Please note that the curriculum is undergoing continuous review and improvement and is subject to change at any time.
Last updated 5/18/2022
Course objectives are available to enrolled students and course faculty in Canvas under each course site.
Preclerkship Curriculum Support Contact: Caitlin Hoey
Course Director: Katherine Miller
Course Director: Anita Vanka
Associate Course Director: Robert Stern
Course Director: Randy King
Course Director: Julia Charles, Ruth Ann Vleugels
Course Director:John L. Dalrymple, Fidencio Saldana
Course Director: Tony Breu, Laura Garabedian
Course Director: Barbara Cockrill, Keri Shafer
Course Director: Melanie Hoenig
Course Director: Tamara Bockow Kaplan
Course Director: Celeste Royce, David Meguerdichian
A year-long clinical immersion experience that exposes students to the medical disciplines and experiences essential to becoming a physician. The year consists of 1-month to 3-month clinical rotations in medicine, surgery, pediatrics, obstetrics and gynecology, neurology, psychiatry, and radiology at a single site, supplemented by mentoring and assessment. Students also complete the longitudinal experiences: the multidisciplinary PCE case conferences, the Primary Care Clerkship, and the Developing Physician course.
Course goals and objectives are available to:
Requirement checklists are available to enrolled students and course faculty in OASIS.
PCE/Clerkship Curriculum Support Contact: Sally Bartlett
PCE Director: Katharyn Meredith Atkins
PCE Manager: Lidia Graziano—lgrazian@bidmc.harvard.edu
PCE Director: Katie O’Donnell
PCE Coordinator: Winnie (Su Wen) Yu—SuWen.Yu@childrens.harvard.edu
PCE Director: Erik Karl Alexander
PCE Manager: Alessandra Alavarez Hinojosa - aalvarezhinojosa@bwh.harvard.edu
One of the greatest features of the Pathways curriculum is the opportunity for students to customize their route through Years III and IV to prepare optimally for whatever aspect of the profession of medicine that has attracted their curiosity and passion. While rigorous demands and high expectations will be set for students in Years III and IV, the expanded time following the PCE allows for considerable flexibility as students pursue advanced integrated science courses, clinical and non-clinical electives, and scholarly research projects, and take advantage of myriad opportunities across Harvard University and around the world.
Scientific research is at the core of evidence-based medicine, and is transforming medical care at an increasingly rapid pace. Physicians have to evaluate new research advances, incorporate them judiciously into clinical practice, and provide leadership for new research into the most urgent patient needs.
The goal of the Advanced Integrated Science Courses (AISCs) is to provide students with a generalizable skill set to engage with research at the boundary of the known and unknown, and its relationship with clinical medicine.
AISCs don’t aim to cover the content of a field, instead the goal is to use examples from the AISC subject area to develop these generalizable skills.
Each course represents a major field of current frontier research linked to major unsolved problems in patient care. Whereas the pre-PCE phase focuses on science that is known, AISCs engage at the boundary of the known and the unknown, where there are controversies, gaps, and unmet needs, which students explore with course faculty and other HMS experts in the field.
AISCs use flipped-classroom and other active learning methods as in the pre-PCE phase, with an increasing emphasis on self-directed learning. Additionally, each AISC includes experiential learning activities, in clinical or other settings, which serve to illustrate underlying science principles and promote the development of scientific questions. Students actively participate in scientific inquiry, culminating in a final product at the end of the course, working with faculty mentorship to identify and explore unsolved questions that interest them.
Video: AISCs Overview
Students are required to take two AISCs of their choice (see course selection process), at least one during Year III. Each AISC is offered once per year in either October, January, February, March, or April.
AISCs are full-time courses, four weeks in length. Classroom time and unscheduled time are built-in for each course. Unscheduled time is critical for preparation, self-directed exploration and development of original questions and work products.
Requirement Note: AISC courses are not required for MD-PhD students, who may choose to take them as electives if they wish.
AISC placements are made via the OASIS lottery process. During the lottery, students rank their top AISC course preferences. The lottery maximizes preferences and assignments are made. Each course has an enrollment cap.
In past years, about 85 - 90% of students have received their first choice, and almost all students have received at least their second choice based on submitted selections. Add/drop changes for AISCs may be completed by self-service up to 45 days in advance of the start date of each course.
Video: How do I Choose an AISC?
During each course, students should plan to devote their full-time effort for classroom and experiential activities, as well as unscheduled time for course preparation.
The bulk of structured course time is spent in the classroom rather than in a clinical setting. The goals and objectives of AISCs differ significantly from those of clinical electives. The goal of the AISCs is to promote an understanding of scientific concepts and to encourage scientific inquiry, whereas the goal of a clinical elective is to promote a deeper understanding of clinical medicine.
For example, the goal of a cancer clinical elective is to learn about the diagnosis and treatment of various malignancies. In contrast, the goal of the cancer biology AISC is to develop a skill set to engage with frontier research, to explore how the scientific understanding of the cellular and molecular basis of cancer relates to clinical cancer care, to explore questions at the boundary between the known and unknown, and to consider how such questions might be answered. As such, the AISCs devote a significant amount of time to self-directed learning and deep exploration of a question of interest rather than teaching in depth about the diagnosis and treatment of cancer.
Typical of most AISCs, there are two half-day experiential activities per week, and three half-days in the classroom, though there are differences between the AISCs. The experiential activities vary by course. Typically, they are clinical experiences, and span a number of different specialties or sub-specialties within a single AISC. The goal of the clinical experiences is to identify unmet patient needs rather than focus on learning the clinical medicine of the field. Non-clinical experiences such as laboratory experiences or visits to industry are also utilized in some AISCs. Importantly, clinical experiences are integrated into the course through facilitated discussions at the clinical sites and at HMS focusing on the bidirectional interaction between basic science and clinical medicine.
Video: What is the Purpose of the Clinical and Other Experiential Components?
The AISCs are designed to accommodate students at different levels of knowledge and experience in basic science research. Mechanisms for mentorship and feedback, as well as primers on the basic knowledge required for each course are built into the AISCs to enable students to explore a scientific topic and engage in the scientific process in an unfamiliar subject area. Performance evaluations take prior experience into account.
Video: What is the Value of AISCs to Students who may not go into Research?
The AISCs aim to encourage self-directed study and independent thought. Each course has several work assignments including a creative final work product. Students choose their own topic, within the broad scope of the course, based on their clinical experiences and developing professional interests. The format of the work product is set by each course, and some courses offer more than one option.
Examples of final work products include a research proposal, an explanation for a patient about research relevant to their condition and clinical choices, a short review of progress and challenges in a research field, educational materials for students, or a newspaper article for the general public. Whatever the specific format, the work product provides an opportunity to develop and display the generalizable skills that the AISCs are designed to enhance.
AISCs are graded on a satisfactory/unsatisfactory basis. A narrative assessment is provided to each student. Each course has both a final product and one or more smaller intermediate products (written or oral presentations) that serve as the basis for assessment. The number and type of assignments vary by course. The formal learning objectives are the generalizable skills, placed in the context of the questions and approaches of the field of each AISC.
The AISCs Absence Policy outlines procedures for a planned absence, residency interviews, illness or family emergency and religious observances.
Course Directors: Meredith Atkins, Kate Treadway
Course Manager: Tina Sherman
Course Director: Jennifer Kasper
Scholarly Project Faculty Director: Jeffrey Katz
Scholarly Project Program Manager: Kari Hannibal
The scholarly project is designed to provide students with an opportunity to pursue a mentored scholarly experience analyzing a health-related question, issue, or problem in depth. The student can approach the problem through any of a wide range of disciplines in the biomedical sciences, clinical sciences, humanities, arts, or other fields. For more info for students and faculty mentors click here.
Required Subinternship
Overall Course Director: Mary Montgomery mwmontgomery@bwh.harvard.edu
Course Manager: Sally Bartlett
BWH Course Director: Mary Montgomery mwmontgomery@bwh.harvard.edu
BIDMC Course Director: Vilas Patwardhan vpatward@bidmc.harvard.edu & Marisa Jupiter mjupiter@bidmc.harvard.edu
CHA Course Director: Rachel Hathaway rhathaway@challiance.org
MTAH Course Director: David Miller dmiller3@mah.harvard.edu
MGH Course Director: Benjamin Davis btdavis@mgh.harvard.edu
Course Description
The overall goal of the Medicine Core II Subinternship is for students to continue to learn to deliver excellent medical care to patients. The clerkship is designed to allow students to evaluate and manage patients with complicated medical problems under the supervision of house staff and medical attending staff. Core II students are expected to function in a more independent manner than in Core I student and to assume more direct responsibility for patient care.
The majority of admissions are for the evaluation and subsequent management of acutely ill patients; some patients are admitted for diagnostic procedures. Each patient admitted has an identified attending physician who oversees that patient’s individual care. Students will be expected to interact with the resident and attending physician in all aspects of the care of that patient.
The broad range of common disorders (and the uncommon as well) represent rich opportunities for the trainee. Also vital is preparation of the subinterns for their future role as housestaff with course attention to the basic elements of teaching and the conduct of effective ward rounds. Students are integrated into the ward team and manage patients from admission to discharge under the direct supervision of the team resident. Bedside teaching also offers direct observation of student interviewing and examination skills. In addition to participating in the full range of conferences designed for the house staff, students will meet with faculty for seminar-based discussion of specific subintern curricular topics, as well as bedside rounds devoted to the interview, physical examination, review of primary data and problem formulation. Feedback will be provided to the students on a regular basis with a fixed mid-month review of performance. Evaluations will be based on input from housestaff and faculty. Students will meet individually with the course directors at the end of the rotation to review performance, achievements, and goals for the future.
SITE INFORMATION
Beth Israel Deaconess Medical Center
Brigham and Women's Hospital
Cambridge Health Alliance
Massachusetts General Hospital
Mount Auburn Hospital
Visit the Course Catalog for more information on post-clerkship elective courses and contact information.
Last updated 5/18/2022