Harvard Medical School... a work in progress.

Hi all,
in line with OldManDave’s idea of having us answer questions about our medical schools, I’m open for questions about Harvard Medical School.
A couple of things worth mentioning.
First: Anything I say now may change: the school is now in a process of rethinking its approach to the curriculum. In particular, it is considering how to change third and fourth years to make the teaching more standardized and effective, and how to more clearly integrate clinical learning into the first and second years.
Another important thing to know: Although HMS is well-known for problem-based learning, the curriculum also includes plenty of lectures and small/medium-sized group didactic or lab sessions.
The plusses of HMS: great hospitals, great faculty, and many students who are doing interesting things with their lives and their careers.
Minuses: an increasingly young student body (although students in their late twenties and early thirties are part of each class); uncertainty about the future direction of curriculum reform means that you may get something different when you show up from what you expected; and its freakin cold in Boston.
I think the best thing to say about HMS is that because of its size and ability to attract faculty, if you want to find someone to help you learn something you can. I’ve always found faculty (with the possible exception of a couple of superstars, and even then) pretty accessible to anyone with a genuine interest in the topic at hand.
Another misconception to address: not everyone here has a super MCAT score and turbo-charged GPA. HMS sees itself as generating the leaders of medicine, and although scores and grades are important, it also places a significant emphasis on other activities like research, projects, organizations, athletic achievements or other things that show evidence of independent drive and determination.
HMS is committed to diversity, and although unlike some schools it does not offer special scholarships to students from underrepresented groups outside of financial aid, the Harvard name and decent financial aid is enough to attract a fairly diverse student body. The male-female ratio is generally equal these days.
Although primary care is not a major emphasis at the school, it is possible to leave HMS with a good training in primary care.
–joe

Cool deal, thanks!

Hey Joe,
I have a question for you…
One of the “cuts” I’m making for med schools is looking to see if they have a public health school, preferably one that has a strong international health component. This makes the a priori assumption that there’s going to be sort trickling of public health/international principles into the medical curriculum. For example, I know that many of the faculty at JHU’s SPH have joint appointments: SOM as well as SPH. So I assume that a lecturer at SOM would also bring a public health perspective into their med school lectures.
IYHO, is this a valid assumption to make? At least, in your experience at Haaavaaaad?
I can’t believe I’m actually at the stage where I’m going to start applying. Last year seems like a dream (nightmare)…
Thanks for any insight you can offer to someone trying to make an evidence-based choice.
Hope you’re enjoying the end of the first year!
cheers,
Vera

Vera,
I think your assumption is not generally correct in the case of HMS. I would examine whether it is true for what daily life is like at JHU. You are going to be spending most of your time worrying and learning about diseases most common in the US population when you are not learning about basic science. But there are plenty of opportunities to integrate international work into your own.
There is also talk of a global health track within HMS, run not by public health folks but by the Partners in Health people (Paul Farmer, et al). The international part of the med school is more from that wing than from the public health school. I don’t know what the status of that will be; you can ask when you come for an interview.
Although it may be different at JHU, the public health school and med school don’t have a huge amount of interconnectedness when you see it from the med school side. Although there are plenty of faculty with joint appointments that does not translate to classroom time; and I would doubt that it translates to much classroom time at JHU either. Something you might want to examine.
At any rate, either school would doubtlessly give you many opportunities to work and study internationally.
Glad to hear that you’re getting closer to the finish/starting line.
cheers
Joe

Thanks for quick and thoughtful reply, Joe. I have yet to talk to my advisor about what I’m looking for in the ideal school and find whether that exists in real life! That will come next week. And I’m heading to the FedEx office this afternoon to pick up the AMSAR and start digging.
When I spoke to someone at JHMI, he said essentially the same thing about the instruction focusing on US-resident illnesses. So I’ve resigned myself to having to work in various stints in other countries. Fortunately, there are many options available.
Wow, I can’t believe you mentioned Paul Farmer. When I grow up, I want to be like him. He personally managed to convince the Russians that AIDS was a problem and that they should actually treat prisoners, drug addicts and the like, rather than have the attitude that such populations deserve to suffer. That man is my personal hero. Pathologies of Power is sitting on my desk, waiting for May 14th (the day after the last day of school–when I can begin to read for pleasure again!).
Thanks for the 411. I guess I’ll revise that SPH requirement as something that makes it easy for me to identify faculty with similar research interests.
I hope everything is going well for you up there!! Congrats on making it to year II.
cheers,
Vera

I’d also say that before coming to medical school I probably exaggerated to myself the extent to which faculty with similar interests would be important to me. For two reasons: 1. your interests, believe it or not, will change somewhat; and 2. for those of us already looking beyond clinical practice it is easy to forget, but medical school is actually pretty consuming and the process of learning clinical medicine in and of itself is pretty big. Sounds obvious but I know I forgot that and I am betting that you’re forgetting it too.





Now, that said, I’m going to be on a 5 year plan and I intend to work with faculty here, and I’m very appreciative of the broad range of faculty who share various aspects of my interests. For my own somewhat eclectic interests, I think HMS is a good choice because of that range. Whereas, for example, before I came here I thought UCSF would be a better choice for me, because it has a bigger emphasis on AIDS.





But of course, some of this ends up being not up to us (as in me getting in to HMS and not UCSF!) and much of it ends up being about where we’ll be happy for other reasons–family, cities, good restaurants, and so on.





Re: Paul Farmer et al. The Partners in Health team dominates much of the discourse here about international health. If you are ready to love those guys 100% that is fine and they offer a lot of opportunities. They are especially good for people who are just getting their start as they really take people up and nourish them within their organization and way of doing things. I love them 85% and that is occasionally frustrating for me. Just to take one example, I don’t think directly observed therapy is the be-all-and-end-all; I think the approach that Medicins Sans Frontieres is using in South Africa of “treatment partners” from people’s own social networks (as opposed to paid staff) is a better approach… not in terms of better disease outcomes, b/c both are good, but in terms of its effect on building power and connections in the community.





So, this may sound trivial but this sort of thing is why you may want to think beyond particular faculty… because if you count on one or another person you may find that in the slightly longer run you disagree with some part of their approach with enough force that you would really rather work with someone else. That’s why schools that offer lots of options are what I would gravitate towards from an academic point of view. Just my take… different strokes for different folks, of course.





Keep me posted…





cheers


Joe

An article on current ideas about curriculum reform at Harvard is at:


http://www.boston.com/news/globe/magazine/articles/2004/05/02/how_do_you_make_a_better_doctor?

Thanks for taking the time to pass along info and your experiences, Joe. You are wise beyond your years, and so incredibly helpful to us. You rock!





Funny you should mention how interests change. I have a friend who did the Peace Crop thang, then a public health degree, then a post-bac. She was certain she’d do something related to women’s health. When it came time to choose a specialty, she was torn between ob/gyn and cardiology!!! And she never thought she’d care about anything other than women’s health. Which illustrates your point about falling in love with things you never even thought about.





The Boston Globe article was very informative…and I see from you integrated clerkship post that you’re one of these lucky eight. Congrats! I imagine it will be fulfilling.





I meet with my advisor Friday to put together a list of med schools to apply to. It will be interesting to see what she has to say about my draft list, and the parameters I used to create it!





cheers,


Vera