Harvard Medicine

April 16, 2008
HMS student (name withheld by request)

Scholarly project "requirement"

As a current HMS student, I read the comments regarding the benefits of establishing a "scholarly project" requirement with trepidation. I hope my words are not miscontrued. I visited Stanford as one of my choices for medical school, and one of the deterrents was the so-called scholarly project. I believe medical schools work similarly to businesses everywhere, you get what you advertise for.

The implication that HMS will not begin to see a progressively higher percentage of students engaged in research as components of their careers is erroneous. Research is not a bad thing! I should say that, but for some, it is not a part of why and what it means to be a clinician. Introducing students to the importance of critical thinking, evaluation of relevant medical data, and incorporation of these ideas into one's practice is a model that should be sought after. That is a different message than the one that would be sent by requiring a scholarly project. I believe firmly that the ripple effect of such a requirement will be seen not simply in the product of the HMS education, but more subtly and convincing in the admissions are of this institution.

It is interesting to read the comments that students, without research background, would have an opportunity to engage in rigorous research that may stimulate their future career interest. I submit that for every student that fits that example, there is the student who knows that research is not what they are interested in, and for whom, this "requirement" will serve as a deterrent to their acceptance to HMS. I believe that in making a scholarly project a requirement, HMS will field a new and different type of applicant, not necessarily better or worse, just different. I would simply caution against striking out onto a path where the curriculum is condensed into a smaller time frame and now adding another rigorous mandatory component.

I hope my argument has been clear; it is very late and my child won't go to sleep. Thank you.

Thank you for writing about the scholarly requirement. From reading your note, I would conclude that you are concerned about requiring students to participate in research, and that misses the point. We are not urging students to participate in research but, instead, to partner with one of our faculty over an extended time to work on a scholarly project, i.e., to identify a problem and to work on it. For some, this will be a research project in the lab or in a clinical trial, but for others, it will be a focus on a problem (e.g., in social medicine, medical ethics, community service) along with one of the faculty. The concept is to engage students actively in problem solving, which is an important ingredient in leadership.
Whether our students end up in academic medicine or in practice, inevitably, they will identify problems that beg for solutions, and we want our students to have had a model experience in medical school upon which to draw when encountering such issues. Our highest goal is to prepare students as change agents, to make a real difference in whatever sphere of medicine they pursue. If you are in practice some day, and you identify a problem in the way your patients are receiving care for a specific medical problem, we would like you to have had a faculty-tutored experience in framing a problem, finding ways to address the problem, and actually carrying out the undertaking. Advancing medicine is one of the key ingredients in our HMS mission. Because HMS is known as a research institution, almost all successful applicants to HMS include in their application portfolio a record of substantial independent scholarship; why should we not expect them to continue in this vein once they get here?

If you ask college students years after college what their most memorable college academic experience was, almost always it is not this class or that class but, instead, it is their sustained work on a longitudinal project, such as an honors project, with a faculty member. If adding this focus on active scholarship (which is what distinguishes our faculty here) scares off applicants, then, perhaps they would be more comfortable at a different medical school. In fact, for students like you who are so highly qualified and who consider, and are competitive for admission to, the top-echelon medical schools, in the near future, they will not have a choice. Every one of the top schools, and a large number of the next tier schools and even many in the "middle of the pack," are in the process of introducing a requirement for a scholarly project (e.g, in addition to Yale, Stanford, U Pittsburgh, and Duke, which have had such requirements for many or several years, you can add to the list not only HMS but also Hopkins, Columbia, Rochester, U Chicago, Cornell, Brown, Penn, UCSF, Case, Vanderbilt, etc. In the very near future, top students will have no choice but to add active engagement in scholarship as a component of medical school preparation. An underlying principle is that the study of medicine should not be a "spectator sport" but a participatory one.

Incidentally, most of the medical schools that have already adopted scholarly projects have not seen any dilution or substantial change in their applicant pool or their matriculant composition (except for a welcome "upgrade" in quality, as defined by some schools). We at HMS have been discussing this future requirement with applicants and revisiting accepted students for the last several years, and the response has been very positive. We did hear that, at Stanford, the new requirement led to a drop off in applications from underrepresented minority students, but no such change occurred at Duke or Pittsburgh or anywhere else that we are aware of. At HMS, we are very committed to providing opportunities for students from groups underrepresented in medicine, and we see no conflict between that commitment and our adoption of a focus on scholarship.

Finally, the addition of a required in-depth scholarly project was one of the main pillars of medical education reform, as defined carefully over the last six years by multiple committees, workshops, task forces, and working groups. Each of these groups included students who helped formulate the current plan. The planners of this new program were careful not to label it "research" or to label the required written work product (the opportunity for careful, formal reflection on what had been pursued and accomplished) a thesis. I hope this helps place the program in a more understandable light.

Jules Dienstag, Dean for Medical Education

HMS Strategic Planning

Comments and Discussion