HMS STRATEGIC PLANNING |
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FEBRUARY 12, 2008Message from Dean FlierDear Colleagues: The idea of the “scholarly project” has been much discussed and sometimes leads to confusion. Let me make clear at the outset that “scholarly” does not mean “at the bench”. The Yale example is instructive: only a little over a quarter of the projects are lab-based. Clinical, epidemiologic or sociologic (including medicine and humanities) topics account for almost three-quarters of the projects. The requirement for a project is designed to promote “development of critical judgment, habits of self-education and imagination, as well as the acquisition of knowledge and research skills.” The project is typically completed in 6-9 months spread over the four years of training. About half of the students then elect to perform an additional year of research as the fifth year of their degree. I was impressed by the fact that a very large percentage of the projects (65%) eventually result in a publication. Why should HMS introduce a scholarly project requirement? For me there is one main reason: it is a way to make more explicit our view that investigation and generation of new knowledge are, alongside clinical medicine, a core element of the HMS ethos. Our students should leave medical school with some understanding of the process whereby new knowledge is obtained and assessed. The project focus could be wet lab, dry lab, clinical research, literature review, global health, health disparities, public health, ethics or legal aspects of medicine. Working on a project may have other benefits. Students who may not have been exposed to research in their previous training would have a chance to discover that they have both affinity for this kind of activity and capacity to succeed in it. Some students may choose to extend their project further and thus lay a foundation for a potential career in research. Others would continue to pursue a traditional clinical path, but the experience of a period of research would have a lasting effect on their approach to their clinical career, and their capacity to lead. What would argue against introducing such a requirement? The biggest argument here is that it is already difficult to fit all the requirements into four years. Would the time taken to do a project stress students excessively, causing burn-out? Or would students enjoy doing the project, and find it a worthwhile investment of time? I would be very interested to hear your views, which can be submitted via the comments section. There is one other question that consideration of a scholarly project requirement brings up. At a recent steering committee meeting, we discussed at length the question of what kind of time commitment is needed for an MD to transition into a research career — should he or she wish to do this — and whether the scholarly project is a good step in this direction. I would like to stress again that if we were to introduce a scholarly project requirement, launching students into a research career would not be the goal. However, it is probably worth thinking about whether we have offered a varied enough list of routes into research for our medical students. Some students will wish to pursue a full PhD; the MD/PhD program certainly offers outstanding training, and perhaps this program should be expanded (this is a strong recommendation of the Education advisory team). Other students might be better served by substantial, but shorter research experiences (say, one or two years), towards the end of the MD training. I can think of several examples of outstanding scientists who went directly into post-doctoral training after a research experience of this kind of length. Perhaps we need to build in options for exploration of research at many points in the career of a student; the 5th year option might be only one of these. Whatever the extent of choices for scholarly activity by HMS students, it must never be forgotten that expertise as physicians is a bedrock goal. While some students may have outstanding research careers, others will have outstanding clinical careers, and yet others will blend research and clinical activity. Our challenge is to create a program that is flexible enough to prepare all of our students to excel. Currently I am leaning towards the notion that a scholarly project requirement will be a step forward. I look forward to your comments, positive or negative. Jeffrey Flier
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