLE, and interviews;
• February–April: Integrated courses and intensive clinical preparation for internship.

The design group thought electives should include traditional and multidisciplinary electives as well as longitudinal experiences to build a broader base of knowledge and skills.

Members identified guidelines for directors of elective experiences, including submitting new course descriptions and developing parallel lists of skills, such as writing, evidence-based medicine, teamwork, and basic sciences. An annual evaluation of electives and a review of electives taken outside HMS were also proposed.

The design group focused on the need to increase emphasis on basic science, coordinate simulation training, provide longitudinal in-depth experiences, and design multidisciplinary, interinstitutional electives.

The group recommended that

• course directors identify the electives’ content and skills areas in course proposals;
• reviews of advanced electives include a statement describing how the student will be evaluated;
• uniform assessment tools for courses and student evaluations be created;
• advisers use the content and skills areas of courses to guide students in course selections;
• students be encouraged to broaden the scope of their electives beyond areas or career choice;
• duplicate electives for purposes of auditioning be discouraged.

The group’s concerns included

• being able to provide mechanisms to support weaker students who might need more time to complete basic science courses;
• whether HMS has the resources to ensure consistent high-quality electives; and
• the need to identify sufficient financial support to effect these changes.

Partners Receives Award For Human Research

Partners HealthCare received the Health Improvement Institute’s 2005 Award for Excellence in Human Research Protection, for promoting the well-being of participants in research studies through its Human Research Quality Improvement Program. The program was developed in 2000 by Delia Wolf, HMS assistant professor of radiology at Massachusetts General Hospital, while she was a graduate student at the MGH Institute for Health Professions. Her efforts became the prototype for the quality improvement program implemented by the Office for Human Research Protections at the U.S. Department of Health and Human Services.

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