Thoughts from the Dean

Transforming Medical Education

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September 23, 2015
Transforming Medical Education

At Harvard Medical School, we have dramatically transformed our curriculum for the class that just entered.  Why? 

The answer is actually quite simple.  Our curriculum has been transformed dozens of times over our 233-year existence, as medicine, medical science and society have changed.  But as much as the medical profession has changed in the past, the pace of change is faster and more profound today than ever before.

At the core, the doctor-patient relationship remains central, but the science of medicine is rapidly evolving as genomics and big data combine with other elements to usher in an era of personalized or, as it’s also called, precision medicine. 

Medical practice is also well along the road to transformation with many fewer physicians self-employed and practicing solo.  Physicians of the future will require new skills enabling them to practice in inter-professional groups, with added responsibility for the overall health of the population under their care. 

The availability of medical information online, albeit now of variable quality, will also change the way students, practitioners and patients approach medicine and health information. 

These realities, and others, are reshaping medical practice.  In addition to the rapid maturation of digital learning paradigms, there is also great opportunity to alter pedagogy and emphasize active learning based on insights into how millennials learn.

Our approach to curriculum redesign had few preconceptions.  This allowed us to create, rearrange and integrate disparate curricular elements in a way not otherwise possible.

The new curriculum, which we are calling Pathways, attempts to respond creatively to all of these important influences.  The classic two-plus-two basic science/clinical paradigm has been re-imagined into a three-phase model, with the preclerkship curriculum shortened to 14 months, allowing students earlier immersion in clinical settings.  

Both the content and pedagogy were completely redesigned to provide the analytical skills we now believe students need before they enter hospital clerkships, which were redesigned several years ago. 

A new, lengthened post-clerkship curriculum will provide depth and opportunities for scholarship and specialization, allowing students to return to basic science having greater familiarity with human disease and its treatment. 

Although all of our graduates become physicians, history shows they will enter an incredibly diverse array of professional careers, from practitioners in every medical specialty to leaders of organizations as varied as the Food and Drug Administration, the World Bank and the U.S. Senate. This reality demands a curriculum that provides personalized “pathways” for a diverse student body that will practice the precision medicine of the future.

Longitudinal exposure to bioethics, professionalism and related meta-topics begins in the first week and is ongoing.  We will conduct research on the effects of these innovations and anticipate several mid-course corrections.  This will certainly not be the last transformation of medical education at Harvard, or at the many other schools seeking to train physicians for a medical future that we can only partially envision