Beginning with the 2007–2008 academic year, what had been a five-week block on pharmacology in the students’ first year will now kick off the second year as a two-week introductory block under course director Carl Rosow, HMS professor of anesthesia at Massachusetts General Hospital. (Rosow has directed the Health Sciences and Technology pharmacology course for 13 years.) The shorter block, an introduction to basic principles of pharmacology, does not mean short shrift: the principles Rosow and his colleagues teach will be elaborated upon in the Human Systems (pathophysiology) courses that follow throughout the second year.
“The pharmacology course isn’t just two weeks,” said Rosow. “There will be more pharmacology rather than less, and it will be taught in a sequence—alongside pathophysiology—that will, hopefully, be more intuitive for the students.”
“The first year is not the best time to teach pharmacology, because learning about drug therapy is difficult when you don’t know very much about the diseases being treated,” Rosow said. His two-week course will introduce students to broad concepts, such as the ways that drugs can be absorbed, distributed, metabolized, and excreted. It will also cover how drugs bind to receptors, how they interact with one another, and how they may cause toxicity. “For example,” he said, “drugs for cardiac rhythm disturbances can cause arrhythmias as well as treat them. Or consider multiple-drug treatments for cancer and hypertension. We will use drugs from both classes to illustrate how they may be combined to increase effectiveness and reduce side effects.”
During their careers as doctors, the students will use drugs that haven’t been invented yet, so training them to be aware of general issues is essential. This introduction will give students the vocabulary to discuss drugs in relation to specific organs and diseases covered in later courses.
Rosow is collaborating closely with second-year pathophysiology faculty and with Pharmacology co-director John Pawlowski, HMS assistant professor of anesthesia at Beth Israel Deaconess Medical Center, on the division of labor and how they will follow up on the principles presented in the two-week introduction. “The key goal of our integration effort is to teach about the basic science and clinical application of drugs in a coordinated way,” Rosow said. “For example, a cardiovascular drug may illustrate an important theoretical principle, but it may also be an important part of clinical treatment. The Pharmacology faculty will introduce this prototype drug by describing its molecular mechanism or dose–response curve, and we will also indicate its place in the treatment of heart disease. Later in the year, the faculty in cardiovascular pathophysiology may review the mechanism, but spend more time discussing the use of related drugs or describing how the pressures and flows in the diseased heart will change from a given dose. The focus is expected to be different, and we believe that student learning will be facilitated by stressing both perspectives.”
The best methods for integrating a longitudinal piece of the curriculum like Pharmacology are currently being determined. Rosow explains that one method might be to swap faculty. “I or one of the other Pharmacology instructors might go into the Human Systems module and give a drug lecture. On the other hand, a cardiologist, nephrologist, or pulmonologist might come and give a lecture in pharmacology.” The syllabus for his two-week introduction, in fact, will cite lectures in other components of pathophysiology throughout the second year.
Students in Rosow’s block will meet every weekday morning and two afternoons a week, totaling 44 hours of study over two weeks—about the same number of hours as his seven-week Health Sciences and Technology pharmacology course.
