Third-year MD student Athena Apfel meets with PCE core faculty member Jacob M. Koshy. Image: Julia Zhogina
As a doctor, knowing how to ask a patient questions can be as important for building trust and providing care as knowing what to ask.
Harvard Medical School student Felita Zhang honed this skill this spring during her Principal Clinical Experience (PCE), a year-long period in an MD student’s medical education when they are immersed completely in caring for patients.
For example, instead of making assumptions about a patient with liver cirrhosis and asking leading questions such as whether they have used alcohol, Zhang learned to ask open-ended questions, such as “What do you eat or drink during a typical day?” She found that this approach to taking a medical history helped patients feel more comfortable and offer more nuanced information, which allowed her to better evaluate them and develop care plans.
Zhang and fellow students are benefiting from enhanced skill development as a result of a new type of position at the School, called the PCE core faculty.
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Implemented in January 2025, the initiative supports 80 physician-educators at the School’s major affiliated hospitals so that they have dedicated time to give personalized attention to a small number of medical students throughout one of their rotations, also called clerkships.
This model is unique for training MDs, leaders said. Typically, a large number of clinical educators instruct a student throughout a rotation, and the student may be paired with each instructor only once or twice.
“Their guidance is surely beneficial, but there’s only so much that can be gained from a series of snapshots from multiple instructors,” said Sara Fazio, chair of the Principal Clinical Experience Subcommittee at HMS and HMS professor of medicine at Beth Israel Deaconess Medical Center.
The core faculty model provides a more complete picture because one individual observes the student from beginning to end of a clerkship, Fazio said. The faculty member helps the student integrate the feedback they’ve received from their clinical instructors, identify their strengths and areas for improvement, discuss any concerns, and assess their development.
“It allows us to work with individual students on the connection of clinical skills, reflective practice, formation of professional identity, assessment, remediation, all these domains — and across time,” said core faculty member Jessica Berwick, HMS assistant professor of medicine at Massachusetts General Hospital, who has been teaching students in the PCE since 2016.
So far, the model appears to be raising satisfaction among both teachers and students.
“It’s gratifying to see students start out with no experience on the wards and then see them learn and grow week over week,” said core faculty member Kimberly Keefe Smith, HMS instructor in obstetrics, gynecology, and reproductive biology at Brigham and Women’s Hospital.
Students have expressed that they have developed trusting relationships with their core faculty members, Fazio said. More fully supported, the future doctors readily progress toward mastering clinical skills.
