Overview of the Post-PCE Phase of the MD Curriculum...The Comprehensive Clinical Skills Exam is a...
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Overview of the Pathways Post-PCE Phase of the MD Curriculum Contents (last updated 2/19/18): I. Brief Summary of Pathways Post-PCE Requirements/Timing p. 3 Read this section in its entirety first! II. Notes on Advising and Sample Schedules p. 7 III. Advanced Integrated Science Courses (AISCs) p. 11 IV. Essentials II: Advanced Social and Population Sciences for Medicine p. 16 V. Clinical Electives, Sub-Internships, and the Clinical Capstone p. 17 VI. Scholarly Project Requirement p. 19 VII. HST and MD-PhD Students p. 20 VIII. MD-MBA, Other Masters Degrees, and Research Years p. 22 IX. Appendix: Pathway to Residency Timeline p. 24 As students in the Pathways curriculum at HMS anticipate the post-PCE period, they find themselves with many exciting options, chances to explore fields of interest, hundreds of elective opportunities, and more. The post-PCE phase is when many things that have been fuzzy become clear, and students have the incredible experience of becoming increasingly confident in their ability to take care of patients. This prospect is likely both exciting and a bit daunting since the HMS curriculum is fairly prescribed from matriculation right through the PCE. As students embark on the new experience of creating a study card – and the process for all the add-drops that often follow – their advisors guide them through every step of the process. While this document – and the many information and advising sessions that are programmed in for each class – are inevitably focused on logistics and details, the most important thing to remember is that most students find the post-PCE phase to be the most enjoyable and energizing part of medical school, since they have the opportunity to tailor so much of it to their personal and professional interests. It is important to remember that less than half of all students have any idea what specialty to choose when they finish the PCE, and generations of students have used the post-PCE period to help figure that out. For students reading this earlier in their HMS journey, please remember that all the details and logistics included here are not intended to cause stress that they should already be farther ahead than they are in narrowing down a specialty choice. Toward the end of the PCE, students are asked to submit preferences for how they wish to organize the first nine-month period after the PCE (October – June of Year III) through a phased set of electronic study cards that are due beginning in early August, and there are multiple advising sessions and class meetings organized well in advance of that time each year. Appended to this document is also a “Pathway to Residency Timeline” detailing future class meetings and other events that are timed to ensure students have all the information they need to make choices well in advance of making any decisions. For example, since
Transcript of Overview of the Post-PCE Phase of the MD Curriculum...The Comprehensive Clinical Skills Exam is a...
OverviewofthePathwaysPost-PCEPhaseoftheMDCurriculum
Contents(lastupdated2/19/18):I. BriefSummaryofPathwaysPost-PCERequirements/Timing p.3
Readthissectioninitsentiretyfirst!II. NotesonAdvisingandSampleSchedules p.7III. AdvancedIntegratedScienceCourses(AISCs) p.11IV. EssentialsII:AdvancedSocialandPopulationSciencesforMedicine p.16V. ClinicalElectives,Sub-Internships,andtheClinicalCapstone p.17VI. ScholarlyProjectRequirement p.19VII. HSTandMD-PhDStudents p.20VIII. MD-MBA,OtherMastersDegrees,andResearchYears p.22IX. Appendix:PathwaytoResidencyTimeline p.24AsstudentsinthePathwayscurriculumatHMSanticipatethepost-PCEperiod,theyfindthemselveswithmanyexcitingoptions,chancestoexplorefieldsofinterest,hundredsofelectiveopportunities,andmore.Thepost-PCEphaseiswhenmanythingsthathavebeenfuzzybecomeclear,andstudentshavetheincredibleexperienceofbecomingincreasinglyconfidentintheirabilitytotakecareofpatients.ThisprospectislikelybothexcitingandabitdauntingsincetheHMScurriculumisfairlyprescribedfrommatriculationrightthroughthePCE.Asstudentsembarkonthenewexperienceofcreatingastudycard–andtheprocessforalltheadd-dropsthatoftenfollow–theiradvisorsguidethemthrougheverystepoftheprocess.Whilethisdocument–andthemanyinformationandadvisingsessionsthatareprogrammedinforeachclass–areinevitablyfocusedonlogisticsanddetails,themostimportantthingtorememberisthatmoststudentsfindthepost-PCEphasetobethemostenjoyableandenergizingpartofmedicalschool,sincetheyhavetheopportunitytotailorsomuchofittotheirpersonalandprofessionalinterests.ItisimportanttorememberthatlessthanhalfofallstudentshaveanyideawhatspecialtytochoosewhentheyfinishthePCE,andgenerationsofstudentshaveusedthepost-PCEperiodtohelpfigurethatout.ForstudentsreadingthisearlierintheirHMSjourney,pleaserememberthatallthedetailsandlogisticsincludedherearenotintendedtocausestressthattheyshouldalreadybefartheraheadthantheyareinnarrowingdownaspecialtychoice.TowardtheendofthePCE,studentsareaskedtosubmitpreferencesforhowtheywishtoorganizethefirstnine-monthperiodafterthePCE(October–JuneofYearIII)throughaphasedsetofelectronicstudycardsthatareduebeginninginearlyAugust,andtherearemultipleadvisingsessionsandclassmeetingsorganizedwellinadvanceofthattimeeachyear.Appendedtothisdocumentisalsoa“PathwaytoResidencyTimeline”detailingfutureclassmeetingsandothereventsthataretimedtoensurestudentshavealltheinformationtheyneedtomakechoiceswellinadvanceofmakinganydecisions.Forexample,since
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selectionofadvancedclinicalclerkshipsrequiresanunderstandingofwhatdifferentdisciplinesexpectinaresidencyapplication,weholdaseriesofresidencyprogrampanelswellinadvanceofwhenstudentsneedtosubmitpreferences.Thesesessions,includingmoredetailedinformationabouthowtheResidencyMatchworks,areorganizedincollaborationwithPCEandclerkshipdirectorstoensureallstudentsarereleasedfromclinicalresponsibilitiestocometoTMEConthoseevenings.MostofthematerialinthisdocumentrelatestoPathwaysstudents,althoughsomeoftheinformationalsorelatestoHSTMDstudentsandtotheHSTandNewPathwayMD-PhDstudentswhoarestillcompletingthePCE.CommonrequirementsforallHMSstudentsincludetherequirementstotakeandpassUSMLESteps1,2CSand2CK,therequirementtotakeandpasstheHMSComprehensiveExaminthesummerafterthePCEisfinished,and–forallstudentswhomatriculatedin2015orafter–theClinicalCapstoneCourse.ThereisalsoasectionwithinformationforMD-MBAstudentsandotherstudentsdoingcombineddegrees.Eachsectionendswithasetof“frequentlyaskedquestions”(FAQs)aboutthattopic.ChecklistforReference:HMSGraduationRequirementsforPathwaysMDStudentsRememberthatallstudentsshouldhaveatleasttwomaingoalsforthepost-PCEphase:todeterminethespecialtytheywishtoapplyinforadvancedtrainingandtoensuretheyhaveabroadfoundationinmedicalsciences.Linktoacademiccalendarfoundhere:https://meded.hms.harvard.edu/academic-calendars• ComprehensiveClinicalSkillsExam:SummerafterPCE• AdvancedIntegratedScienceCourses:2xfour-weekcourses,atleastoneinYearIII*• EssentialsII:1xfour-weekcourse,YearIIIorIV• Clinicalelectives:Atleast3xfour-weekclinicalelectivesatHMSaffiliatedhospitals• Scholarlyproject:
o December31,YearIII-Project/mentorproposaldueforglobalhealthprojectsonlyo April15,YearIII-Project/mentorproposaldueforallotherprojectso 2-5monthsfull-timeSiMo March1,YearIV-Finalreportdue
• Sub-InternshipinMedicineorPediatrics–1xfourweeksbyJulybeforegraduation• ClinicalCapstone:1xfourweeks–January,February,MarchorApril,YearIV• Fulltimeenrollmenteachsemester• Steps1,2CSand2CKrequiredforgraduation(furtherdetailsforalloftheabovefollow)*TheseAdvancedIntegratedScienceCoursesarenotrequiredforMD-PhDstudentsI.BriefSummaryofPathwaysPost-PCERequirementsandTimingUSMLE(PassingSteps1,2CSand2CKrequiredforgraduation):
• TakeStep1byDecember31ofYearIII;
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• TakeStep2CSbyNovember1ofYearIV;• TakeStep2CKbyDecember31ofYearIV.
StudentsfinishingthePCEinSeptemberwillgenerallytakeaboutsixtoeightweekstostudyforStep1,usingeitherOct-NovorNov-Dectostudy,alongwithaweekortwoofvacation(USMLEexamscanbescheduledforanydayoftheweekexceptSundaysandholidays).Atleastonemonthofcredit-bearingactivity(typicallyinOctoberorDecember)mustbetakenduringtheOct-DecquarterofYearIII,suchasaclinicalelectiveorsub-I,Essentials2,aSiMmonth,theAdvancedClinicalPharmacologycourse,ortheHBSMedicineandManagementCourse(whichisrequiredforMD-MBAstudentsandwhichrunsparttimethroughthesecondhalfofthisthree-monthblock–seebelow).Exceptionstothisrequirementforonemonthofcredit-bearingactivitymayberequestedfromastudent’sAdvisoryDeanforpersonaloracademic/learningreasons,andtheserequestsareconsideredforapprovalbytheAdvisoryDeansasagroup,toensurefairnessacrossSocieties.StudentsarealsopermittedtotakeStep2beforeStep1onlywiththepriorapprovaloftheirAdvisoryDean;ifapprovalisgranted,thestudentispermittedtoextendtheStep1deadlineuntilJanuary31(seefirstFAQbelow).TheComprehensiveClinicalSkillsExamisa4-hour,6-stationOSCEdesignedtoassessintegratedclinicalskills,includingfocusedhistory-taking,physicalexamwithpropertechnique,communicationandcounselingskills,anddemonstrationofclinicalreasoningthroughdocumentationofeachclinicalencounter,allinaprofessionalmanner.Thisrequiredexamcertifiesclinicalskillsforthepost-PCElevel,preparesstudentsforsuccessintheStep2CSexam,andprovidesfeedbacktostudentsattheendoftheexamday.TheComprehensiveExamisscheduledoveraperiodthatspansthemid-JuneandbeginningoftheJulyblocks,ensuringthatstudentscanscheduleitwhennotontheirsub-internshipmonth(studentsaregivenamorningorafternoonofffromclinicalelectivesandothercoursestodotheCompExam).TheexamisrequiredofallstudentsinthesummeraftertheycompletethePCE.AdvancedIntegratedScienceCourses(“AISCs”–SectionIII):Aminimumoftwoofthesefour-weekcoursesisrequired;theyareofferedinJanuary,February,andMarch.AtleastonemustbetakeninYearIII.AnoverviewofthesecoursesisfoundinSectionIIIbelow.EssentialsII:AdvancedSocialandPopulationSciencesforMedicine(SectionIV):Thisrequiredfour-weekcourseistakeninOctoberorMarchofYearIIIorYearIV.ClinicalElectives(SectionV):AllstudentsmustcompleteatleastthreeclinicalelectivesatHMS-affiliatedhospitals,inadditiontotherequiredsub-IandClinicalCapstone.Nomorethantwoelectiveswiththesamecoursenumbercancounttowardthisrequirement(e.g.,cannotcountthethirdofthreemonthsofneurosurgery).Itisexpectedthatmoststudentswilldomorethantheminimumnumberofclinicalelectives,alongwithothernon-clinicalelectives,awayrotations,internationalclerkships,etc.
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Sub-Internship(SectionV):Therequiredfour-week“sub-I”inmedicineorpediatricsistakenafterthePCEandnolaterthanJulyofYearIVforallPathwaysstudents(byAugustofYearIVforHSTstudents).Sub-InternshipsaredoneatadifferentclinicalsitefromtheonewherethePCEwascompleted.Notethatthe“requiredsub-Internship”iseithertheMedicineIIorAdvancedPediatricsrotation,andallstudents(bothPathwaysandHST)musttakeoneortheother(byJulyorAugust,respectively).Otheradvancedelectivesaresometimesreferredtoas“sub-I’s”(e.g.,doinga“surgicalsub-I”oran“GYNsub-I”):thoseareadvancedclinicalrotationswherestudentsaregivenmoreresponsibilitythanonatypicalclerkship,andstudentsapplyinginthosefieldsreceiveadviceastowhentheseother“sub-I’s”shouldbepartoftheirschedule,butnoneofthoseisrequiredforgraduation.ClinicalCapstone(SectionV):AllstudentsmustcompletetheClinicalCapstonecourseinJanuary,February,March,orAprilofYearIV.Thecourseinvolvesthreeweeksofanadvancedclinicalelectivethatmeetsthecriteriafordirectpatientresponsibility,alongwitharequiredone-weekprofessionaldevelopment/transitiontointernshipcurriculumconductedatTMEC.Forthethree-weekclinicalcomponent,studentsselectfromrotationssuchasemergencymedicine,ICUelectives,advancedsurgeryorOB-GYN,etc.–rotationswherethestudentworksuppatientsandwritestheorders(whichgetco-signedbyaphysician)inthewaytheydidintheirsub-Iinmedicineorpediatrics.TheClinicalCapstonepreparesstudentstoself-assesstheareasofclinicalworktheyshouldfocusonastheentertheirinternshipandensurestheyhavehaddirectpatientcareresponsibilityinthesixmonthsbeforeinternshipbegins.ScholarlyProjectRequirement(“SiM”–SectionVI):ThedeadlineforproposalisApril15ofYearIIIandthefinalscholarlyreportisdueMarch1ofthefinalyear.StudentsareencouragedtouseanAISCorEssentialsIItohelpidentifyaSiMtopicandmentorifthishasnotalreadyhappenedduringthepre-clerkshiporPCEphasesofthecurriculum.Thistimelinehelpsstudentschoosecourses,e.g.,ifastudentisconsideringanEssentials-relatedSiMproject(globalhealth,socialmedicine,clinicalepidemiology,healthpolicy,ethics),itisadvisabletodothatcourseinOctoberorMarchofYearIII;ifconsideringaSiMprojectinvolvingcancermedicine,takethecancerbiologyAISCinYearIII.Studentstypicallyhaveaminimumoftwofull-timemonthsofSiM500ontheirtranscript(unlesstheydotheirSiMthroughamaster’sorPhDproject),buttheymayhaveuptofivemonthsoffull-timeSiMandstillbeabletograduateinfouryears.Studentswhodoacombineddegree(mastersorPhD)generallyfulfilltheSiMrequirementbysubmittingthewrittenproducttheyproduceforthatothergraduatedegree.MaintainFull-TimeEnrollment:Allstudentsmustensurethattheyremainenrolledfull-timeforalleightsemestersintheMDprogramatHMSinordertograduate.Asstudentscompletestudycardsfortheirnextperiodofenrollment(typicallydoneinapproximatelynine-monthstudycardperiods),they–withtheiradvisors’help–mustensurethattheplanrepresentsastrongapproachnotonlytocompletingallgraduationrequirementsandpreparingforresidencyapplications,butalsothatnolapsesoffulltimeenrollmentoccur(recognizingthatapersonalillnessorfamilyemergencycanpullstudentsawayforperiodsoftime).
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Moststudentscanmeetallrequirementsandhaveuptofivetosixunscheduledmonthsacrossthe19-monthpost-PCEphase,buttheymustbeenrolledatleastthreemonthsineverysemester(Jan-JunandJul-Dec)toremainenrolled“full-time.”Onlyinthefinalgraduatingsemestermayastudentbeenrolledforonlytwomonths(eightweeksfulltimeJan-Apr),andthisonlyiftheyareontracktocompletetheirdegreerequirements.Anysemesterinwhichastudentisenrolledlessthanfull-time,exceptforthatfinalterm,mayaffectfinancialaideligibility.Enrollmentmonthsmayincludenotonlyclinicalelectivesandsub-Is,butalsoSiM500months,awayelectivesatothermedicalschools,andnon-clinicalelectives,suchastheleadershipcourse,advancedanatomy,medicalSpanish,student-as-teacher,advancedclinicalpharmacology,narrativemedicine,andmanyothers.Studentsinthe5-yearMD-MBAprogramshouldreviewtheirspecialprogramrequirementscarefully(seesectiononMD-MBArequirements).Studentswhocompleteothermastersprograms(MPH,MPP,MMSc,MBe)generallydothesedegreesintheacademicyearbetweentheirthirdandfourthyearofmedicalschool,sothisdoesnotaffectanyotherrequirements.FrequentlyAskedQuestions:1.ShouldIconsidertakingStep2beforeStep1?Asnotedabove,studentsarepermittedtotakeStep2beforeStep1onlywithpriorapprovaloftheirSocietyAdvisoryDean,inwhichcasetheyarepermittedtoextendtheStep1deadlineuntilJanuary31.ThisrequirementfortheAdvisoryDean’sapprovalisdesignedtoensurethatstudentshavecarefullyconsideredalloftheimplicationsofthisstrategyfromtheperspectiveoftheresidencyapplicationprocess.Mostothermedicalschoolsthathaveframe-shiftedtheclerkshipyearearlierallowstudentstotakeStep2first,butbenchmarkingsuggeststhatvirtuallynostudentsdoso.TakingStep2firstsoundscompellingtoastudentinthemidstofclerkships,sinceitfeelsasifitmightoptimizetheStep2score,giventheoverlapofcontentwithalltheshelfexams.Thisapproachdoesnottakeintoconsiderationalltheclinicallearningstudentsdoinadvancedelectives.Moreimportantly,itmeans“losing”amonththatcouldcontributetoresidencyplanningandapplication(sincestudentsotherwisetypicallyfitinStep2duringresidencyinterviewsanddonot“lose”acriticalpre-applicationmonthjuststudyingforStep2).ConventionalwisdomsuggeststhattakingStep2first“canonlyhurtyou”inresidencyscreening(i.e.,thescoreisgenerallynotafactorintheresidencyselectionprocessunlessitisalreadyavailableandverylow).Thepolicyof“optoutonlywithapprovalfromtheAdvisoryDean”allowsforflexibility,butensuresstudentsarenotoverthinkingtheadvantagesfortheirStep2scoreandlosingsightofthefactthatStep1istheonlyscorethatisusedasascreenforresidencyinterviewsbyprogramswhousesuchscreens.Furthermore,ifastudentapplyinginsuchaspecialtydoesnotgettheStep1scoreheorshehopedfor,additionalstudyingforStep2toproduceahigherscorecanoftenmitigatethis–butisonlyworthdoingaftertheStep1scoreisknown.
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2.Howdovacationsworkinthepost-PCEphaseofthecurriculum?Theentireacademiccalendarinthepost-PCEphaseworksjustlikethePCEcalendar.Theyearisdividedinto12four-weekblocks,withoneweekofspringbreakbuiltin,oneweekofasummervacation,andtwoweeksforwinterbreakattheendofDecember.ThecalendarsforeachyearareavailableontheRegistrar’swebsite:https://meded.hms.harvard.edu/academic-calendarsThismeansthereisa“drift”throughtheyearofwheneachfour-weekblockactuallystarts–withtheJanuaryblockstartinginearlyJanuary,buttheDecemberblockactuallystartinginmid-November,sinceitendswithtwomoreweeksinDecember.Thus,wheneveryouseeacourseorclerkshipreferencedas“April”or“October,”youshouldbeawarethatittypicallystartstheendofthemonthbeforeandfinishesbeforetheendofthatmonth(moresoasyoumovethroughthesecondhalfoftheyear).Inadditiontothosefourweeksofvacationbuiltintotheacademiccalendar,moststudentsleaveseveralfour-weekblocksunscheduled,includingoneortwomonthsforStep1study,oneortwomonthsoftravelforresidencyinterviews(althoughstudentsalsooftenfitinterviewsinduringSiMresearchmonths),andothervacations.Thecalendarhasenoughflexibilityforastudenttotakeuptofiveorsixunscheduledmonthsduringthepost-PCEperiod(inadditiontothefourvacationweeksbuiltin)andstillgraduateontime.Asnotedabove,itiscriticaltomaintainfull-timeenrollment,whichmeanshavingatleastthreecredit-bearingmonthsineachsemester(January-JuneandJuly-December),withtheexceptionofthefinalsemester,whentwofulltimemonthsareallowedifalldegreerequirementshavebeenmet.3.OnceIsubmitmystudycardandgetthenextphaseofmyschedule,mayIrequestchangesalongtheway?Yes.Oncestudycardassignmentsforeachperiodarecompleted,studentshavetheopportunitytorequestand/ormakechangestotheirpost-PCEschedulesbasedonavailability.TheschedulingofclinicalelectivesisusuallymoreflexiblethantheschedulingofAISCsandtherequiredmedicineorpediatricssub-internships:
• ForAISCsandrequiredmedicineorpediatricssub-internships,requestsforadd/dropsaremanagedbytheRegistrar'sOfficeandmustbedoneatleast60daysinadvance;
• Forclinicalelectives,ascheduleformonthlyonlineadd/droprequestswillbemadeavailable,andtheseareusuallysubmitteddirectlyonline.
II.NotesonAdvisingandSampleSchedulesPlanningthepost-PCEphaseofthecurriculumisoneofthecriticaljuncturesatwhichourSocietyadvisingsystemisofthemostusetoallstudents.Notonlydostudentshavetheirfirstmajoropportunitytochoosewhattheyaredoingfrommonthtomonth,butthereareanincrediblenumberofpossibleexperiencesandsequences.AllSocietyadvisorsarefullyinformedofthevariousstudent-specificfactorsthatmightplayaroleinpost-PCEplanningandhowbesttousethese,onanindividualizedbasis,torecommendpossiblechoices.
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TheoverarchinggoaloftheadvisingprogramduringYearsIIIandIVistohelpstudentscreatecoherentmulti-monthtracksinordertoaccomplishthefollowingaims,inapproximateorder:
• Toexploretheircareergoalsinmoredepththanispossibleinthepre-clerkshipcurriculumorthePCE
• Astheynarrowtheirspecialtychoicesandultimatelyselectaclinicalfield,toshapetheirschedulesaccordinglytomaximizelearningopportunitiesandstrengthencompetitivenessforresidencyapplications
• Toroundouttheirexperiencewithelectivesandotheractivitiesthatshoreupareasinwhichtheyneedmorework,helptopreparethemforinternship,stimulatequestionstoapproachinaSiMproject,orsimplybefunthingstotryout
AnimportantadvisingmeetingforallstudentstakesplaceduringthelastthirdofthePCEyear,whenstudentsdiscusswiththeirSocietyadvisorstheirevolvingcareergoalsandhowbesttousethepost-PCEphasetoachievethesemultipleaims.Oneexample,amongmany,ofhowastudent’sspecifictrajectorywouldhelpdeterminetheappropriatesequencingofpost-PCEactivitiesrelatestothetimingoftheSiMprojectmonths.Since,formoststudents,itisoptimalforSiMresearchtoberelevanttotheirdesiredcareerpath,studentsunsureabouttheirspecialtyinterestsimmediatelyafterthePCEmightbeadvisedtodomoreclinicalelectivesearlierandtheirSiMprojectlater,whilestudentswhoarealreadycommittedtoaparticularspecialtymightdotheirSiMprojectearlierandmoreclinicalelectiveslater.BesidestheindividualSocietyadvisingmeetings,therearealsoclass-widemeetings,specialtypanels,andothersessionsscheduledeachyearinwhichdetailsaboutspecialcasessuchasthecouplesmatch,militarymatch,earlymatchingspecialties,andtheCanadianmatchareprovided.Therearealsoclass-widesessionswithworkshopsonpreparingapersonalstatement,asetofmockinterviews,anddiscussionsofstrategiesforpreparingaranklist.Inaddition,HMShasdesignatedacadreofspecialtyadvisorsavailabletostudentsineachfieldtotoprovidespecialty-specifictipsontheapplicationprocess.Followingaremockschedulesforfivehypotheticalstudents:Hermionestartsoutthinkingshe’sgoingintoneurology,butswitchestointernalmedicine.HerSiMisonhealthpolicy.HarryfinishesthePCEfairlycertainaboutorthopedicsurgeryandwantstodoatranslationalresearchSiMinortho.RonfinishesthePCEtotallyundecided–mostlikelyleaningtowardeitherpsychiatryorpediatrics,butdefinitelyinterestedinglobalhealthandwantstodoaSiMprojectwithPartnersinHealthinRwanda.Hedecidesonpediatrics.Nevilleknowsitwillbesomething“procedural,”andafterafewexplorationsendsupgoingintoOB-GYN,alsowithaninterestintranslationalresearch.Lunahasbeenenthusiasticaboutsurgerysincefirstyearandplanstocontinuesomebasicsciencecancer-relatedresearchbegunbeforestartingmedicalschool.
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AISCsareshowninredandEssentialsIIingreen. Hermione Harry RonOct Step1study Clinelective:ortho EssentialsIINov Step1study/exam Step1study Step1studyDec Clinelective:advneuro Step1study/exam Step1study/examJan Clinelective:pedineuro RegenerativeMedicine Clinelective:pedsFeb Immunology Clinelective:SICU Clinelective:psychMar EssentialsII MedicineSub-I NeurobiologyApr MedicineSub-I SiM500 Clinelective:cardiologyMay Clinelective:nephrology Awayrotation:ortho PedsSub-IJun Clinelective:rheum/Comp Vacation/Step2CK Clinelective:GI/CompJul Vacation/wedding Clinelective:endocrine/CompVacation/weddingAug Clinelective:derm Awayrotation:ortho* SiM500/Step2CS Sep Vacation/Step2CK SiM500/Step2CS SiM500:abroadOct SiM500/Step2CS SiM500 SiM500:abroadNov SiM500/Interviews Unsched/Interviews SiM500:return/Step2CKDec Unsched/Interviews Unsched/Interviews Unsched/InterviewsJan ClinicalCapstone SiM500/Interviews Unsched/InterviewsFeb ComputMedicine Immunology ClinicalCapstoneMar Women’shealthelective EssentialsII Microbio/InfectiousDisApr NarrativeMedicine ClinicalCapstone Clinelective:ER Neville LunaOct Step1study SiM500(backtopreviouslab) Nov Step1study/exam Step1study Dec Clinelective:cardiology Step1study/exam Jan TranslationalPharm CancerBiologyFeb Clinelective:GynOnc Clinelective:SurgOnc Mar MedicineSub-I SiM500 Apr Clinelective:intervrays MedicineSub-I May SiM500 Clinelective:SICU Jun SiM500/Step2CS/Comp Vacation/Step2CK Jul Clinelective:MFM Clinelective:Adv.Surg/Comp Aug Clinelective:derm SiM500 Sep Vacation/Step2CK SiM500/Step2CS Oct EssentialsII EssentialsII Nov Unsched/Interviews SiM500/InterviewsDec Unsched/Interviews Unsched/Interviews Jan Clinelective:fammed Clinelective:InfectiousDiseases Feb ComputMedicine ClinicalCapstoneMar OB/GYN“BootCamp” Microbio/InfectiousDisApr ClinicalCapstone Clinelective:anesthesia
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*Thisthirdorthomonth,urgedbystudent2’sorthoadvisor,isnon-creditbearing.(Studentsarelimitedtonomorethantwoclinicalelectivesrepresentingthesamecourseinthesamemedical/surgicaldiscipline.Studentswhochoosetotakemorethantwowillnotreceiveadditionalacademiccredittomeetclinicalelectiveand/orunspecifiedelectiverequirements.StudentHandbookSection1.03:CourseandExaminationRequirements.)FrequentlyAskedQuestions1.HowshouldIthinkaboutthegoalsandobjectivesformypost-PCEcurriculum?Asyougothroughthepost-PCEphaseofthecurriculum,youofcoursehavemajorgoalsaroundthechoiceofaresidencyfieldandsuccessfullymatchingintoaresidencyinthatfield.Pleaserememberthatinadditiontothosecareer-choicegoals,youshouldbeorganizingyourprogramofstudytoensureyouaremeetingsuchcurriculargoalsforthepost-PCEphaseas:MedicalKnowledgeandPatientCare
• Tosolidifyandexpandknowledgeinthebiomedicalandclinicalsciencesandimprovetheabilitytousethatknowledgeinthecareofpatients
• Toassumeincreasingresponsibilityforpatientcare• Todeterminewhenapatient’sclinicalconditionisindicativeofaseriousand
potentiallylife-threateningproblem• Toprepareforthenextphaseofmedicaltraininginalaboratoryorclinicalsetting
Professionalism
• Todevelopanunderstandingoftheresponsibilityandprivilegeassociatedwithprovidingcareforpatientsandtocultivateasenseofownershipforapatient’sclinicalcourse
• Toapplyethicalprinciplesinthecontextofclinicalcare• Toseekandmakeuseoffeedback
CriticalThinkingandInquiry
• Toenhancecuriositythroughthepursuitofindividuallydefinedinterests• Tobuildupontheskillsneededtopursuescientificendeavorsandscholarlywork• Torefinecriticalthinkingandclinicalreasoningskills• Tobuildupontheskillsneededforself-directedlearning,includingtheabilityto
identifygapsinknowledgeandtouseandevaluateresourcesinthemedicalliterature
Interpersonalandcommunicationskills• Toworkwithinterprofessionalteamsinaneffectiveandrespectfulmanner• Tocommunicatemedicalandscientificinformationtocolleaguesinameaningful
manner• Tocommunicatemedicalinformationtopatientsandfamiliesinlaytermsandinan
empathicmanner
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• Tocommunicatetheuncertaintyinherentinmedicaldiagnosticandtherapeuticapproachesinamannerthatsupportstheprinciplesofhighvaluecareandshareddecision-making
OrganizationalandSocialDeterminantsofHealthcare
• Tosolidifyandexpandknowledgeinthesocialsciencesandimprovetheabilitytousethatknowledgeinthecareofpatients
• Tosolidifyandexpandknowledgeofthehealthcaresystemstoenhanceefficiencyandqualityofcarewhileensuringpatientsafety
• Tocareforpatientsrepresentingadiversepopulationwithsensitivityandrespect2.AsIhitthemid-pointofmyPCE,howmuchpressureshouldIfeeltofigureoutmypreferencesfortheperiodfollowingmyPCE?None!YoudonothavetodecideaboutthisuntilthefinalmonthsofyourPCE.Ifyouarefeelingpressureprematurely,pleaserereadtheintroductionabovecontainingtherationaleforprovidingallthisdetailsofaraheadofwhenyouneedit.Thisdocumentandourclassmeetingsarenotintendedtogetyoustressedaboutfeelingyoushouldalreadybefartheraheadincareerplanningthanyouneedtobe.RememberthatmoststudentsfinishthePCEunsureofwhattheywanttodo,andtherearemultipleclassmeetingsandadvisingsessionsscheduledtoassistyouinatimelyway.III.AdvancedIntegratedScienceCourses(AISCs)Scientificresearchisatthecoreofevidence-basedmedicineandistransformingmedicalcareatanincreasinglyrapidpace.Physicianshavetoevaluatenewresearchadvances,incorporatethemjudiciouslyintoclinicalpractice,andprovideleadershipfornewresearchintothemosturgentpatientneeds.TheAdvancedIntegratedScienceCourses(AISCs)aredesignedtoengagestudentsinthecriticaltwo-wayrelationshipbetweenresearchandclinicalmedicine:Howcancuriosityaboutclinicalexperienceandtheformulationofkeyquestionsleadtonewresearchprogress?Andhowcananunderstandingofcurrentresearchdevelopmentsinfluenceclinicaldecision-makingandpatientcare?TheAISCsuseflipped-classroomandotheractivelearningmethodsasinYearI,whilehavinganincreasedemphasisonself-directedlearning.Theyareparticularlydistinguishedbyengagingwiththefrontierofclinically-relevantresearchattheboundaryoftheknownandtheunknown.Clinicalorotherexperientiallearningactivitiesintegratedintoeachcourseservetoillustrateunderlyingscienceprinciplesandpromotethedevelopmentofscientificquestionsaboutthemechanismofdisease,diagnosisortreatment.Studentsactivelyparticipateinscientificinquirybyidentifyingandexploringunsolvedquestionsthatinterestthemwithfacultymentorship,culminatinginafinalproductattheendofthecourse.TheAISCsalsohelpstudentsdevelopgeneralizableskills:findingandevaluatingresearchinformation,communicatingaboutsciencetopeersorpatients,understandinghowresearchinfluencespatientcare,anddevelopingquestionsandideasforscientificinvestigationandmedicalprogress.TheAISCsaimtoenhancethe
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capabilitiesofstudentstoworkattheinterfaceofclinicalcareandresearch,asfirst-ratecontributorstothemedicineoftodayandthecomingdecades,whileprovidinganintroductiontofrontierresearchtopics.Thesegeneralizableskillsaremoreimportantasgoalsthantheparticularscientificareaagivencourseusestoteachthem.SimilartoYearsIandII,theAISCsaregradedonasatisfactory/unsatisfactorybasis.Anarrativeassessmentofperformanceisprovidedtoeachstudent.Atypicalcoursehasbothafinalproductandoneormoresmallerintermediateproducts(writtenororalpresentations)thattogetherserveasthebasisforassessment.Thenumberandtypeofassignmentsvarybycourse(seeFAQs,below).StudentsarerequiredtotaketwoAISCsoftheirchoice,atleastoneduringYearIII.EachAISCisofferedonceperyearduringJanuary,FebruaryorMarch.Duringeachfour-weekcourse,studentsshouldplantodevotetheirfull-timeefforttotheAISC;althoughtheremaybeblocksofunscheduledtime,thistimeiscriticalforpreparation,self-directedexploration,anddevelopmentoforiginalquestionsandworkproducts.ThefollowingAISCsarecurrentlyplannedforJanuary,FebruaryandMarchof2019;datesarestilltentative,andothercoursesmaybefinalizedinthemonthsahead.AfinallistofcoursesandmonthsofferedarepostedbyearlyJulyeachyear,wellbeforestudycardsaredue.CancerBiology(January)CourseDirectors:RandallKing,HaroldJ.Burstein.Arevolutioninthescientificunderstandingofthecellularandmolecularbasisofcanceristransformingthescienceandartofclinicalcancercare.Thecourseemphasizeshowthebasicscienceofcancerbiologyunderpinsissuessuchascancerprevention,screening,diagnosisandchoiceoftherapy.Studentsreviewanddeepentheirunderstandingofbasicprinciplesincellbiology,genetics,andpharmacologyinthecontextofcancerbiology.Participationinmultidisciplinaryoncologyclinicsserveasastimulustoidentifybasicsciencequestionswhichstudentsinvestigatethroughoutthecourse.RegenerativeBiomedicine(January)Coursedirectors:DavidT.Scadden,WilliamJ.Anderson,DavidP.Steensma.Regenerativebiomedicineaimstorepairtissuesandorganstorestorenormalfunctionandislikelytobecomeanincreasinglyimportantcomponentofclinicalmedicineinthecomingyears.Hematopoieticstemcelltransplantationisalreadyinwideclinicaluse,whileotherregenerativetherapieshaveenteredtheclinicmorerecentlyorareinclinicaltrials.Thiscourseexplorestheroleofstemandprogenitorcellsintissuehomeostasis,howdefectsinthisprocesscanleadtoillness,andtheroleofstemcelltherapyinthetreatmentofdisease.Thecoursechallengesstudentstothinkcriticallyintheareaofstemcelltherapyandregenerativebiologyasitappliestoclinicalapplicationsinstemcelltransplantation,woundrepair,andagingamongothers.Variedclinicalexperiencesrangingfromtransplantmedicinetogeriatricsfacilitateintegrationofbasicscienceconceptsandstimulateformulationofquestionsatthescientificfrontierwhichisexploredduringthecourse.
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TranslationalBiomedicalEngineering(January)Coursedirector:DavidR.Walt.Innovations in biomedical engineering are having a significant impact on healthcare. Advances in genomics technologies are transforming diagnostics/therapeutics, including personalized medicine. Prosthetic technologies are giving patients who have lost a limb the opportunity for near-normal lives. Robots, swallowed or injected, are changing surgery and diagnostics. Nanomaterials are being used as therapeutics and for new imaging modalities. In this course, students interact with faculty who have successfully translated their work to the private sector, and spend time in labs at the Wyss Institute where novel technologies are currently being developed. Students also meet with investors, visit startup companies to see how technologies are scaled and manufactured, and meet with business development and marketing groups. Student teams are then tasked with going into the clinic and developing a novel use case for technology. The course is designed to provide students with an understanding of the entire process from academic discovery to commercial and patient impact. TranslationalPharmacology(January)Coursedirectors:DavidE.Golan,CatherineI.Dubreuil,DonaldM.Coen,JageshV.Shah.Therehasneverbeenabettertimeinscienceandmedicinetodiscoveranddevelopeffectivetherapiesforhumandisease.TheTranslationalPharmacologyAISCcoversprinciplesofpharmacology,drugdiscovery,andtherapeuticdevelopmentfromunmetneedtodrugdeploymentintheclinicalsetting.Throughcasestudiesofsuccessesandfailuresintranslationandgroupprojectstoproposedrugdevelopmentstrategiesfromunmetneedthroughclinicaltrialsandpharmacovigilance,thiscourseexplorescurrenttopicsintherapeuticdiscovery.Visitstoclinicsandbiotech/pharmacompaniesaswellasmeetingswithpatientsandphysiciansinrelevanttherapeuticareasareutilizedtofurtherexaminehowunmetmedicalneedsaretranslatedintonewclinicalpractices.Computationally-EnabledMedicine(February)Coursedirectors:IsaacKohane,PaulAvillach.Computationalapproachestoanalyzinglargedatasetsandapplyingtheinsightsderivedtoclinicaldecisionmakingarecentraltothepresentandfutureofbiomedicine.Thiscourseenablesstudentstoacquireacomputationalframeworkandtoolkitforaddressingthisgrowinganalyticchallenge.Selectedexamplesfromgenomicsclinicaldecisionmakingandfromepidemiologyinformedby“bigdata”obtainedfromelectronichealthcaredata,claimsdataandeventhesocialwebserveasthebasisforexplorationofthecomputationalframework.Mentoredexperiencesatmedicaldatasciencecompaniesandstate-of-the-artclinicaldiagnosticsenterprisesenablestudentstoexperiencetheapplicationofandelaboratequestionsthatcanbeaddressedbycomputationalbiomedicine.HumanGenetics(February)Coursedirectors:MatthewL.Warman,DavidT.MillerThiscourseexaminesgeneticprinciplesandexperimentalapproachestoaddressfundamentalquestionsabouthumanvariation,health,anddisease.Byexaminingtopicssuchaschromosomaldisorders,genomics,genetherapyandforensicgenetics,aswellasparticipatinginwholeexomeandwholegenomesequencinganalyses,studentsgainan
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understandingofthescientificunderpinningsandtechnologythatdriveadvancesingenetics.Clinicalopportunitiesfocusedonthegeneticsofcancer,cardiovasculardisease,birthdefects,developmentaldisability,andneurodegenerativediseasepromotethedevelopmentofscientificquestionsinordertodeeplyinvestigatehowtousegenetictechnologiestodiagnoseandtreatpatientsaffectedbyageneticdiseaseandhowtocounselpatientswhomaybeatriskfordevelopingdisease.Immunology(February)Coursedirectors:StephanieK.Dougan,MichaelL.Dougan.Thebasicscienceofimmunologyhasresultedinanimpressivearrayofnewtherapiesoverthepastdecadethathavedramaticallychangedclinicaloutcomesinawiderangeofdiseases.Usingfourfundamentalconceptsasaframework(Bcelldevelopmentandantibodyfunction,antigenprocessingandpresentation,activationandregulationofadaptiveimmunity,andcell-cellcommunication),thiscourseexaminestheimmunologicfoundationsunderpinningtherapidexpansionofimmunemodulatingtherapeuticsinclinicaluse.Thecourseillustratestheseconceptsusingspecificdiseasesincludingprimaryimmunodeficiency,allergy,rheumatoidarthritis,inflammatoryboweldisease,andcanceraswellasthroughintegratedimmunology-focusedclinicalexperiencesacrossarangeofspecialties.Clinicalexperiencesandclassroomdiscussionsenablestudentstoidentifyandexplorequestionsthatexamineourunderstandingofhowwecanbroadentherepertoireofimmunetherapiesinthefuture.Metabolism,NutritionandLifestyleMedicine(February)Coursedirectors:Marie-FranceHivert,ChristopherDugganAlifestylewithhealthynutritionandphysicalactivitycouldpreventupto80%ofnon-communicablediseases,anddietarypatternsaretheetiologyfornumerousacuteillnessesinwomen,childrenandothersusceptiblepopulations.Recentadvancesinknowledgeandtechnologyaretransformingthewaythatweintegratelifestyleintoclinicalpractice.Thiscoursecoversfourmajorthemes:1)energyregulation,fromundernutritiontoovernutrition;2)gene-nutrition/lifestyleinteractions;3)developmentaloriginofhealthanddiseases;and4)noveltechnologicalapproachesinnutritionandlifestyle.Studentshavetheopportunitytoparticipateinawidevarietyofspecialtyclinicalprograms,includingweightmanagement,diabetescare,hyperlipidemia,parenteralnutrition,neonatalandotherintensivecareunits,celiacdisease,intestinalfailure,andothers.Classsessionsincludestudents’clinically-inspiredquestions,casediscussions,journalclubs,andexperientiallearning.ThisAISCcombinestheexpertiseofmultiplefacultymembersacrossHMS-affiliatedinstitutionstoofferstudentstheopportunitytoexpandtheirknowledgeandskillstointegratenutrition,physicalactivity,andotherlifestylebehaviorsintheirfuturecareers.MicrobiologyandInfectiousDiseases(March)Coursedirectors:CammieF.Lesser,MaxL.Nibert.Despiteoursubstantialprogressincontrollinginfectiousdiseasesthroughvaccines,therapeutics(e.g.,antibiotics),andotherpublichealthmeasures,theycontinuetobeasourceoftremendoussufferinganddeatharoundtheworld,especiallyinlow-resourcesettings.Thiscourseexploresthebidirectionalinteractionsbetweenthepracticeofclinical
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medicineandbasic/translationalresearchinBacteriology,Virology,andImmunology.Mentoredexperiencesinclinicalsettingsenablestudentstoformulateandinvestigatespecificquestionsattheinterfacebetweenmedicineandscience.Focusingonantibioticresistance,HIV/AIDS,thehumanmicrobiomeandemergingvirusessuchasZika,thiscourseexploresthechallengesandpossiblesolutionsthatinfectiousdiseaseswillbringtothe21stcentury.Neurobiology(March)Coursedirectors:JohnAssad,ToddHerrington.Thehumannervoussystemisoneofthegreatfrontiersofmodernbiology.Currentadvancesinneurosciencehavetransformedneurologyfromprimarilyadiagnosticspecialtytoonerichwiththerapeuticoptions.Inthiscourse,clinicalexperiences,inadditiontoneurology,incorporateradiology,psychiatryandneurosurgery.Topicsincludepainandsensoryloss,theetiologyandtreatmentofseizures,thedisruptionofcognitivefunctioninneurodegenerative,neurodevelopmentalandpsychiatricdisease,theroleoffunctionalneuroimaginginunderstandingbrainnetworks,andtheuseofneurotechnologyincludingdeepbrainstimulationtotreatneurologicandpsychiatricdisorders.Inthiscourse,studentsdeepentheirunderstandingofbasicneurobiologywithagoalthattheybecomeinspiredtocontributetoscientificunderstandingandtranslatediscoveriesintonoveltherapies.Note1:Othercoursesmaybeaddedtothislistandsomemonthsmayshift;thefinallist(withallcoursedescriptionsandmonthsoffered)ispublishedbyearlyJulyeachyear,beforestudycardsaredueforthefollowingyear.Note2:AISCcoursesarenotrequiredforMD-PhDstudents,whomayelecttotakethemaselectivesiftheywish.AISCFrequentlyAskedQuestions1.HowdoesanAISCdifferfromaclinicalelective?ThegoalsandobjectivesofAISCsdiffersignificantlyfromthoseofclinicalelectives.ThegoaloftheAISCsistopromoteanunderstandingofbasicscienceconceptsandtoencouragescientificinquiry,whilethegoalofaclinicalelectiveistopromoteadeeperunderstandingofclinicalmedicine.Forexample,thegoalofacancerclinicalelectiveistolearnaboutthediagnosisandtreatmentofvariousmalignancies.Incontrast,thegoalofthecancerbiologyAISCistoexplorehowthescientificunderstandingofthecellularandmolecularbasisofcancerrelatestoclinicalcancercare,toexplorequestionsatthefrontierbetweentheknownandunknown,andtoconsiderhowsuchquestionsmightbeanswered.Assuch,theAISCsdevoteasignificantamountoftimetoself-directedlearninganddeepexplorationofaquestionofinterestratherthanteachingindepthaboutthediagnosisandtreatmentofcancer.Thebulkofformalcoursetimeisspentintheclassroomratherthaninaclinicalsetting.
2.HowaretheclinicalexperienceswithintheAISCsdifferfromaclinicalelective?
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TheclinicalexperienceswithintheAISCsarefocusedonidentifyingunansweredquestionsrelevanttothepatientsencounteredduringtheclinicalexperiences,ratherthanfocusingonthecomprehensiveclinicalcareofapatient.Onaverage,therearetwohalf-dayclinicalexperiencesperweekinatypicalAISC.Theclinicalexperiencesvarybycourse,andtypicallyspananumberofdifferentspecialtiesorsub-specialtieswithinasingleAISC.Non-clinicalexperiencessuchaslaboratoryexperiencesorvisitstoindustryarealsoutilizedinsomeAISCs.Importantly,clinicalexperiencesareintegratedintothecoursethroughfacilitateddiscussionsattheclinicalsitesandatHMSfocusingonthebidirectionalinteractionbetweenbasicscienceandclinicalmedicine.3.Ihaveneverdonebasicscienceresearchpreviously;howwillthisimpactmyperformanceinanAISC?TheAISCsaredesignedtoaccommodatestudentsatdifferentlevelsofknowledgeandexperienceinbasicscienceresearch.Mechanismsformentorshipandfeedback,aswellasprimersonthebasicknowledgerequiredforeachcoursearebuiltintotheAISCstoenablestudentstoexploreascientifictopicandengageinthescientificprocessinanunfamiliarsubjectarea.Performanceevaluationstakepriorexperienceintoaccount.4.WhatdoesanAISCfinalworkproductlooklike?TheAISCsaimtoencourageself-directedstudyandindependentthought,andinkeepingwiththis,eachcoursehasacreativefinalworkproduct.Studentsareabletochoosetheirowntopic,withinthebroadscopeofthecourse,basedontheirclinicalexperiencesanddevelopingprofessionalinterests.Theformatoftheworkproductissetbyeachcourse,andsomecoursesoffermorethanoneoption.Examplesoffinalworkproductsincludearesearchproposal,anexplanationforapatientaboutresearchrelevanttotheirconditionandclinicalchoices,ashortreviewofprogressandchallengesinaresearchfield,educationalmaterialsforstudents,oranewspaperarticleforthegeneralpublic.Whateverthespecificformat,theworkproductprovidesanopportunitytodevelopanddisplaythegeneralizableskillsthattheAISCsaredesignedtoenhance:findingandcriticallyevaluatingresearchinformation;effectivelycommunicatingscientificinformationtopeersorpatients;understandinghowresearchcaninfluencepatientcareorclinicaldecision-making;andformulatinggoodquestionssuitableforfutureresearch.
5.CanIusemythirdyearAISCtodevelopmySiMproject?TheAISCsareofferedpriortotheApril15deadlineforsubmissionoftheSiMprojectproposalinYearIII.ThisisdesignedsothatstudentsmayusetheAISCs(and/orEssentialsII)todeveloptheirSiMprojectorinformaprojectalreadyunderdevelopment.DuringeachAISC,studentsinteractwithanumberofleadingHMSscientistsandclinicianswithafocusinresearch,whichcanhelpyoudevelopideasorfindmentorsforyourSiMproject.
6.Istherebeacaponenrollmentinindividualcourses?WhatifIdon’tgetmyfirstchoice?StudentsarerequiredtoranktheirtopthreeAISCcoursepreferences.Firstchoicesareaccommodatedwheneverpossible,althoughitisoftennecessarytocapenrollmentstoachieveaworkabledistributionofstudentsacrosscourses.Studentswhodonotreceive
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theirfirstchoiceAISCinYearIIIaregivenpriorityforthatcourseinYearIV,unlesstheylaterindicateadifferentpreference.
7.WilladditionalAISCsbeofferedinthefuture?InadditiontothefirstgroupofAISCsofferedin2018,additionalAISCshavealreadybeenaddedfor2019,andweplantodevelopadditionalcoursesinto2020.Potentialareasbeingexploredincludesocialsciencetopicssuchashealthcarepolicyandglobalhealth;aswiththeotherAISCs,thefocuswouldbeonadeepandrigorousengagementwithfrontierresearchinthosefields.However,planningfor2020isstillpreliminary.Ifyouhavesuggestionsfora2020course,pleasefeelfreetocontacttheAISCCurriculumDirectors(JohnFlanagan,[email protected];orEliMiloslavsky,[email protected]).IV.EssentialsII:AdvancedSocialandPopulationSciencesforMedicine The“EssentialsoftheProfession”courseinYearIintroducedstudentstocoreprinciplesofclinicalepidemiology,healthpolicy,medicalethicsandprofessionalism,populationhealth,andsocialmedicine.ThatcoursetaughtstudentshowtothinkcriticallyaboutmedicalknowledgeandhowtounderstandthesocialandpoliticalcontextsofhealthandhealthcareintheUnitedStates.“EssentialsII:AdvancedSocialandPopulationSciencesforMedicine”buildsonthisfoundationandontheexperiencesstudentshadduringthePCE.Whatarethemostimportantmoraldilemmasofclinicalcareandhowcantheybeaddressed?HowcanhealthcaresystemsandfinancingbereformedtooptimizethevalueofcareintheUnitedStates?Whatroledoeshealthcareplayaspartofabroadersystemthatworkstoachievepublichealth?Whoisresponsibleforensuringthatpatientsachievethebestpossiblehealthoutcomes?ThecoursealsoincludesanovelcollaborationwithHarvardBusinessSchool,whereHBSfacultycometoHMStoteachclassicHBScasesonValue-BasedCare.“EssentialsII”isofferedinOctoberandMarchofbothYearsIIIandIV–therearefouroptionstoschedulethiscourse.LiketheAISCs,itisgradedonasatisfactory/unsatisfactorybasis,withanarrativeprovidedforeachstudent.Requiredclasssessionsareconcentratedintheafternoons,withstudentsusingthemorningstoprepareforclass,workontheirfinalprojectsforthecourse,andotherpurposesdependingonwhentheytakethecourseandtheirspecificinterests.StudentswhoplantodotheirscholarlyprojectsinanyoftheEssentialsIIdisciplinesshouldconsidertakingthecourseinOctoberorMarchofYearIII,sothattheycanusethetimeandmentorshipprovidedbythecoursetomakeprogressontheirprojectsanddeveloptheirproposals.SinceinternationalSiMprojectsaredueearlierthanotherprojects,studentsconsideringaninternationalSiMprojectareadvisedtotakeEssentialsIIinOctoberofYearIII(immediatelyfollowingthePCE).Otherstudentswillcompleteindependentorgroupprojectsrelevanttothecourseandtheirinterests.StudentswhotakethecourseinMarchofYearIV,forinstance,canconcentrateonproblemsinmedicalethicsorhealthpolicythattheyexpecttoencounterduringtheirresidency.Otherscancombinecourseworkwithclinicalexperienceswheretheycanapplytheperspectivesofsocialmedicineorpopulationhealth.
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EssentialsIIFrequentlyAskedQuestions1.HowdoIdecidewhichofthe4opportunitiestotakeEssentialsIIisbestforme?Anyofthefourofferings(OctoberorMarchofYearIIIorIV)isequallygood,sothisdependsentirelyona)howthecoursefitsintoyoureducationalplanandb)whatotherprioritiesmighttakeprecedenceforyouinoneormoreofthosemonths.Forexample:
• IfyouarethinkingofdoingyourSiMprojectinanarearelevanttothecourseorhaveaninterestinbuildingtheseacademicdisciplinesintoyourmedicalcareerinasignificantway,itwouldmakesensetoprioritizetakingEssentialsIIinOctoberorMarchofYearIII,asnotedabove(andmorelikelyOctoberifyouareplanningtodoaninternationalSiMproject,sincethoseproposalsaredueearlier).
• If,say,youarethinkingaboutdoingaSiMprojectinanarearepresentedbyanAICSofferedinMarch(suchasMicrobiologyandInfectiousDiseasesorNeurobiology),thenyoushouldchooseoneoftheotherofferingsofEssentialsII.YouwouldhavetheopportunitytotakeanyoftheMarchAISCsinMarchofYearIVaswell,ifitisasubjectofparticularscientificinterest(bynotaplanforyourSiMscholarship).NotethattherearealwaysfewerAISCsofferedinMarchthaninJanuaryandFebruary,sinceMarchisoneofthemonthswhenEssentialsIIisoffered.
• TheOctoberYearIVofferingisscheduledafteralltheresidencyapplicationsareinandbeforemostinterviewsbegin,soifyouareveryunsureofwhatspecialtyyouwantandprefertouseadditionalearliermonthstotryoutvariousclinicalelectives,OctoberofYearIVmightbeagoodoption.
• Asyourresidencyplansevolve,youmaydiscoverotherfactorsthatwillinfluenceyourchoice.Forexample,youmaybethinkingthatMarchofYearIVinitiallysoundslikeagoodoption,butovertherestofthirdyearyoumightdecidetogointoOB-GYN,andyourOB-GYNadvisormayinformyouofacourseofferedonlyinMarchofYearIVdesignedtopreparestudentsforresidencyinOB-GYN(afewspecialtiesorganizesuch“bootcamps,”whicharehighlyvalued).Onceyoudecideonyourspecialty,youshouldinquireabouttheschedulingofsucha“bootcamp”courseinthatfield,soifitisheldinMarchyoucouldthenscheduleEssentialsIIinOctober.
Thefourofferingsofthisrequiredcoursearedesignedtoensurethateverystudentcanscheduleitasoneamongmultiplepriorities,sothekeyisworkingcloselywithyourSocietyAdvisor,sinceEssentialsIImustbetakeninoneofthosefourslots.V.ClinicalElectives,Sub-Internships,andtheClinicalCapstone ClinicalElectives:HMSoffersover200clinicalelectives,providingstudentswitharichmenuofopportunitiestoexplorealmostanyclinicalfieldofmedicine,usuallywithachoiceofclinicalsettingsforeach.Thesearefour-weekexperiencesandofteninvolveparticipationonaspecialtyconsultationservice,sothatasthestudentontheendocrinologyorthegastroenterologyservice,youwillbecomepartoftheteamthatassessespatientswhenaconsultinthatareaiscalledbymedicine,surgeryorother
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services.Someoftheclinicalelectivesinvolvedirectpatientcare(moresimilartocoreclerkshipsduringthePCE),astypicallyisthecasewhenastudentdoesanelectiveintheemergencyroom,anintensivecareunit,andcertainprimarycareelectives.Intheseelectives,thestudentisassignedprimaryresponsibilityforasetofpatientsandengageswiththeirfamiliesandwritestheirorders.EverystudentisrequiredtodoatleastthreeclinicalelectivesatHMSaffiliatedhospitalsduringthepost-PCEphase,butmoststudentsdomanymorethanthatastheyexploreareasofinterestandthensolidifytheirspecialtychoice,meetfacultytogetlettersofrecommendationforresidency,andcontinuetolearnmoremedicine.AcompletelistofclinicalelectivesisavailableinthecoursecatalogueontheRegistrar’swebsite:http://www.medcatalog.harvard.edu/.Sub-Internships:AllHMSstudentsarerequiredtodoafour-week“sub-Internship”ineithermedicineorpediatrics.Fall-entryPCEstudentsarerequiredtodothe“sub-I”bytheJulybeforegraduation,sothattheevaluationcanappearinthestudent’sresidencyapplicationpacket,anditmustbedoneatasiteotherthanthePCEsite.Spring-entryPCEstudentsaregivenuntilAugustbeforegraduationtocompletetheirrequiredsub-I.Thecompletelistofthesecoresub-I’smayalsobefoundinthecoursecatalogueontheRegistrar’swebsite:http://www.medcatalog.harvard.edu/under“CoreClinicalClerkships”sincetheyarethe“CoreSub-Internships.”Theserotationsareuniquebecausethestructureoftheclinicalteamisalteredtoenablestudentstoactastheinternontheteam.Thestudenttherebyhasincreasedresponsibility,andmoststudentsfindthatthismonthiscrucialinpreparingthemforthemulti-taskingandclinicaldecision-makingthattheywillexperienceasanintern.Theterm“sub-I”islooselyusedforcertainotherelectiverotationswherestudentsaregivenmoredirectpatientresponsibility,butthese“surgicalsub-I’s”or“OB-GYNsub-I’s”usuallystillhavetheinternontheteam,butwiththestudentbeingentrustedwithmoreresponsibility.Sincethestructureoftheclinicalteam(howmanyinternsandresidentsareoneachservice)hastobescheduledwellinadvancefortherequiredsub-I’s,studentassignmentstothesesub-I’satspecificsitesarealwayssubjecttoavailability.ClinicalCapstone:Allstudentswhomatriculatedin2015orafter(includingbothPathwaysandHSTstudents)arerequiredtotaketheClinicalCapstoneinJanuary,February,MarchorApriloftheyearinwhichtheygraduate.Thiscourseinvolvesthreeweeksofa“sub-I-like”rotationinwhichstudentshavedirectpatientresponsibility,interactwithfamilies,writeorders(whichgetco-signedbyanMD),etc.(incontrasttoconsultservicerotations,andotherlessclinically-focusedexperiences).Thefulllistofclinicalrotationsthatareeligibleforthiswillbebuiltintothecoursecataloguewellbeforestudycardsforthatperiodaredue.TheotherweekoftheClinicalCapstone(threedaysduringthefirstweekandtwodaysduringthelastweek)isdevotedtoaclassroom-basedcorecurriculumthatincludesvariedprofessionaldevelopmentactivities,anOSCEfocusingoncomplexcommunicationskills,andopportunitiestoreflectonwhichclinicalskillsstudentsshouldfocusonfurtherdevelopingastheybegintheirinternships,alongwithpracticalcontenttopreparestudentstostartasinterns(howto“pronounce”apatientwhentheydie,howtoestablishcodestatus,tipsformaintainingone’shumanityasanintern,etc.).
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TheClinicalCapstoneensuresthatallgraduatingstudentshavehaddirectpatientresponsibilityduringthelastfourmonthsofmedicalschoolandarepreparedforcertainaspectsofthetransitiontoresidencythathaveconsistentlybeenidentifiedaschallengesforinterns.Itisgradedsatisfactory-unsatisfactory.FrequentlyAskedQuestions:1.HowdoIdecidewhichofthefourmonthstoschedulemyClinicalCapstone?Formoststudents,theschedulewilldependprimarilyonotherinterests.Thatis,ifastudenthasaparticularinterestinanAISCscheduledinFebruary,orstillneedstotakeEssentialsIIinMarch,heorshewouldscheduletheClinicalCapstoneinJanuaryorApril.Forsomestudents,thereareotherconstraints.Forexample,MD-MBAstudentswhospendthespringtermoftheirfinalyearatHBSalwaystaketheirClinicalCapstoneinJanuary,sincetheywillbeatHBSfromFebruarythroughgraduation.Inaddition,thereareasmallnumberofspecialties(suchasEmergencyMedicineandOB-GYN)thattraditionallyorganize“bootcamps”inMarchorAprileachyear.StudentswhodecidetoapplyforresidenciesinoneofthosespecialtieswillknowwellinadvancewhichmonthsthesespecialrotationsareofferedanddecidetoscheduletheirClinicalCapstone(andEssentials2)duringadifferentmonth.VI.ScholarlyProjectRequirement(ScholarsinMedicine–SiM)Topic:ManystudentsidentifytopicsandmentorsfortheirscholarlyprojectbythetimethePCEends.OthersseekascholarlyprojectoncetheycompletethePCEandthesestudentscantakeadvantageoftheAISCsofferedinJanuary,February,andMarchoftheirthirdyear(witheveryonerequiredtocompleteatleastoneAISCduringYearIII)aswellasEssentialsII(offeredinOctoberandMarch).Allofthesecoursesencouragestudentstoproposeresearchquestionsandconsiderwaysofansweringthem.Thisinterchange,alongwiththeopportunitytonetworkforaprojectmentor,isveryusefultostudentsseekingtodefineascholarlyproject.Thescholarlyprojectmayaddressanyquestionortopicrelevanttomedicineorhealth,andstudentsmayapproachthesetopicsthroughanydiscipline.Manystudentsdotheirscholarlyworkinbasicsciencelaboratoriesorclinicalresearchgroups.Othersexaminequestionsthroughthelensesofhistory,ethics,policy,healthcaredelivery,globalhealth,anthropology,literature,creativewriting,musicalcompositionorperformanceorart.Studentswhopursuemaster’sdegreeswhileatHMSmayusetherequiredwritingprojectintheirMaster’sprogramastheirscholarlyproject.Mentor(s):Thescholarlyprojectisamentoredexperience.StudentsworkinginaresearchgroupsettingwouldlogicallyhavethePrincipalInvestigator(PI)orafacultyco-investigatorinthegroupserveasmentorforthescholarlyproject.Studentspursuinga
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lesstraditionalscholarlyprojectmighthavetwomentors,oneintheclinicalareaandoneinthescholarlydiscipline.StudentsshouldworkwiththeirSocietyresearchfellows,whowillhelpstudentsnetworktoidentifyappropriatefacultymentorsfortheirwork.Timeline:WiththescholarlyreportduebyMarch1ofthestudent’sfinalyearinmedicalschool,studentswillneedtocarefullyplanthetimewhentheycarryouttheirscholarlyproject.StudentsplanningglobalhealthprojectsneedtosubmittotheScholarsinMedicineOffice(SMO)theirprojectconceptandon-sitementornolaterthanDecember31oftheirthirdyear.AllotherstudentswillsubmittheirscholarlyprojectconceptandmentortotheSMOnolaterthanApril15oftheirthirdyear.Onceapproved,thestudentwritesafullproposalthatdescribestheresearchorprojectquestion,mentor,afeasibleprojectdesign,andtimeline.ProposalsmustbeapprovedbySIMfacultypriortothestudentbeginningtheproject.TheReport:Forstudentswhosescholarlyworkconsistsofhypothesis-drivenresearch,thescholarlyprojectreportwilltaketheformofascientificmanuscript.TheSMOhasseveralscholarlyreporttemplates(seethecollaboratepageURLunder“Resources”below).Ifstudentshavesubmittedamanuscriptorpublishedapaperontheirscholarlyprojectalready,theymayincludethesubmittedmanuscriptorthepublishedpaperastheirreport.Inthesecircumstances,ifthestudentisnotfirstauthorthereportshouldalsoincludeafewpagessummarizingtheresearchgaptheprojectaddresses,thestudent’sroleintheproject,andtheimplicationsofthefindingsforresearch,practiceorpolicy.Studentsenrolledinjointordualdegreeprograms(e.g.MDalongwithMPH,MPP,MBA,M.Ed,etc.)generallymustcompleteawrittenproductasarequirementfortheotherdegree.Thestudentmaysubmitthisproductfortheirscholarlyprojectreport.CreditandFunding:Studentsmaydedicateuptofivemonthsontheiracademiccalendarstotheirscholarlyproject.StudentscanobtaincreditforthesemonthsbyregisteringforSIM500.TheSIMmonthsdonothavetobecontiguous(astudentcouldtaketwomonthsinspringandonethefollowingfall).StudentswhotakeafifthyearforresearchdonotneedtosignupforSIM500creditbutmayrequestfundingfromtheSMO.Forstudentswithmeritoriousapplicationsforfunding,theSMOprovides$1250permonth;thementorisexpectedtomatchthiscontribution.Inaddition,travelfundingisavailableforstudentswithprojectsoutsideofNewEngland.EachHMSstudentisrequiredtowatchtwoonlinevideosthatpresentfoundationalmaterialonIRBproceduresandonResponsibleConductofResearch.Thoseworkingabroadarerequiredtowatchanadditionalonlinevideothatsummarizeskeyprinciplesandproceduresforglobalhealthwork.HonorsinaSpecialField:StudentsmaypursueHonorsinaSpecialField.ThisprograminvolveswritinganHonorsThesisandthendefendingthethesisbeforethreeHMSfacultymembersinanoraldefenseheldduringthespringmonthspriortograduation.TheHonorsthesismaybeanelaborationofthescholarlyprojectreportoritmaybedoneinanentirelydifferentcontentarea.StudentsinterestedinthisprogrammaysignupthroughtheSMOinthefallbeforetheygraduate.
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Resources:Manyresourcesareavailabletohelpstudentsidentifytopicsandmentorsfortheirscholarlyprojects.PerhapsthebestsourceisoneofyourSocietyFellows,whoenjoyhelpingstudentstoidentifysuitableprojectsandmentors.Alloftherelevantformsthatfacilitatetheprocessesnotedhere(scholarlyprojectproposal,report,applicationforSIM500credit)canbefoundathttp://collaborate.hms.harvard.edu/display/scholarlyproject.Behindallofthepaperworkisadelightful,knowledgeablestaffintheSMOinTMEC347.FeelfreetoreachouttoKariHannibal,MarcieNaumowicz,andJasmineSteckertoclarifyanyoftheseprocesses.Also,feelfreetoreachouttotheSIMDirector,Dr.JeffreyKatz([email protected]).VII.HSTandMD-PhDStudentsHMSholdstwoclassmeetingseachyeartoreviewthematerialinthisdocumentindetailandanswerquestions:oneintheearlyspringforfall-entryPCE(mostlyPathways)students,andoneintheearlyfallforspring-entryPCE(mostlyHST)students.Allstudentsaregiventhateveningofffromtheirclerkshipstoattendthismandatorymeeting.MuchoftheinformationinthisdocumentisspecifictoPathwaysstudents,butallinformationrelevanttoHSTstudentsisnoted,andinformationtailoredforHSTstudentsisprovidedattheearlyfallmeetingeachyear.ThesemeetingsaredesignedforstudentsinthelasthalfoftheirPCEyear,astheystarttoconsidertheirpost-PCEschedules.ThemostobviousdifferencesforHSTstudentsinthepost-PCEphaseisthatallHST(aswellasreturningNewPathwayMD-PhD)studentsarenotrequiredtotakeEssentialsIIoranyAISCcoursesforgraduation.Subjecttoavailability,thesecoursesmayofcoursebetakenaselectives,buttheyarenotrequired.AllHSTandMD-PhDstudentshavealsoalreadysatisfiedtheScholarlyProjectRequirementbeforethePCE,buttheyare,ofcourse,encouragedtodoadditionalresearchinthepost-PCEphaseiftheywouldliketodoso(forexample,iftheywishtosubmitthesesforHonorsconsideration).WhatisnotdifferentisthatallHMSstudentsarerequiredtotaketheClinicalCapstonecourseinoneofthelastfourmonthsbeforegraduation(Jan,Feb,Mar,orApr)andtoremainfullyenrolledineachsemesterafterre-enteringtheMDcurriculum.DeadlinesfortheMatchprocessarealsothesame,whichmeansthatstudentsinthesegroupshaveslightlyamendedtimelinestoenablethemtofillouttheirresidencyapplicationsbySeptemberoftheirgraduatingyear:HST4-yearstudentsenteringthePCEinAprilwillcompletetheirPCEbytheendofMarch2018.ItisrecommendedthatthisgroupstudyforandtakeUSMLEStep1bytheendofApril2018tomaximizethenumberofmonthsofelectiverotationspriortoapplyingforresidency,asdiscussedattheirclassmeetingheldbeforetheyenteredthePCE.HST5-yearstudentswhodoaresearchyearbeforeenteringthePCEinJulyhavealreadytakenStep1.TheyarerequiredtoparticipateintDPgroupsfromApril-Julywhiletheyarecompletingtheirresearchyear.IftheyhavecompletedthetwomonthACErotationatMt.
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AuburnHospitalbeforetheirresearchyear,then,duringthe9monthsofthePCEfromJulythroughMarch,thesestudentshaveonemonthoftimeduringtheMedicinecorerotationwhenaclinicalelective,or(ifavailable)aone-monthrequiredPCEclerkship(psychiatry,radiologyorneurology),maybesubstitutedfortheout-patientambulatoryexperience.These5-yearstudentsmustcompleteallthreeofthoseone-monthrotationsbytheendofNovemberofYearIV.MD-PhDstudentsenteringthePCEinAprilhavealsoalreadytakenStep1andhavesimilarpost-PCEexpectationsasthe5-yearHSTstudentsabove.TheyarealsorequiredtoparticipateintDPgroupsstartinginAprileveniftheyarecompletingtheirresearchworkandnotenteringtheirfirstclerkshipsforoneormoremonths.Dependingonwhenthesestudentsstartclinicalrotations,theywillhavebetween9and12monthsofthecorerotationsbytheendofMarch.Thesestudentsmustalsocompleteallthreeone-monthrotationsbytheendofNovemberofYearIV.Again,detailedinformationaboutthepost-PCEphaseforthesegroupsiscoveredattheearlyfallclassmeeting,asthesestudentsenterthesecondhalfoftheirPCE.VIII.MD-MBA,OtherMastersDegrees,andResearchYearsMoststudentswhocompleteamastersdegreealongwiththeirMDinsertthisextradegreebetweentheirthirdandfourthyearsofmedicalschool.StudentstypicallyfinishtheirthirdyearinJulyorAugust,gointotheMastersofPublicHealth(HarvardT.H.ChanSchoolofPublicHealth),MastersofPublicPolicy(HarvardKennedySchool),MastersofBioethics(HMS)orotherdegreeinlateAugust/earlySeptember,andthenfinishthatotherdegreeinMay,sothey“gain”anextrasummerandactuallyendupwithafewextramonthsinwhichtocompletetheMDrequirements,givingthemaddedflexibility.Somedegrees,suchastheMMScinMedicalEducationandtheMMScinGlobalHealthDeliveryScienceinvolveadditionalexpectationsforaresearchthesis,andsostudentshaveaslightlymoreconstrainedschedulebycompletingboththeMDandMMSc-Med-EdorMMSc-GHDSinfiveyears.Sincealmostallmastersdegreesrequireascholarlyproduct,arrangementsaremadeforthisscholarshiptofulfilltheHMSSiMrequirement,sothesestudentsarenotexpectedtoscheduleadditionalSiMmonths(althoughtheymayiftheywanttopursueadditionalresearchorperhapsapplyforHonorsinaSpecialField).TheacceleratedMD-MBAjointprogramisaspecialcase,andstudentswhopursuetheMDandMBAprograminfiveratherthansixyearsarecommittedtoadditionalscheduleconstraintsformostoftheirpost-PCErequirements.FollowingthePCE,theyuseOctobertostudyforStep1andthentakeStep1atsomepointinNovemberorDecember,whiletheyhavealreadystartedtheMedicineandManagementcoursewhichrunsinNovemberandDecember(andwhichincludessomeStep1studytimebuiltin).Duringthatrequiredcourse,studentsreceiveapprovalfortheirSiMproposal,alongwiththepossibilityofcompletinganon-linecourserequirementforHBSaswell.
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Becausethefive-yearMD-MBAprograminvolvesafullyearatHBSstartinginAugust(aboutayearafterthePCE)andthenanadditionalfullsemesteratHBS,studentsinthisprogramhavetoworkcloselywiththeiradvisorstomeetallgraduationrequirements.ManyoftheconstraintsaredeterminedbywhethertheadditionalsemesterisdoneinthefallorspringofYearV.Forexample,ifMD-MBAstudentstaketheirfinalsemesteratHBSfromFebruaryuntilgraduationoftheirlastyear,theyarerequiredtotaketheClinicalCapstoneinJanuary.SincetheyarethenunabletotakeanAdvancedIntegratedScienceCourseintheirfinalyear,theywouldalsoneedtotaketwoAISCsandnotjustoneinthemonthsimmediatelyfollowingMedicineandManagementinYearIII.ThisstillgivesthemtwoopportunitiestoscheduleEssentialsII:MarchofYearIIIandOctoberoftheirfinalyear.
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SampleMD-MBASchedulefor5-yearjointdegreeprogram: YearIII(’17-’18) YearIV(’18-’19) YearV(’19-’20)July Clinelect:adolescentmed MedicineSub-IAug Unsched:vaca/Step2CK Clinelective:ER/Step2CSSep HBS Clinelective:dermOct Unsched:Step1study HBS Clinelective:adolescpsychNov Med&Mngmnt/Step1 HBS Unsched:InterviewsDec Med&Mngmnt/BeginSiM HBS Unsched:InterviewsJan CancerBiology HBS ClinicalCapstoneFeb Genetics HBS HBSMar EssentialsII HBS HBS/SubmitSiMApr Clinelective:MICU HBS HBSMay Clinelective:primarycare HBS HBSJun Clinelect:MICU/Comp Clinelective:cardsNote:thisisjustasample–someMD-MBAstudentstakeStep2CKduringtheirfifthyear,andsomedotheirlastsemesteratHBSinthefallratherthanthespring.Inthesamplescheduleabove,thestudentmeetsallMDandMBArequirementsinfiveyearsbyfinishingthePCE,spendingOctoberstudyingforStep1,takingMedicineandManagementinNovemberandDecemberwhiletakingStep1,andthendoingtwoAISCsinJanuaryandFebruary,followedbyEssentialsIIinMarch.ThisstillgivesthemAprilthroughAugustbeforetheRCyearandJunethroughDecemberaftertodoclinicalelectivesandthelike.Butthisacceleratedprogramclearlyplacesthemostpressureonstudentstoensurethattheysignupforcourseswithgreatcareandattentiontoconstraintsontheirschedule.NoteonMD-MBAProgram:Theaboveonlyappliestostudentsdoingtheacceleratedfive-yearMD-MBAcurriculum.Studentswhoelecttodothefulltwo-yearMBAandcompletebothdegreesinthestandardsixyearssimplyfollowtheusualMDscheduleduringthefouryearstheyareintheMDcurriculum,enteringHBSaftercompletingthreefullyearsatHMS.Pathwaysstudentswhotakeayearoutforresearch(eitherintheUSorabroad)generallydothisfortheacademicyearbetweentheirthirdandfourthyearsoftheMDcurriculum.Theseresearchyearsenablestudentstopursuearesearchprojectevenmoredeeply,whichalsoproducestheirSiMproject.Thus,studentswhodoayearoutforresearchtypicallydonotneedadditionalSiMmonthsintheirschedule.FundingforresearchyearsisorganizedthroughtheScholarsinMedicineOffice(SMO),andusuallyinvolvesmatchingfundsfromSMOandthestudent’sresearchmentor.VariousfoundationsandtheHowardHughesMedicalInstitutealsofundresearchyearsformanyHMSstudents,andinformationaboutthoseapplicationsissharedbytheSMOmonthsinadvanceofdeadlines(whicharetypicallyJanuaryofYearIII).InterestedstudentsshouldcontactSMOforfurtherinformationonresearchyearopportunitiesandfunding.
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IX.PathwaytoResidencyTimeline
Road to ResidencyTimeline: 2018
March
April
May
June
July
August
September
October
December
March 5Class Meeting on Years 3 and 4
Career PanelsGeneralist/Primary CareSurgery and SubspecialtiesSubspecialties
Class Meetings5th Year Options Meet with Society Advisor
May - July
Study Cards Due
Class Meeting:Approach to Step 1
Take Step 11 Clinical Elective
October to December
November
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Road to ResidencyTimeline: 2019
April
May
June
July
August
September
October
November
December
MarchFebruary
January
October –JanuaryInterview at Programs
MSPE goes into ERASSept - OctInterview Tips SessionMock interview Session
July- SeptemberWork on application
Submit application
May – AugustMeet with MSPE writer
Class MeetingsPersonal Statement
LettersCV
Class MeetingsThe Year AheadSpecialty Panels
Residency Application Process
January-MarchIdentify Specialty AdvisorMeet with Society Advisor
Summer Work Early Match
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Road to ResidencyTimeline: 2020
April
May
June
March
February
January
Enter Match List
MATCH DAY!!
GRADUATION!!
TO RESIDENCY!!
EARLY MATCH DAY!Interviews
Class Meeting: Rank list
Feb – AprilComplete Graduation Questionnaire
