Harvard Medicine

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How to Build a Better Doctor

Harvard Medical School has rewritten its assembly instructions.

FIRST CLASS: Ishani Ganguli began her medical career with the HMS Class of 2010, whose members gave continuous feedback to the architects of the New Integrated Curriculum during its first two years.<br/><br/>Photo by Katherine Lambert

First, the disclaimer. Harvard Medical School—like medical schools around the world—has been building great doctors for decades, even centuries. But as biomedical research discoveries continue to mushroom, today’s doctors must be nimbler than ever.

In response to this growing pressure, several years ago the School reengineered its curriculum for the first time in nearly a generation. The latest reform—the New Integrated Curriculum—builds on the foundation of the previous one, the New Pathway, by better integrating lessons taught in the classroom with those learned in the clinic. The ultimate aim: superbly trained, clinically and socially responsible physicians with a deep understanding of the underlying science of medicine.

The first HMS class to have progressed through the entire new curriculum will graduate this spring. To commemorate this milestone, we offer instructions for assembling doctors who are well prepared for the challenges of today’s medicine.

1. Before beginning assembly, select the highest-grade material available.

The importance of choosing excellent medical school candidates cannot be overstated. HMS admissions committees follow a simple formula of seeking aptitude and attitude, idealism and intellectual curiosity, scholarly promise and compassionate engagement.

2. Gather the right tools.

Proper physician assembly requires proper instruction, technologies, and community. Through the Academy, HMS works to build better teachers by identifying best practices, fostering innovation, and rewarding excellence in teaching. In addition, today’s students can avail themselves of a range of educational aids, from state-of-the-art simulated patients to iPod-downloadable, multi-media-enhanced lectures. And the School encourages its students to join in creating new knowledge rather than just mastering it, by offering opportunities to participate in world-class research.

3. Ensure proper alignment of individual parts.

Teach your doctor not only the fundamentals of medicine but the big picture as well through a cohesive curriculum. At HMS, the first two years of training now build from molecules to cells to organisms, with seamless transitions to anatomy, pathophysiology, and clinical care. Afternoon tutorials on drug-resistant tuberculosis, for example, now follow morning presentations on lung physiology.

4. Maximize the operating system (and not just for surgeons).

“The essential quality of the clinician is an interest in humanity,” Francis Peabody, Class of 1907, famously declared, “for the secret of the care of the patient is in caring for the patient.” The School now integrates the science of medicine with the sociology of medicine. All HMS students study medical ethics, global health, social medicine, and health care policy.

5. Follow quality assurance guidelines.

Integrate the content students learn in the clinic. The Principal Clinical Experience, the School’s new longitudinal, multidisciplinary clerkship, now places students in a single hospital for an entire year. This experience not only affords them rich mentoring opportunities, but also allows them to work with the same patients over time, replacing snapshots of understanding with streaming video. Compared with their peers in traditional clerkships, students in the new clerkships report more confidence in their clinical skills, an improved ability to integrate science with clinical medicine, and a better understanding of how the socioeconomic context affects patients.

6. Avoid placing a one-size-fits-all label on your completed doctor.

Recognize that there’s no one ideal path to becoming a physician. Some hope to become leaders, research investigators, or academics; others want to safeguard the health of individuals, communities, or the entire world. Celebrate their diversity and nurture their talents, for the secret of the care of the doctor is in caring for the doctor.

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