Harvard University (Harvard Medical School)

Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area section of Boston, Massachusetts. The school was founded by Dr. John Warren and established in 1782, and was moved from Cambridge to Boston in 1810.

HMS is home to about 650 students in the M.D. program, 550 in the Ph.D program, and 130 in the M.D.-Ph.D program. HMS M.D.-Ph.D program allows a student to receive an M.D. from HMS and a Ph.D from either Harvard or the Massachusetts Institute of Technology.

The school has a large and distinguished faculty to support its missions of education, research, and clinical care. These faculty hold appointments in the basic science departments on the HMS Quadrangle, and in the clinical departments located in multiple Harvard-affiliated hospitals and institutions in Boston. There are approximately 2,900 full- and part-time voting faculty members consisting of assistant, associate, and full professors, and over 5,000 full or part-time non-voting instructors.

Prospective students apply to one of two tracks to the M.D. degree. New Pathway, the larger of the two programs, emphasizes case-based learning. HST, operated by the Harvard-MIT Division of Health Sciences and Technology, emphasizes medical research.

You will begin your learning adventure by developing a solid general foundation in medicine through an engaging, continually innovative curriculum, a problem-based investigative approach to medical diagnoses and treatment, and small, highly interactive classroom sessions. In the process, you will explore the biological and social sciences relevant to medicine, understand pathophysiology and the various mechanisms of disease, and absorb the many dimensions of the patient-doctor relationship.

Subsequently, through an array of electives offered at HMS, and clinical experiences in patient care and clerkships at one of our many affiliated institutions, you will focus your studies in the specific areas of your choice.

Throughout, you will benefit from the many opportunities that Harvard offers.

* Collaborate on research projects with medical practitioners and researchers who are the very best in their fields.
* Take a fifth year before you graduate to complete your research.
* Opt for an elective, or pursue a joint degree, at one of the other world-renowned faculties at Harvard University, or at the Massachusetts Institute of Technology.
* Travel to Russia to work with AIDS patients, educate homebound elders in Boston about their health care options, or participate in one of the many other service opportunities Harvard offers.

Regardless of your educational, cultural, or social background and irrespective of your individual professional goals, an HMS education will equip you to become a leader in your field.

Throughout its history, Harvard Medical School has influenced the design of medical school education. From Harvard University President Charles Eliot’s 19th century reform—developing he concept of a medical school as we know it today—to the groundbreaking New Pathway curriculum of the 1980s, HMS has been in a continual process of growth and change. Now, HMS is ready to lead again by redesigning its curriculum to meet the needs of 21st century medicine by integrating clinical and basic science across the curriculum, developing new models for clinical education, and engaging students in an in-depth scholarly experience.

The curriculum will begin in mid-August with a new course, Introduction to the Profession, designed to introduce students to the profession, the practice of medicine, and the experiences that lie before them as they embark on the process of becoming physicians. Courses focused on the scientific basis of medical practice [basic, population, and behavioral sciences] and the patient-doctor relationship [professionalism, communication, physical diagnosis] span the first 3 and a half semesters of the curriculum. In April of Year II, students begin making the transition from classroom to the clinical realm. Individual clerkships in the major disciplines of medicine (medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, neurology, radiology) will be unified in a “Principal Clinical Experience,” which will provide opportunities for longitudinal experiences with patients and faculty mentors as well as an interdisciplinary curriculum that integrates the scientific and clinical aspects of important diseases.

Throughout the four years of medical school, students will have many opportunities to work one-on-one with faculty mentors. In this vein, a capstone experience for our students will be a several-year, faculty-mentored, in-depth scholarly experience culminating in a written work product. This exploration of a topic in-depth will allow students to participate with faculty in the excitement of discovery and scholarship. While still in the development phase, the new HMS curriculum will prepare graduates to function in an increasingly multicultural landscape undergoing radical scientific, social, economic, and technological transformation. HMS seeks to ready students for this new world by providing them with the ideal educational environment and carefully integrated global experience to foster their growth as clinicians, scholars, discoverers, and leaders.

Harvard University is organized into ten principal academic units, or faculties. These faculties oversee the operation of the eleven Harvard Schools. The work of a number of allied institutions and University-wide initiatives further expand Harvard's academic reach. HMS students are encouraged to explore Harvard's academic resources to examine medicine from an interdisciplinary perspective.

Students at HMS are encouraged to take advantage of the resources of the larger Harvard University community. Many of the organizations, facilities, and activities located at Harvard's Cambridge and Allston campuses welcome the participation of medical students. The Harvard Graduate Council, a University-wide organization, sponsors activities that bring together students from all of Harvard's graduate programs.

Student life at Harvard Medical School is a celebration of diversity.

It is the coming together of extraordinarily talented individuals from a wide variety of ethnic, cultural, social, and educational experiences and backgrounds who share an intense ambition to be leaders in everything they do. It is about discovering a culture of support that respects difference and an abundance of resources to nurture talent. It is about being inspired by a history of achievement to transform your potential into achievements that can make a difference to our world.

Beginning with early orientation events like the White Coat Ceremony, FEAT (the First-Year Education Adventure Trip), and FUNC (the First Year Urban Neighborhood Campaign) — through your participation in the many HMS student groups, through conversations in your society offices, passionate debate in your discussion groups, shared experiences in the Vanderbilt residence hall, and time spent discovering Boston together — at HMS, you will develop rewarding relationships, learn about the world, and create memories that last a lifetime.

An HMS education is a learning adventure guided by a faculty of more than 9,000 of the world’s leading scientists, medical researchers and academicians, and practicing physicians.

These are the teachers you will learn from, the mentors you will depend on, the researchers you will collaborate with, and the friends who will help expand your intellectual and professional boundaries.

In classrooms, discussion halls, and laboratories; at HMS-affiliated hospitals; and within Society offices—through a powerful combination of tutorials, group discussions, classroom lectures, and clinical experiences—Harvard Medical School allows you easy access to the vast knowledge and experience of faculty who are pioneers in research, patient care, and education across every field of medicine.

As you approach the quadrangle of neoclassical marble buildings that dominate Longwood Avenue, pause to read the words “Harvard Medical School” engraved below an imposing row of tall columns, and walk up a set of white marble steps into the School, you will admire the classic elegance of the campus while reflecting on its inspiring history of medical achievements.

A powerful integration of the functional and the aesthetic—of sophisticated classroom, laboratory, library, and research facilities, cutting-edge scientific technologies, and the warm character created by a rich tradition of intellectual debate and discussion—it is a campus that perfectly complements the education you receive here.

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Harvard Medical School Medical School Location

Harvard Medical School Courses

YEARS I & II

Through classes and lectures held in the Daniel C. Tosteson Medical Education Center (TMEC), through long hours in the library and at various laboratories, through actual patient contact, and through passionate medical discussions with classmates in the TMEC atrium, at the various Society offices and elsewhere, you will spend your first two years at HMS exploring the fundamentals of modern medicine.

* Year I focuses on human physiology and the biomedical sciences. You will master concepts in morphology; biochemistry; physiology; pharmacology; developmental and molecular biology; pathology, microbiology, and immunology; and in neurosciences. You will also take courses in behavioral, social, and preventive medicine, including the statistical sciences and epidemiology.

* Year II is centered on the study of pathophysiology, where you will investigate and understand the various structural, functional, and clinical dimensions of human disease. You will also prepare to take Step I of the United States Medical Licensing Examination.

For New Pathway students, the first two years are largely self-directed and independent. Adopting an investigative, problem-based team approach, they study basic and clinical science through small, highly interactive tutorials that are complemented by class lectures, laboratory and library work, and conferences. HST students attend courses developed jointly by the faculties of both Harvard and MIT. They also often spend the summer in between these two years collaborating with faculty on various biomedical and health care research projects.

PRECLINICAL COURSES YEAR 1 :

* Clinical Epidemiology : Students who complete this course will have developed skills to find and evaluate reports of research studies. Specific learning objectives include the following: Identify different study designs and recognize their strengths and weaknesses. Assess the roles of chance, bias, and confounding in evaluating the validity of reported results. Recognize how results are presented and how to draw inferences from the results. Evaluate how well the results of a published study apply to an individual patient. Characterize how physicians use information to make decisions about patients and groups of patients. Balance skepticism of reported results with a respect for the strengths of a well-conducted study. Articulate questions related to clinical practice and translate those questions into successful literature search strategies. Search the Medline database to find the best available evidence to answer clinical questions.

* Introduction to the Profession : This course will be required for all entering medical students. It is designed to provide a broad overview of the profession and expectations, demands and experiences the students will face as physicians in training.

* The human body : The Human Body is an eight-week intensive introduction to the basic sciences, centered on the structure of biological systems from molecules to organisms. It is taught using problem-solving, case-based methods in small tutorial sessions and laboratories. Medical cases guide and define learning agendas which are set in the individual tutorials. Occasional lectures will focus on general principles and will not offer systematic coverage of the course material. The laboratories offer experience in solving structural problems in cell biology and histology, gross anatomy and radiology. The central focus of the course is to integrate structural principles across all levels of magnification, and to build a fundamental knowledge of structure/function correlation and general systems rules. Six to eight hours of study outside class are expected each day. Students are expected to develop their own learning agendas in the tutorial groups and in individual study.

* Genetics, Development and Reproductive Biology : This course will focus on fundamental aspects of human genetics, reproduction, early development and morphogenesis. Both classical and molecular genetics will be addressed, with particular application to human biology and medicine. Laws that govern inheritance and variation among individuals and populations will be considered, with special attention to the molecular aspects of inheritance, mutation and gene control. Newer molecular, cellular and cytogenic approaches will be emphasized, with reference, whenever possible, to human gene systems and inherited disease. The course will discuss the endocrine events of puberty, the hormonal basis of human sexuality, and the control of gametogenesis. Early human development and the morphogenesis of selected organ systems are presented in lectures. Major concepts of experimental embryology are introduced to provide the context for thinking about developmental mechanisms. The course aims to provide a foundation for the appreciation of, and preparation to take advantage of, the impact genetics and development will have on the practice of medicine in the future.

* Immunology, Microbiology and Infectious Disease : This course will cover the major groups of microorganisms, the host immune response, and how the race between the immune response and replication and spread of a microbe can lead to clearance of the microbe or infectious disease. Students should gain an understanding of 1) the concepts of microbial structure, replication or growth, and pathogenicity; 2) mechanisms of microbial diseases; and 3) the normal and abnormal functions of the immune system. Tutorials and laboratories will emphasize problem-solving skills, integration of knowledge and independent learning. The laboratories will provide training in basic microbiologic and immunologic techniques and an understanding of the cells and tissues of the immune system, and an introduction to Infectious Diseases.

* Patient-Doctor Year I : The objective of Patient-Doctor I is to enable all Year I students to consider topics relating to patients' experience of illness, to learn the fundamentals of basic communication skills, to discuss social, ethical, and psychological aspects of the doctor-patient relationship, and to develop an ongoing relationship with a preceptor-clinician. Units of six students and three faculty, meet weekly in 2 hour sessions for tutorial discussions and interviewing of patients. The fundamentals taught in this course will serve as a prerequisite to Patient-Doctor II.

* Chemistry and Biology of the Cell : Chemistry and Biology of the Cell provides an introduction to biochemistry and cellular and molecular biology. The course will cover not only well-established findings but also recent advances that have particular importance in medicine. The first part of the course emphasizes the structure, function and turnover of proteins, the mechanism and regulation of gene expression, and protein sorting. The second part focuses on the biochemical pathways involved in energy metabolism and their regulation, and the major signal transduction networks. The final section covers the cell cycle, control of cell proliferation, membrane properties, the cytoskeleton, and muscle function. Typically, there will be two lectures per day. In addition, each week there will be small-group conferences based upon problem sets as well as tutorial sessions that will involve case-based learning. The goal of these exercises is to enable students to utilize knowledge from lectures and readings and to appreciate its relevance for understanding and treating human disease.

* Integrated Human Physiology : The Integrated Human Physiology course builds on anatomy, biochemistry, and cell biology. Using case tutorials, lectures, focused exercises, laboratories, and demonstrations, Integrated Human Physiology (IHP) material will be presented as an introduction to human physiological systems. The goals of the course are: 1. To introduce several major physiological systems in a manner that emphasizes the interplay of cellular, molecular and biochemical processes that underlie system function. 2. To emphasize the homeostatic interactions that take place between those component physiological systems and that give rise to the integrated functioning of the human body. 3. To provide a conceptual background for the function and interplay of human organ systems. We view this course as part of a continuing medical education in which vocabularies and concepts are presented sequentially, and are periodically reinforced to allow an understanding of normal and pathological processes.

* Human genetics : This course will focus on fundamental aspects of human genetics. Both classical and modern genetic principles and methods will be covered, with a strong emphasis on applications to human biology and medicine. Topics covered will include fundamental principles of genetics, genomics, and genetic variation, patterns of inheritance of monogenic, polygenic and chromosomal disorders, cytogenetic and molecular methods, approaches to finding diseases susceptibility genes, therapy of genetic diseases, pharmacogenetics, population genetics, and societal implications, including interaction with concepts of ethnicity. Clinical examples are used throughout to expand on these topics. The course aims to provide a strong foundation in human genetics, which influences all of medicine, and will be an increasingly important part of the practice of medicine in the future.

* Molecular Biology of Human Disease : This 8-week course will provide an in-depth analysis of recent advances in our understanding of human disease pathogenesis, as afforded by contemporary biomedical research in the basic sciences. Topics to be covered include: congenital birth defects, autoimmunity, neurological disease, genetics of hearing, signal transduction, genomic technology, model organisms, cancer genetics, and mechanisms of viral pathogenesis. The course format will consist of individual blocks devoted to the above topics, with lectures, discussions of selected readings, and a final paper.

PRECLINICAL COURSES YEAR 2 :

* Human Nervous System and Behavior : This course provides an introduction to the nervous system and human behavior. One of the aims of the course is to enhance, where possible, integration of the various ways in which the functions and malfunctions of the nervous systems are studied: anatomy, physiology, pharmacology, pathology, psychology, neurology, psychiatry. One clinical case per week will introduce a wide range of issues and provide the context for their study. Among the topics are the following: the general organization of the brain and spinal cord, and the localization of function; nerve impulse conduction; synaptic transmission; depression; addiction; panic and anxiety; control of movement; sensory systems; psychosis; neuronal death and degeneration; cognitive function; and control of excitability in neural circuits. Independent study of topics identified as central learning issues in the clinical cases, after discussion in tutorial, will be a major activity. The lectures will help students organize complex bodies of material, will provide up-to-date information not readily available in textbooks, and will help consolidate material already studied. The laboratories will provide access to fixed tissues and to radiological and scanning techniques; pathological specimens will be studied in the context of "mini cases".

* Human Systems : The major focus of the Human Systems course is on disease mechanisms. Building on the basic knowledge of normal structure and function acquired in Year I, students will learn the processes that cause disease (pathogenesis), the impact of disease on the functioning of the body (pathophysiology), and the consequence of the disease on the structure of the body (pathology). The module format of Human Systems emphasizes the concept that dysfunction of one organ system rarely occurs in isolation but commonly has an impact on other organs throughout the body. The Dermatologic, Respiratory, Cardiovascular, Hematologic, Gastrointestinal, Musculoskeletal, Renal, Endocrine, and Reproductive organ systems are studied, with many opportunities for interdisciplinary learning. Case study in small-group tutorials forms the basis of the course, with closely coordinated lectures (an average of one per day), minicases, multistation exercises, and pathology laboratories used as teaching methods as well. Pertinent issues in infectious diseases, human development and pharmacology related to the various organ systems are woven throughout the course.

* Patient-Doctor Year II - Introduction to Clinical Medicine : Patient-Doctor II is a prerequisite to all core clerkships. It extends instruction in the techniques of interviewing and examining patients begun in Patient-Doctor I. The emphasis in Patient-Doctor II is on the development of clinical skills and professional behavior appropriate for the beginning of clerkships, with special focus on learning the physical examination. The patient-physician relationship receives continued attention. Teaching in small groups and at the bedside are the primary methods of instruction. The application of the principles of pathophysiology is emphasized. The course meets on Wednesday afternoons from September through January, all day Wednesdays February through March, and all day Mondays and Wednesdays April through mid-May. The course is offered at ten sites, with several centrally administered sessions in the evening. Although the course format varies slightly from site the site, course objectives and the major assessment exercises are the same at all sites. Assessment of student performance includes an observed history and physical examination and an OSCE.

* Pathology : Pathology is a four-week intensive introduction to general pathology, which represents an essential foundation for understanding cell and tissue responses to injury and the pathophysiology of diseases. The course will focus on general pathological mechanisms, including cell injury, inflammation, wound healing and angiogenesis, atherosclerosis and neoplasia, and will be taught using lectures; case-based,small group tutorial sessions and laboratories. Lectures will focus on general principles rather than systematic coverage of the course material. The laboratories offer experience in the use of light microscopy to identify many of the features of general pathological processes that are relevant to diverse diseases. Both tutorials and laboratories will emphasize problem-solving skills, integration of knowledge and independent learning. Exercises in hospital-based anatomical and clinical pathology will provide an introduction to how these disciplines contribute to patient care.

* Preventive Medicine and Nutrition : This course builds on students' knowledge of epidemiology and pathophysiology to explore issues in clinical preventive medicine and clinical nutrition. The overall goal is to consider how to avert the major causes of morbidity and mortality in the U.S. The course encompasses both primary prevention (preventing the onset of disease) and secondary prevention (screening for disease before the time of usual diagnosis). Students have the opportunity to improve their skills in counseling patients for behavior change. A major focus of the course is clinical nutrition. We consider dietary guidelines for the U.S. population and discuss methods for assessing and improving patients' diets. The course covers major concepts in nutrition and disease prevention, including vitamin deficiency, the metabolic syndrome diabetes, obesity and the relationships between nutrition and cardiovascular disease. Throughout the course, students evaluate and work on improving their own dietary and other health habits.

* Psychopathology and Intro to Clinical Psychiatry : This course provides an introduction to the clinical features, scientific understanding, and most effective treatments of the major mental health disorders that characterize medical practice. Psychiatric Disorders such as Mood Disorders, Schizophrenia, Anxiety Disorders, Trauma and Personality Disorders will be discussed in depth in both lecture formats and in small group discussions. Biweekly centralized sessions will feature didactic presentations and live or videotaped patient interviews. These sessions will alternate with smaller group sessions at clinical sites of the Departments of Psychiatry. At site visits, students will learn to assess patients with a range of psychiatric disorders. Patient write-ups will be reviewed. Material from the centralized sessions and from assigned readings from textbooks and original articles will be discussed. On-line self assessment questions will be posted throughout the course as study aids.

YEARS III & IV

These are the clinical years when your medical education comes alive, when you learn the practice of medicine by practicing your skills in real-world clinical settings.

During these demanding years, all HMS students immerse themselves in one- to three-month clerkships at the various world-class hospitals affiliated with HMS. They work with real patients and renowned doctors in the different fields of medicine—including surgery, pediatrics, obstetrics and gynecology, neurology, psychiatry, and radiology. They participate in primary care clerkships, working half a day every week at the offices of a primary care internist, pediatrician, or family physician. They also prepare to take Step II of the United States Medical Licensing Examination.

New Pathway students often create their own specialized clinical experiences and clerkships to take advantage of the incredibly diverse opportunities offered by HMS and its affiliated hospitals. They can also examine the many connections between the basic sciences and clinical practice through month-long advanced biomedical science courses.

HST students complement their clinical clerkships with HST-specific clinical electives that allow them to conduct in-depth research into the scientific basis of clinical medicine. They also continue to work on individual research projects, eventually presenting their findings to HMS in the form of a scholarly thesis.
Confronted with the everyday visceral and emotional realities of the practice of medicine, HMS students find these years both challenging and incredibly fulfilling.

* Primary Care Clerkship : The Primary Care Clerkship provides a learning experience in the office practice of primary care and an opportunity to work with patients over time. Students will see patients with primary care physicians (general internists, general pediatricians, family physicians and others) three afternoons per month, and participate in a central curriculum one afternoon per month, for nine months starting in January of year III. Sites are HMS affiliated hospitals and in the community. Students will work with a panel of patients, some of whom are chosen because they require frequent visits for active medical problems. The longitudinal nature of the course allows students to practice preventive care, observe how patient's circumstances (such as expectations and social support) change over time, and to use time as a diagnostic test and treatment.

* Women's and Children's Obs/Gyn Component at MtAH : This clerkship offers the opportunity to experience a ?real life? obstetrics and gynecology practice in a community hospital. The student will have a high degree of exposure to attending staff, midwives, and nurse practitioners. The student will be exposed to a variety of outpatient settings: a hospital-based women?s service and midwifery program, as well as private offices including both general Ob/Gyn and specialty practices in urogynecology, maternal fetal medicine, infertility and IVF, and gynecologic oncology. Students will have the opportunity to follow obstetrical patients through their labor, deliver and post-partum care. Operating room experience includes exposure to both general gynecologic surgeries and to advanced laparoscopic and urogynecologic procedures. As the Department of Ob/Gyn at Mount Auburn does not have a house staff to provide continuous supervision, this clerkship is best suited to the students who are mature, self-motivated, and willing to take an active role in their own education.

* Women's and Children's Obs/Gyn Component at BIDMC : This course exposes the student to general OB/GYN as well as the subspecialty and primary care aspects of the field. One week is spent in the ambulatory setting, 2 weeks in labor and delivery, and two weeks in the gynecologic operating room and inpatient gynecology service. The ambulatory experience utilizes a preceptor model in which each student is paired with a faculty preceptor in order to enhance continuity. Students also have ambulatory experiences to expose then to OB/GYN subspecialties, including reproductive endocrinology, maternal fetal medicine, gynecology, oncology, genetics, and general Obstetrics and Gynecology. Gynecology experiences include operative gynecology, gynecologic oncology, urogynecology, family planning, and reproductive endocrine and infertility. Labor and delivery experiences include low and high risk obstetrics. Three to four student seminars per week on key topics complement the clinical experience. Weekly rounds with the department chairman completes the experience. Evaluation includes clinical performance, oral examination and written examination.

* Women's and Children's Obs/Gyn Component at BWH : The clerkship provides an overview of important aspects of obstetrics and gynecology. The primary objective is to impart a basic knowledge of those aspects of the care of women essential for all future physicians. Included is the fundamental clinical information and skills development necessary to care for the pregnant woman and female patients with disorders of the reproductive system. The clerkship also strives to stimulate thinking and problem-solving, to develop skills for effective communication and to strengthen self-confidence and study skills. The clerkship is divided into an obstetrics and a gynecology rotation, with sites in ambulatory clinics, health centers, the operating room, inpatient units, and Labor and Delivery. Wednesdays are devoted to comprehensive seminars. Each student will be asked to prepare a case presentation. Presentations are expected to be case-based, interactive and evidence-based. In an effort to develop team building, students are assigned to individual residents in each component of the clerkship. Students are supervised by housestaff, faculty, midwives, nurses and other professional staff. Midway in the clerkship, a review session is scheduled for feedback with the Clerkship co-Director. This provides students an opportunity to openly discuss their experiences, pro and con, and to address any difficulties. Each student is scheduled for an end of the clerkship feedback session.

* Women's and Children's Obs/Gyn Component at HVMA : The course provides an overview of the most important aspects of obstetrics and gynecology. The objective is to offer students concepts and skills relevant to the care of women by physicians in any specialty. To this end, office experience is precepted by attending physicians and midwives in the obstetrics and gynecology department of Harvard Vanguard Medical Associates (HVMA), a multispecialty group practice. HVMA physicians and midwives will also precept at BWH on labor and delivery and in the operating room. Although the emphasis is on general obstetrics and gynecology, students will also have some exposure to areas such as perinatology, reproductive endocrinology and genetics. Students also attend weekly core lectures in common with other students doing their OB/Gyn clerkship at BWH. The office locations for this course are accessible by public transportation. This course is a component of the Core Clinical Clerkship in Women's and Children's Health.

* Women's and Children's Pediatrics Component at MGH : Working with children provides opportunities for observing the natural growth process, leading to maturation. Students can familiarize themselves with indicators of health and disease by becoming involved in the clinical management of infants, children and adolescents. Students will participate in all aspects of patient care - work rounds, visit rounds, admissions, as well as in various educational offerings. This clerkship ordinarily includes 4 weeks of pediatric wards and 2 weeks in the pediatric emergency room, general pediatric outpatient settings, and newborn nursery. Acquisition of clinical skills and approaches to patient management are emphasized. All core clerkships in pediatrics also now participate in a common lecture series during Friday afternoons of the rotation. These lectures will take place at either the MEC or MGH.

* Patient-Doctor III : Patient-Doctor III is a case-based course that prepares third-year students for patient care, by integrating principles of basic science with clinical knowledge, skills and attitudes taught in the core clerkships. We complement the teaching of diagnosis, differential diagnosis and treatment of the individual patient with the study of the emotions, values, beliefs, cultural norms and characteristics of the healthcare system that are inherent in the daily work of physicians. Multidisciplinary lectures, taught by senior clinicians will supplement small group tutorials. Students will learn how to collaborate in teams; how to talk with patients and colleagues in difficult situations; how to support patient safety and quality of care; and how to use their own reactions and reflection as the starting points of investigation and problem solving. Students conduct an exercise in giving bad news, write three reflection papers, and present an analysis of a problem in health care.

* Core Medicine Clerkship I : Students spend two months on one of four Medical Firms, functioning as integral members of the housestaff team. Monthly Attending Physicians and Firm and Associate Firm Chiefs provide supervision and teaching. Students admit patients with their inpatient teams every other day on "long" and "short" call days. Inpatient conferences include an EKG course, didactic lecture series, interns' report, Attending and Firm Chief rounds, Firm Conference, Medical Management Conference, Grand Rounds, and course director meetings. During the clerkship, students are encouraged to use on-site educational and simulator facilities at the Carl J. Shapiro Institute for Education and Research.

* Core Medicine Clerkship II : The Mount Auburn Core Medicine II clerkship will provide the subintern with an explicit, written curriculum reflecting relevant educational goals, and serve as the basis for evaluation within the rotation. The broad range of common disorders (and the uncommon as well) represent rich opportunities for the trainee within Mount Auburn Hospital. 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. Core Medicine II students are integrated into the ward team and manage patients from admission to discharge under the direct supervision of the team resident. In addition to participating in the full range of conferences designed for the house staff, the Core II students will meet, at least twice a week, with senior faculty for both case management review, 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. Students will be assigned topics for review and reporting based on these patient encounters. Feedback will be provided to the Core II students on a regular basis with a fixed mid-month review of performance. Evaluation will be broadly based, with input as to the student's clinical and professional work gathered from housestaff, nursing and faculty. Bedside teaching also offers direct observation of student interviewing and examination skills. There will be a required exit meeting to review the student's evaluation. The written evaluative report will be forwarded to the Registrar's office at HMS within 2 weeks of completion of the rotation.

* Core Clerkship in Neurology : The clerkship is an introduction to clinical neurology during which students are assigned to the inpatient ward or consultation services in Neurology at the Beth Israel Deaconess Medical Center (both East and West campuses). Students learn to take neurologic histories, examine patients with particular attention to the nervous system and learn about and perform appropriate procedures used in the evaluation of patients on the Neurology service. They learn to recognize and evaluate a wide variety of neurologic problems, including neurologic emergencies. They have a full schedule of ward and consult rounds and teaching conferences and participate in the care of patients under the supervision of Neurology residents and faculty members.

* Core Clerkship in Psychiatry : The clerkship at McLean Hospital will expose students to a wide range of psychopathology in order to facilitate recognition and management of psychiatric disorders encountered in the practice of medicine. Diagnostic evaluation and therapeutic considerations (for both hospitalized and non-hospitalized psychiatric patients) will be emphasized. A seminar on the biomedical aspects and pharmacologic treatments of the major psychoses will be presented. An introduction to psychodynamic psychiatry is provided through case discussions and seminars. Each student will be assigned a tutor with whom he/she will meet twice a week, as well as supervisors who will oversee their clinical work. Students will also be integrated onto the Clinical Evaluation Center where they will interview patients referred for immediate assessment. Students may elect clinical experiences on various specialty services, including bipolar psychotic disorders, geriatrics, substance abuse, child and adolescent , Partial Hospital Program and others. Exposure to research in neuropsychiatry may also be arranged. While students are expected to master a core knowledge base in psychiatry, they are encouraged to communicate with the Clerkship Director before the rotation begins, so that their individual interests can be addressed.

* Core Clerkship in Radiology : The course is designed to teach fundamentals of diagnostic image interpretation and clinical indications for imaging examinations and special procedures. It is formally structured with didactic lectures, problem-based learning exercises, programmed audiovisual teaching seminars, algorithm tutorials, conferences, observation of film interpretation and observation of special procedures. NOTE: Attendance on the first day, fourth Monday and last day of this course is mandatory.

* Core Clerkship in Surgery : The overall goal of the Core Clerkship in Surgery at BWH is to offer exposure to diseases encountered by surgeons and to gain insight into surgical decision-making. The clerkship is divided into three 4 week blocks. In one block, the student participates in the daily activities of an inpatient General Surgery service and sees outpatients with an assigned General Surgery preceptor. In the second block, the student spends two weeks evaluating patients with surgical problems in the BWH Emergency Department, and two weeks in a combined Anesthesia/ Pathology rotation. In the third block, emphasis is placed on outpatient evaluation and management. They will spend one week each in Urology, ENT, and two weeks in Orthopedics.

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