HMS Clinical Academic Departments

The HMS Preclinical Departments serve as the appointing departments for basic and social sciences faculty and trainees whose work and employment are based at the HMS Quadrangle (“HMS Quad”). They also host primary (“Quad B”) and secondary (“Quad C”) faculty appointments for some HMS faculty who are in the corresponding basic science discipline but whose employment and effort are located primarily at one of the HMS affiliates. 

Among the 11 preclinical departments, three are referred to collectively as social sciences departments: the Departments of Biomedical Informatics, Global Health and Social Medicine, and Health Care Policy. The remaining eight: the Departments of Biological Chemistry and Molecular Pharmacology (BCMP), Cell Biology, Genetics, Immunology, Microbiology, Neurobiology, Stem Cell and Regenerative Biology (SCRB), and Systems Biology, are referred to collectively as the basic sciences departments. These departments’ faculty and labs are based primarily on the HMS Quadrangle, with the exception of SCRB, which, though based on the Harvard Cambridge campus, has faculty embedded on the Quad and in various HMS affiliate hospitals. SCRB faculty hold joint appointments in the Harvard Faculty of Medicine and the Harvard Faculty of Arts and Sciences.

In contrast to the HMS Preclinical Departments, which both provide academic appointments and also typically act as the primary employer for their faculty, the HMS Clinical Academic Departments provide faculty with their HMS academic appointments but do not serve as their employer. As HMS’s organizational superstructure for faculty and trainees employed by the 15 HMS teaching affiliates HMS Clinical Academic Departments connect academic leadership, faculty, and learners within a clinical field across the HMS teaching affiliates. Each of the 18 HMS Clinical Academic Departments is composed of one or more HMS affiliate-based academic departments in the corresponding clinical field. Academic appointments for faculty in each of these HMS Clinical Academic Departments are hosted through one of their constituent affiliate-based academic departments.

Operating on an HMS-wide level, the HMS Clinical Academic Department serves as a convener of the attention, efforts, and vision of the departmental discipline across affiliate-based departments, facilitates adherence to best practices among its constituent departments, and “lifts all boats” by setting the standard for academic excellence across affiliate-based departments and calibrating such local standards with the University’s standards for academic excellence. 

The School expects that the HMS Clinical Academic Department will foster, oversee, and maintain a milieu conducive to academic excellence, integrity, and professionalism for its constituent affiliate-based academic departments, faculty, and learners. Moreover, an academic department is expected to foster collaboration among the leadership of its constituent affiliate-based departments at HMS and to uphold standards for academic quality in the Faculty of Medicine. In this domain, HMS Clinical Academic Departments are tasked with maintaining their calibration of excellence both with other departments at the School and also with counterpart clinical departments at peer institutions.

HMS-wide and affiliate-based clinical departments are mutually interdependent. An HMS Clinical Academic Department cannot be established or operate without constituent affiliate-based academic departments, and, conversely, an affiliate-based department cannot host faculty appointments without being a member of an HMS Clinical Academic Department. 

List of Harvard Faculty of Medicine Appointing Departments

This table displays the names and domains of the appointing departments in the Harvard Faculty of Medicine. The focus here is on HMS Departments; additional information about the configuration of the five HSDM Academic Departments is described elsewhere at https://hsdm.harvard.edu/academic-departments.

Affiliate-based academic departments are the affiliate-based counterparts and constituent members of HMS Clinical Academic Departments. These affiliate-based departments, which reside at non-Quad, predominantly clinical sites, have been recognized by HMS for their academic excellence, standing, and administrative capabilities as primary sites for academic oversight and coordination at the interface of HMS affiliate institutions and Harvard Medical School. Upon this recognition, these departments are delegated aspects of responsibilities for proposing faculty and other academic appointments in their “parent” HMS Clinical Academic Department. Their responsibilities include participation in the evaluation and review of the proposed candidate faculty, whose academic appointments they will host on behalf of the HMS Clinical Academic Department and the HMS affiliate institution. Given their important role in participating as constituent members of the HMS Clinical Academic Department, these affiliate-based academic departments are sometimes referred to as “appointing departments” to distinguish them from other hospital-based departments that have not been delegated these responsibilities (because of limited size, limited academic infrastructure and resources, etc.).

Affiliate-based departments that have not been recognized as an “appointing department” with delegated aspects of appointing responsibilities are not formal members of their parent HMS Clinical Academic Department. In such departments, however, their HMS faculty still hold an appointment in the Faculty of Medicine in one of the HMS Clinical Academic Departments, and this appointment is hosted by one of the member affiliate-based academic departments. 

HMS Clinical Academic Departments

HMS Clinical Academic Departments provide an HMS-wide organizational structure for collaboration among academic leadership and faculty within a clinical field across the 15 HMS-affiliate hospitals and institutions. The scope and depth of aggregate expertise among these faculty and institutions provide unparalleled opportunities for excellence in medical education; clinical training; cutting-edge basic, translational, and clinical research; as well as clinical innovation. 

In particular, the HMS Clinical Academic Department platform is intended to foster field-specific research and educational collaboration that advance and fortify the academic mission of the Department and School, mentorship and career advancement of HMS faculty, and world-class undergraduate and graduate medical educational programming. In addition to facilitating collaboration and discussion across affiliate-based departments in the field, the HMS Clinical Academic Department is a key conduit for communication among the affiliate-based faculty and departments, the School, and the University.

A core responsibility of the HMS Clinical Academic Departments is to participate in the review of faculty promotions and to uphold the rigorous standards for academic excellence and professional integrity of their Department, the School, and the University. The Executive Committee of each HMS Clinical Academic Department works in partnership with affiliate-based academic departments as well as with the HMS affiliates’ senior appointments committees, the Council of Academic Deans, and HMS to propose—and contribute to the evaluation and review of—faculty promotions and appointments. The HMS Clinical Academic Department’s Executive Committee reviews and votes on nominations for HMS faculty promotions and appointments within a given department as the step immediately preceding submission of materials to HMS for review.

Affiliate-based Academic Departments

From the perspective of Harvard University and HMS, all affiliate-based academic departments and department heads are entrusted with the responsibility to ensure a commitment to scholarship and the advancement of new knowledge (the sine qua non of university ladder appointments and promotions) in their respective disciplines as well as to provide the best education for Harvard learners and the dissemination of medical and scientific breakthroughs beyond our walls. 

As mentioned above, Harvard University and HMS delegate aspects of appointing and promotions responsibilities to selected affiliate-based departments; this delegation is based on recognition of their academic standing and capacity to support career advancement of their faculty in academic medicine and maintain a strong learning environment in which educators and learners can thrive. These affiliate-based departments also host academic appointments on behalf of the “parent” HMS Clinical Academic Department. In discharging their delegated responsibilities for aspects of proposing appointments and promotions, they are expected to ensure that the University’s high standards for academic excellence and professional integrity are met. In addition to their responsibilities in proposing and hosting HMS academic appointments, the affiliate-based academic departments also interface with their respective HMS-affiliate hospital or institution, which serves as the principal employer for the members of the department and provides the institutional commitment for proposed senior appointments. Among their responsibilities to the HMS faculty appointees hosted in their departments, affiliate-based academic department heads are expected to fulfill the Liaison Committee on Medical Education (LCME) and HMS requirement that each HMS faculty member has an annual career conference with the department head or their designee. Department Heads also ensure that the HMS faculty they oversee continue to meet HMS requirements for teaching Harvard learners. Finally, Department Heads are expected to hold faculty rigorously accountable to all applicable School and University policies concerning research integrity and professional conduct. This accountability is reflected, for example, in the Chair’s attestation to integrity in proposing academic appointments. 

Included in the domain of this administrative unit is the additional hospital responsibility of delivering clinical care and balancing clinical service with scholarship and education. Whereas clinical care is not a direct component of the University’s academic mission, HMS and Harvard support and partner with the HMS-affiliate hospitals in pursuing their commitment to clinical excellence in delivering high-quality health care in the communities they serve; this health care delivery also provides the substrate for clinical training and cultivating the next generation of physicians and continues to catalyze discovery through bench-to-bedside and bedside-to-population investigation. That being said, affiliate institutions, working through affiliate-based departments and professional staff, bear responsibility for all clinical care delivery. Furthermore, the responsibility for adhering to and meeting relevant accreditation and credentialing requirements (e.g., by such accrediting bodies as the Accreditation Council for Graduate Medical Education [ACGME] and the Massachusetts Board of Registration in Medicine [BORIM]) lies with affiliate-based clinical departments and department chairs. 

Whereas affiliate-based academic departments have substantial overlap with hospital-based clinical departments, occasional differences exist. HMS affiliate hospitals are operated independently and manage their clinical operations through departmental, divisional, and other organizational structures that best fulfill their clinical mission. In some instances, an HMS affiliate hospital may choose to elevate a clinical division to institutional departmental status based on available administrative resources and other operational considerations, independent of academic strengths and capacities.

In addition, many of the affiliate-based academic departments are organized into divisions and subdivisions for administrative, clinical operational, academic support, or other purposes. Although routinely these divisions collaborate closely with the leadership of their department to support career advancement of HMS faculty, these subunits are not delegated formal responsibilities in proposing academic appointments or promotions.

Academic appointments to the Faculty of Medicine: Departmental responsibilities 

HMS Affiliate-based Academic Department Heads

Department Heads of the affiliate-based academic departments are considered Senior Administrative Leaders at Harvard Medical School. Their selection is made through a rigorous search process with the involvement and endorsement of the Dean of the Harvard Faculty of Medicine. These Department Heads also participate in leadership of the HMS Clinical Academic Departments as voting members of their respective Clinical Academic Department Executive Committees. 

HMS Clinical Academic Department Executive Committees

Each HMS Clinical Academic Department is overseen by a departmental Executive Committee, which seats each of the constituent affiliate-based academic department heads. The Dean of the Faculty of Medicine appoints a chair of each Executive Committee for a two-year term. Ordinarily, appointed leadership of each Executive Committee rotates among the affiliate-based academic department chairs in that field, with the proviso that Executive Committee chairs must be at the professorial rank, as required by University policy for oversight of tenure decisions.

At-large voting members may be nominated by the Executive Committee or members of the Council of Academic Deans when they bring faculty development and promotion experience, content expertise, or representation that augments or complements Committee membership and that will serve to advance the academic mission of the department. Nominees must be full professors with either an OID (of indefinite duration) or WLT (without limit of time) appointment to be eligible to serve as an at-large voting member. Upon the advice of the respective Executive Committee chairperson and review and approval by the Council of Academic Deans (CAD), the Dean appoints at-large members to an Executive Committee for a two-year term (renewable). 

An Executive Committee may invite additional non-voting members to their meetings at their discretion, as suited to the needs and interests of each particular HMS Clinical Academic Department.

HMS Clinical Academic Department Executive Committee Heads

The HMS Clinical Department Executive Committee Heads are convened several times annually to meet with the Dean of the Faculty of Medicine, the Dean of HSDM, the Dean for Clinical and Academic Affairs, and the Dean for Faculty Affairs to discuss faculty and School policy updates, emerging opportunities and challenges, and other matters of importance to the academic life of the community.

Harvard Medical School relies on the academic infrastructure provided by affiliate-based academic departments and HMS Departments to recruit, evaluate, retain, mentor, and participate in the promotion of faculty; to vet faculty at the time of their appointments, to monitor and ensure that faculty meet and exceed the School’s qualifications and high expectations for advancement; and to serve as the administrative unit entrusted with the responsibility of collating the nominating letter and materials for the proposed promotion. This governance structure situates the responsibility for the support for the academic success of the clinical faculty in a clearly defined, accountable authority. Moreover, by defining and establishing the HMS Departments that house HMS faculty, the School defines the departmental disciplines that fulfill the highest academic need, into which it invests resources, and from which the School—and its faculty and learners—derive the greatest good. 

The field of medicine is dynamic and in constant evolution. Within this context, occasionally, scientific advancements and clinical innovation reach a level of maturity and specialization around which scientific journals, professional societies, clinical training, and clinical practice are organized and increasingly independent from their parent clinical fields.

Although the launch of new clinical academic departments that are HMS-wide has been a relatively rare event during recent decades, under apt circumstances, academic leaders within the HMS community may recognize an opportunity and potential benefits to establishing a new HMS Clinical Academic Department. Doing so involves embarking on a process to explore whether the requisite academic merits, stature, and resources are substantial and warrant formation of an HMS Clinical Academic Department in the identified field.

The HMS community is often on the vanguard of basic, translational, and clinical research that advances clinical medicine and innovation and, in parallel, provides a platform for premier medical education and clinical and research training. Organization of a research, clinical, and educational portfolio of activities within a clinical field as an HMS Clinical Academic Department may enable integration, cohesion, and synergies that are beneficial to the institution and School.

Establishing a new HMS Clinical Academic Department can generate opportunities for the HMS community by creating a platform for collaboration for joint academic activities within a clinical field. An HMS-wide department leverages the depth and scope of faculty expertise across the 15 HMS teaching affiliates and taps potential synergies that arise through complementary resources and expertise. An additional principal benefit is an enhanced capacity to recruit, mentor, advance the careers of, and retain HMS faculty and trainees within the clinical field. Faculty and trainees benefit from access to the broad, HMS-wide leadership expertise that aligns best with their discipline-specific clinical, research, and educational interests and potential.

The impetus for exploring the launch of a new HMS Clinical Academic Department begins with the recognition of academic strengths and an academic opportunity; generally, this opportunity is recognized and championed by affiliate-based academic leadership in or adjacent to this clinical field. At a minimum, launching an HMS Clinical Academic Department is predicated on well-established academic activities, faculty expertise, and resources in the proposed clinical area across at least several HMS-affiliated institutions. The expectation is that, ordinarily, these activities and faculty would be organized as clinical divisions or hospital-level departments at two or more HMS-affiliated institutions; these divisions or departments should be characterized by a growing cadre of senior faculty, one or more recognized clinical training programs, clinical excellence, and a thriving research portfolio. The number of senior faculty in the prospective department should be adequate to provide leadership, mentorship, and supervision of faculty and trainees as well as to execute the responsibilities of their role in proposing and contributing to the evaluation of candidates for faculty appointments and promotions. 

An HMS Clinical Academic Department can only be established when affiliate-based departments or divisions have demonstrated readiness to operate as affiliate-based academic departments with delegated appointing responsibilities; fulfill criteria and expectations by the School and University for this recognition; and have an institutional commitment to support the necessary resources as a constituent member of the HMS Clinical Academic Department. 

The decision to establish an HMS Clinical Academic Department in a new field requires recognition of the field as a mature and independent discipline, established academic excellence, well-articulated and compelling academic opportunities for the HMS community, and demonstrated capacities and resources adequate to fulfill responsibilities of an HMS academic department. Whereas these criteria may be operationalized somewhat differently across clinical disciplines alongside other relevant contextual considerations, the bar for establishing a new HMS Clinical Academic Department will be uniformly high in alignment with the HMS community’s standards for academic excellence and its shared mission. 

Because, generally, the evolution and maturity of a clinical field falls on a continuum, and because optimal organization of clinical operations, research and educational programming, and faculty support will vary with the local institutional context, some peer institutions may recognize certain clinical fields as independent, whereas others, including HMS, may not. Likewise, peer institutions may see potential and opportunity at a comparatively earlier or later stage of the field’s development than do HMS institutions.

Stakeholder support for the proposed academic department will also be prerequisite to establishing the new department, and stakeholder perspectives regarding the potential benefits and drawbacks to formation of a new department will be integral to consideration of a proposal. For example, stakeholder perspectives on any potential, unintended, adverse impacts on remaining divisions and/or faculty of an established department must be addressed. That being said, a uniform interest in participating across HMS affiliated institutions is not necessarily essential for proceeding toward formation of an HMS Clinical Academic Department when there are compelling benefits for the HMS community in doing so. Leadership at one or more of the HMS teaching affiliates may have strategic priorities that do not align with the organization of clinical services, educational programming, research activities, or administrative oversight as a hospital-level department. Under that scenario or for other reasons, HMS affiliated institutions may choose to have their faculty continue to have their appointments hosted through their existing HMS appointing department. Still, HMS encourages broad participation, because the benefits of forming an HMS Clinical Academic Department will, in part, derive from synergies and aggregate strengths across the HMS community. 

Minimal criteria for establishing an HMS Clinical Academic Department 

• Recognition of the field as an independent and mature clinical discipline: Broad recognition of the field as substantially mature and distinct as a clinical discipline as well as independent in research foci and educational programming; proxies for field independence and maturity may include:
  • Well-established, field-specific professional societies and high-impact journals
  • ACGME-accredited postgraduate training program(s); ordinarily, this would include a residency
  • Peer institutional practices that demonstrate acceptance and value of independent department status.
• Identified academic opportunities that will benefit the HMS community: Evidence supports that HMS-wide department status would benefit HMS learners, faculty, participating hospitals, the HMS community, and the University.
  • Potential for HMS-wide collaboration: HMS Clinical Academic Department status will create and enhance efforts for HMS-wide educational programming, faculty development, research collaborations, clinical excellence, etc. This evidence should support convincingly a “whole is greater than the sum of its parts” argument.
  • Potential for strengthening faculty support: Evidence shows that the HMS Department will strengthen support for faculty recruitment, retention, mentorship, and career advancement.
• Academic strengths and growth potential within individual affiliate-based departments and, in aggregate, across HMS: Academic excellence, strengths, limitations, and trajectory in the proposed field at HMS (and within participating HMS affiliate-based departments) compare favorably with those of peer institutions and other relevant benchmarks.
  • Broad HMS affiliate participation: Ordinarily, at least two or more affiliate-based departments from current HMS affiliates representing more than one health system will constitute the new HMS Academic Clinical Department, will plan to participate on the Executive Committee, and will support and host faculty appointments from their home institution in the new department.
  • National standing and reputation for impact and scholarly contributions: Evidence supports the fact that the participating affiliate-based and aggregate HMS-wide departmental research, educational, and clinical achievements have attained recognition of national standing in the field.
• Capacity to fulfill roles and responsibilities of an HMS Clinical Academic Department: Capacity of the proposed department to meet expectations for its delegated responsibilities with respect to faculty appointments and achieve its other objectives relating to the academic mission (including faculty development, mentorship, retention, scholarly activities, and teaching commitments) is demonstrated.
  • Support of hospital leadership at each participating affiliate for an affiliate-based academic department at their respective institutions
  • Depth of senior faculty with experience in the HMS faculty promotion process across and within participating departments.

•   Resources: Endowment funding, institutional commitments, and infrastructure are sufficient to: 

• Support affiliate-based academic department chairs in their role as Department Head and in Executive Committee participation
• Manage administration of appointments, promotions, and faculty recruitment/retention
• Coordinate HMS-wide events when beneficial to trainees and faculty in the department
• Effect a well-articulated plan to support allocated time for educational programming, faculty teaching, and scholarly engagement within each participating affiliate-based academic department.
• Broad stakeholder support: A wide range of stakeholder perspectives regarding the merits of the proposed new department and related anticipated benefits to the HMS community as well as potential adverse impacts on either the HMS community or the existing affiliate-based departments and/or their remaining divisions and faculty (including their teaching roles and responsibilities) has been solicited and supports establishing the proposed new HMS Clinical Academic Department.

The process for establishing a new HMS Clinical Academic Department includes a rigorous vetting process that examines pertinent data and supporting arguments for how the proposed new department fulfills criteria as well as an analysis of anticipated benefits and potential adverse impacts to the HMS community writ large and to existing affiliate-based departments from which the new department would separate. Establishing a new HMS Clinical Academic Department is a relatively rare event and premised on already robust academic and clinical strengths at HMS-affiliated institutions, which take the lead in developing the proposal and establishing one or more affiliate-based academic departments.  

Initial proposal examined in an exploratory process 

The process begins with an exploratory phase, during which the HMS Committee on Clinical Academic Departments conducts a preliminary review, stakeholder commentary is invited, and the HMS Council of Academic Deans reviews the proposal and commentary and advises the HMS Dean. 

The focus of the preliminary review is to ascertain the adequacy of available institutional commitments and resources, administrative capacities, academic strengths, and relevant experience and depth of senior faculty to fulfill the academic responsibilities of the proposed HMS Department. This preliminary review may identify recommended areas for further development prior to proceeding further through the exploratory phase. 

If the initial proposal is received and reviewed favorably, the affiliate-based lead(s) will be invited to prepare a full proposal, which will advance toward a formal review. 

Full proposal is invited and undergoes formal review

After the exploratory phase yields a recommendation to proceed to a formal review, the affiliate-based lead(s) will be invited to prepare a full proposal in support of establishing the new department. 

The formal review phase of the process includes the convening of an ad hoc expert review committee that seats members with content expertise who will evaluate and advise on the readiness and potential benefits or concerns relating to formation of the proposed new HMS Clinical Academic Department. 

Additional HMS evaluation includes review by the HMS Committee on Clinical Academic Departments, HMS Council of Academic Deans, HMS Clinical Academic Department Executive Committee Heads, and the Faculty Council. 

If evaluation of the proposal is favorable and receives the Dean’s endorsement, the proposal will be submitted for review and consideration to the Provost’s Office, and a final decision will be rendered. 

The key milestones in the process are summarized below (see also Figure 2). The timeline and outcome of this process will vary depending on the strengths, faculty depth, present capacities, and anticipated trajectory. This timeline may be as brief as one year in duration but could also stretch to several years or even longer, depending upon when the criteria can be fulfilled. 

Step 1. Affiliate-based leadership proposes consideration of a new HMS Clinical Academic Department 

Affiliate-based academic leadership initiates a request

A new HMS Clinical Academic Department is predicated on affiliate-based readiness, resources, and interest in establishing a hospital-level department or division as an academic department. Therefore, the request and proposal development will originate from academic leadership at one or more of the HMS affiliates. Academic leads at any one or more of the HMS affiliate institutions who are prepared to support an affiliate-based academic department in that field can initiate a request that HMS embark on the process to consider the readiness, potential merits, and stakeholder support for establishing a new HMS Clinical Academic Department.

Cover letter and brief proposal submitted for review

A request to explore the merits and readiness to launch an HMS Clinical Academic Department in a new clinical field should be submitted in the form of a cover letter and accompanying brief proposal addressed to the Dean for Clinical and Academic Affairs and to the attention of the HMS Committee on Clinical Academic Departments. 

A successful proposal will briefly summarize, point-by-point, how each of the criteria listed in Table 3 either has already been met or is expected to be fulfilled in due course when the department has been established. The request should also list supportive stakeholders with whom the request has already been discussed preliminarily, for example, adjacent divisional and departmental leadership of prospective constituent affiliate-based academic departments as well as affiliate leadership. The cover letter should be signed by the academic leader or leaders at each institution who would be prepared to develop a full proposal for the new HMS Clinical Academic Department.

Preliminary inquiries are welcome

The timeline for establishing an HMS Clinical Academic Department may be quite lengthy, even when successful, befitting the serious task of evaluating the readiness and potential benefits of establishing a new department. Affiliate-based academic leaders are encouraged to seek information and guidance about readiness to meet requirements and embark on the first step of the process. Questions may be directed to:

Dean for Clinical and Academic Affairs deanforcaa@hms.harvard.edu 

Director, Office for Clinical and Academic Affairs sara_kiarsis@hms.harvard.edu 

Step 2. HMS Committee on Clinical Academic Departments conducts a preliminary review of the proposal

The HMS Committee on Clinical Academic Departments will conduct an initial review for the proposed new department. This committee’s charge is to evaluate readiness to meet criteria for establishing the new department, to provide feedback to the authors of the proposal, and to make a recommendation to the Dean for advancing the proposal or deferring further consideration pending resolution of any concerns and further development toward meeting criteria. Their role is advisory to the Dean of the Faculty of Medicine. 

Step 3. HMS Dean endorses or defers an initial exploratory process 

At this stage of the process, the Dean considers the recommendation of the HMS Committee on Clinical Academic Departments alongside the request, initial proposal, and supporting materials. If the Dean endorses the proposal to move forward to an exploratory process, stakeholder commentary will be invited. Alternatively, the proposal may be deferred when one or more criteria are deemed unlikely to be satisfactorily fulfilled in the near term. Under that scenario, the Dean may invite or encourage a resubmission of the proposal pending additional information or progress toward substantiating that criteria have been or will be met. 

Step 4. Stakeholder commentary is invited 

Key stakeholders from HMS affiliated institutions will be invited to share their perspectives on the opportunities, potential benefits and drawbacks, and challenges to developing plans for establishing the proposed new department. Successful launch, operation, and fulfillment of the aims for an HMS Clinical Academic Department will depend upon robust support and collaboration among key participants across HMS and participating HMS affiliate institutions. Constructive feedback on the proposal will be shared. 

Step 5. HMS Council of Academic Deans conducts a preliminary review of the proposal and stakeholder commentary 

Members of the Council of Academic Deans (CAD) include chief academic officers representing the HMS affiliated hospitals, which oversee the majority of affiliate-based academic departments. They will evaluate the proposal and summary of stakeholder commentary on the potential benefits and drawbacks to establishing the proposed department as well as the readiness of the proposed department to fulfill the criteria. Their recommendation of whether to proceed to a formal review is advisory to the Dean.

Step 6. HMS Dean invites or defers a full proposal and formal review 

Upon consideration of the stakeholder commentary and CAD recommendation, the Dean will decide whether to invite a full proposal for the new HMS Clinical Academic Department and proceed to a formal review. 

In moving from an exploratory phase to a formal process, the affiliate-based lead(s) will be expected to engage each of the HMS affiliate institutions with research, educational, and clinical activities in the clinical domain of the proposed department to develop jointly a detailed full proposal.

This proposal will provide data from each of the proposed participating affiliate-based departments relevant to meeting Harvard Medical School’s criteria for recognition as an affiliate-based academic department. Ordinarily, this will include the reports from a formal department review through the HMS External Clinical Review Program, during which academic strengths and capacity to fulfill delegated appointing responsibilities would have been evaluated favorably. 

In addition, the proposal will include a synthesis of aggregate academic strengths and capacities in support of a successful launch and functioning as an HMS Clinical Academic Department across the participating prospective affiliate-based departments. The proposal will also include an analysis of known potential adverse impacts on or unintended consequences for the remaining divisions and faculty of the existing affiliate-based departments and the HMS community that may be associated with establishing the proposed new department. 

Step 7. Ad hoc expert review committee conducts a formal review of the full proposal 

After a full proposal to establish a new HMS Clinical Academic Department is submitted, an ad hoc expert review committee will be convened to conduct a formal review. Ordinarily, this review committee should include external reviewers who are content experts from peer institutions as well as members of the HMS community. The format of this review will be similar to the established process for conducting joint external reviews of affiliate-based clinical departments through the HMS External Clinical Review Program. During this process, academic leadership and other HMS faculty will be invited to meet with members of the review committee in order to provide testimony relevant to evaluation of the proposal. 

The ad hoc committee’s review will include an evaluation of strengths and areas requiring further development relevant to the reputation, productivity, department-wide resources, individual-affiliate-based resources, and faculty that would comprise the proposed HMS Clinical Academic Department and its constituent affiliate-based academic departments. When relevant, the ad hoc expert committee will also comment on the broader context of opportunities and challenges in the proposed field that may bear on the future success of the department and its potential benefits for the HMS community. 

The ad hoc expert review committee will brief the Dean, leadership of participating HMS affiliated institutions, and members of the HMS Committee on Clinical Academic Departments on their findings. A confidential written report will be provided to guide further action. 

At this juncture, HMS and affiliate leadership may request additional information, materials, or commentary prior to issuing a recommendation. 

If the process and information are sufficient to issue a recommendation, the Dean will determine whether compelling grounds have been marshaled to support a recommendation to proceed toward formal approval a) to establish the proposed new HMS Clinical Academic Department and b) to recognize the prospective participating affiliate-based departments as academic departments. 

If a full proposal for a new HMS Clinical Academic Department has been received and reviewed favorably by an ad hoc expert review committee, the leadership of participating HMS affiliated institutions, and the Dean but additional growth and development of capacities and resources are warranted, the process may be paused. Such a pause would remain in place pending resolution of specific concerns and/or progress toward specific benchmarks relevant to meeting criteria to establish a new department. Resumption of the review would begin where it paused at this future stage of the process. Alternatively, the proposal may be declined or deferred when one or more criteria are deemed unlikely to be satisfactorily fulfilled in the near term. Under that scenario, the Dean may invite a resubmission of the proposal pending additional information or progress toward substantiating that criteria have been or will be met.

Step 8. Additional review, commentary, and recommendations advisory to the Dean on the proposed new department 

After a full proposal for a new HMS Clinical Academic Department has been received and reviewed favorably by an ad hoc expert review committee, the leadership of participating HMS affiliated institutions, and the HMS Dean, the Dean will request review and commentary from the following committees to indicate their level of support for establishing the proposed new department: 

• HMS Committee on Clinical Academic Departments
• HMS Council of Academic Deans
• Committee of [Clinical Department] Executive Committee Heads
• HMS/HSDM Faculty Council

Upon review of these recommendations, the HMS Dean will decide whether to decline or defer the proposal or whether to request consultation and review by the Provost. 

Step 9. The HMS Dean consults with the Harvard University Provost, and a decision is rendered

The HMS Dean will request consultation and review of the proposal by the Provost on establishing the new HMS Clinical Academic Department and recognizing the participating constituent hospital departments as affiliate-based academic departments. Following this consultation and review, a final decision will be rendered.