A mandatory scholarly project for HMS students—one suggestion of curriculum reform that was postponed due to cost and implementation concerns—should be a cornerstone of Dean Jeffrey Flier’s strategic planning process. So says the Strategic Advisory Group on Education (SAGE), one of four teams shaping the strategic initiative.
The 33 committee members—drawn from the Medical School’s graduate and undergraduate programs, the teaching hospitals, Harvard’s undergraduate faculty, and the School of Public Health—agreed that a required scholarly project meshes with the broader goal of educating scholarly physicians and physician–investigators who have the potential to create new knowledge. Jules Dienstag, dean for medical education and a committee member, calls the scholarly project recommendation “the most important outcome of SAGE’s work. We have the new administration behind it.”
Pursuing the theme of training scholar–doctors, SAGE recommends enlarging the joint MD–PhD program. “A significant number of the students who turn down offers of admission to HMS do so because we cannot offer funding for all the qualified MD–PhD applicants, and they get fully funded slots in MD–PhD programs at other medical schools,” said Thomas Michel, HMS professor of medicine at Brigham and Women’s Hospital. “To attract these outstanding students, we feel we need to nearly double the size of the program,” admitting about 20 students a year. Michel and Orah Platt, HMS professor of pediatrics at Children’s Hospital Boston, head the SAGE team.
Other proposals include a “New Pathway Investigator Program,” which would lead to a Master of Medical Sciences degree for those who do at least one year of research full time and submit an approved master’s thesis. The new program would be part of a broader drive to “enhance the training of scholarly physicians and physician–scientists,” according to the SAGE report.
“Already, about one half of HMS medical students spend five years or more getting their MDs, and a significant fraction of those students spend the fifth year doing research,” Michel said. The new program would make that process “more uniform, more rigorous, and slightly more structured.”
SAGE did not estimate the costs and timetables involved in implementing its recommendations, but Michel expects that some members of his committee will assist in the implementation phase. “The SAGE was not charged with implementation,” he said, “but it’s clear that some of these proposals can be implemented immediately, while others may take longer, either because of their complexity or cost. We are not insensitive to these considerations.”
“For example,” said Dienstag, “the initial proposal for a scholarly project included the creation of a new, expensive infrastructure to provide mentoring and advising. We remain committed to the new scholarly project requirement, but we are considering the potential for supporting the new program by leveraging the already extant advising/mentoring infrastructure of the HMS academic societies.”
SAGE recommends that the societies serve a major role in guiding students to appropriate faculty members and labs in three broad areas of concentration: biology in medicine (basic science); patient-oriented research, focused on such topics as human physiology, clinical trials, and population-based studies; and medicine in society, covering topics in global health, medical humanities, health policy, service learning, and social medicine.
The committee also recommends enhancing the Academy Center for Teaching and Learning and the cross-HMS focus on assessment. This would essentially expand the current role of the Academy at Harvard Medical School (now supporting clinician–teachers involved with medical students) to the broader faculty involved in teaching PhD students, residents, and fellows. “This is a large and important constituency,” counting as many students as the MD program, said Michel.
The report endorses more robust training of biomedical scientists and educators via a new Program in Graduate Education, which would design graduate curricula and promote faculty development, among other initiatives. The committee also suggests that HMS partner with other schools at Harvard to develop new programs in global health, social medicine, and the basic sciences and translational medicine.
SAGE also notes that medical student debt may influence students’ career choices and recommends that HMS and Harvard University make debt relief a top priority. The School recently took a first step toward this goal by reducing the parent contribution toward medical education for families making $120,000 or less with assets typical of this income group (see related story).
The SAGE report also discusses the need to improve the HMS educational infrastructure. In addition to a planned renovation of the Tosteson Medical Education Center, Michel noted that “new educational technologies have the potential to have great impact on medical and graduate education. For example, new state-of-the-art electronic classrooms should be developed to help connect HMS to the rest of Harvard and beyond, and there’s an emerging interest in medical simulation as a teaching tool.”
