Description: The goals of the Medical Education Longitudinal Elective are to develop the teaching skills of medical students at HMS and to prepare them for careers that include the education of patients, students, and/or colleagues. The core of the elective experience will consist of at least 20 hours of direct teaching in one or more settings (the “Teaching Field Experience”). Students must also complete all sessions in the Fundamentals of Medical Education Seminar Series, observation of one HMS master teacher and one other near peer teacher, observation of their teaching by their faculty supervisor, and both a final reflection and a final experiential product. 8 required seminars, monthly on Thursdays from 6-8p (dates TBD). Course Manager: Eric Shames

Description: The goals of the Medical Education Longitudinal Elective are to develop the teaching skills of medical students at HMS and to prepare them for careers that include the education of patients, students, and/or colleagues. Students who have successfully completed ELO700 may choose to enroll in ELO701 to continue to accrue academic credit for their teaching and further development in medical education.

Description: Human activity is changing the atmosphere and altering terrestrial and marine ecosystems on a global scale. Evidence is mounting that these changes may already be having serious effects on human health, and there is growing concern that in coming decades the effects could be catastrophic. This course was developed because the practice of medicine and public health in this century will require an understanding of the relationship between human health and the global environment. It will provide an overview of climate change and biodiversity loss, two key examples of global environmental change, their potential consequences for human health, and explore solutions to these problems and the challenges inherent in realizing those solutions. The course will be open to all students at Harvard University, but enrollment is limited and preference will be given to students from Harvard Medical School, the Harvard School of Public Health, the Kennedy School of Government, and to undergraduate Environmental Science Public Policy majors.

Description: In this seminar we discuss justice and beneficence near and far, as formulated in views of how benefits and burdens should be distributed within the borders of a just society, and as further brought to bear concerning sharing and stewardship to benefit and prevent harm to peoples and generations distant from us in space and time. Topics have included justice as fairness and the libertarian view of distributive justice, moral demands placed upon us by poverty, famine, and disease in distant lands, conceptions of global justice, and duties to abate anthropogenic climate change and to mitigate its effects on the health of earth’s future inhabitants. In its current iteration, the seminar will focus on the ethics of climate change. Readings of recent works in moral philosophy will draw students into the challenge of formulating individual and collective moral obligations to act and to forbear so as to preserve for humanity its only home.

Description: Introduction to the academic disciplines of business management with illustration from examples in various medical care settings. Topics include: economics of health care; evolving role of physicians and other medical professionals; ethics of business decisions in a clinical context; underlying concepts in financial, marketing, and operations management in health institutions; and the management of risk in health-related enterprise. Presentations by carefully selected multidisciplinary faculty group from the Harvard and MIT communities, guest faculty will include managers with experience in health services and medical products related organizations. Student projects will address current issues occasioned by the rapidly changing health care management environment.

Description: As practicing professionals, physicians continually face complex challenges in relating to the organizations in which they work. This class, designed for students in the HMS/HBS combined MD/MBA program and the Clinical Informatics Fellowship Program provides an overview of the structure and function of health care institutions and illustrates the role of these organization in producing successful clinical outcomes. Class sessions, assigned readings, and written assignments offer a multidisciplinary perspective combining component academic disciplines of management and medicine.

Description: This month-long elective will offer post-clerkship (third, fourth and fifth year) medical students exposure to a portfolio of concepts and skills that will contribute to their professional development as health care managers and leaders. Health care delivery and the roles of health professionals are evolving rapidly; there is now a greater need than ever for physicians to manage and lead effectively within complex organizations. This class will be organized around a set of inter-related themes: leadership, team building and teamwork, organizational culture, change management, innovation, patient safety and quality improvement, and design thinking. These themes will be illustrated in a number of different contexts, including primary care, clinical specialty practice, product/technology development, and global health. Instructors will use multiple teaching formats to link underlying concepts to practical skills. Class sessions will be led by a mix of HMS faculty, faculty from other Harvard schools, and invited guests who are experienced leaders and managers. Students will complete a team project during the course.

Description: The Intermediate Medical Mandarin course provides an excellent opportunity for students with Mandarin experience to refresh their skills and synthesize newly learned medical knowledge in Mandarin. The course will meet for 1.5 hours weekly during the semester. The first 45 minutes of the class will focus on didactic lecture-based instruction. Students will learn common clinical terminology and phrases related to the various clinical topics. The second half of the class will be devoted to interactive verbal practice in order to reinforce the material learned in the first half of class. Students will have the opportunity to practice their Mandarin speaking and listening skills with various guest tutors (faculty and staff from affiliated research laboratories and hospitals) in small groups using a series of mock clinical scenarios. Students will conduct medical interviews in Mandarin and, as the course progresses, will accumulate experience and verbal proficiency. The Medical Mandarin course will be taught at an intermediate instruction level. Students with a significant conversational background in Mandarin are best positioned to benefit from this course. The classes will be taught in Mandarin Chinese with English and Pinyin used at a minimum to facilitate understanding and true linguistic immersion.

Description: The Intermediate Medical Mandarin course provides an excellent opportunity for students with Mandarin experience to refresh their skills and synthesize newly learned medical knowledge in Mandarin. The course will meet for 1.5 hours weekly during the semester. The first 45 minutes of the class will focus on didactic lecture-based instruction. Students will learn common clinical terminology and phrases related to the various clinical topics. The second half of the class will be devoted to interactive verbal practice in order to reinforce the material learned in the first half of class. Students will have the opportunity to practice their Mandarin speaking and listening skills with various guest tutors (faculty and staff from affiliated research laboratories and hospitals) in small groups using a series of mock clinical scenarios. Students will conduct medical interviews in Mandarin and, as the course progresses, will accumulate experience and verbal proficiency. The Medical Mandarin course will be taught at an intermediate instruction level. Students with a significant conversational background in Mandarin are best positioned to benefit from this course. The classes will be taught in Mandarin Chinese with English and Pinyin used at a minimum to facilitate understanding and true linguistic immersion.

Description: Portuguese is the second most spoken language in Massachusetts and the 6th most spoken language in the world, with around 230 million speakers. There are more than 200,000 Portuguese-speaking residents in the Greater Boston area, many of whom seek care at Harvard-affiliated hospitals. This course is designed to give students a basic understanding of applying Portuguese in clinical encounters with a focus on building oral and listening skills. The objective is to provide skills that will allow students to communicate in Portuguese with patients and families in a variety of medical settings. To make this possible, it is expected that students have a basic to intermediate knowledge of Portuguese, Spanish or another Romance Language (Italian, French, Romanian). The course consists of weekly 1.5-hour sessions and mock interviews. Each class will consist of a didactic session followed by a conversational practice session.

Description: Intermediate Medical Spanish is designed for students with some working knowledge of conversational Spanish. Students can take one semester or both semesters of this course. The Fall course (LN705A) will have a particular focus on the basics of taking a medical history with patients. The Spring course (LN705B) will build on the medical history and introduce a range of medical specialty assessments (such as pediatrics, mental health, oral health, nutrition). With weekly sessions led by HMS teaching faculty, we hope to provide a solid base for our students to learn enough medical Spanish terminology to communicate effectively with patients in a variety of medical settings. Requirements for this course include: at least one year of college Spanish or two years of high school Spanish; ability to maintain a basic conversation in Spanish with minimal difficulty or hesitation; ability to discuss personal information, comfort with grammar fundamentals and basic reading and writing skills in Spanish. Course Features: 1) interactive didactic sessions, with a focus on conversational skills, 2) vocabulary lists and quizzes, 3) opportunities to shadow Spanish-speaking physicians and interpreters at Harvard-affiliated sites, 4) OSCE with mock patients at the end of the course for students to practice what they learned during the course.

Description: Intermediate Medical Spanish is designed for students with some working knowledge of conversational Spanish. Students can take one semester or both semesters of this course. The Fall course (LN705A) will have a particular focus on the basics of taking a medical history with patients. The Spring course (LN705B) will build on the medical history and introduce a range of medical specialty assessments (such as pediatrics, mental health, oral health, nutrition). With weekly sessions led by HMS teaching faculty, we hope to provide a solid base for our students to learn enough medical Spanish terminology to communicate effectively with patients in a variety of medical settings. Requirements for this course include: at least one year of college Spanish or two years of high school Spanish; ability to maintain a basic conversation in Spanish with minimal difficulty or hesitation; ability to discuss personal information, comfort with grammar fundamentals and basic reading and writing skills in Spanish. Course Features: 1) interactive didactic sessions, with a focus on conversational skills, 2) vocabulary lists and quizzes, 3) opportunities to shadow Spanish-speaking physicians and interpreters at Harvard-affiliated sites, 4) OSCE with mock patients at the end of the course for students to practice what they learned during the course.

Description: The Advanced Medical Spanish course is designed for medical students with advanced Spanish fluency who are interested in acquiring proficiency in medical Spanish. The goal is to equip the students with the medical vocabulary and conversational skills necessary to communicate with a Spanish-speaking patient, conduct a medical interview in Spanish and learn how to effectively work with a medical interpreter. Students can take one semester or both semesters of this course. The Fall course (LN707A) will have a particular focus on taking a medical history. The Spring course (LN707B) will build on the medical history foundation and introduce a range of medical specialty assessments (such as pediatrics, mental health, oral health, nutrition). This course requires active participation in coursework, simulation sessions, opportunities to shadow Spanish-speaking faculty as well as clinical experiences at the Harvard-affiliated hospitals and community health centers. Pertinent socio-cultural issues will be included in the simulation sessions and discussed in the didactic sessions. This course will be conducted exclusively in Spanish. Course Features: 1. Interactive didactic sessions, with a focus on conversational skills 2. Vocabulary lists and quizzes 3. Opportunities to shadow Spanish-speaking physicians and interpreters at various Harvard-affiliated sites 4. End of course OSCE as an opportunity to practice what students learned during the course.

Description: The Advanced Medical Spanish course is designed for medical students with advanced Spanish fluency who are interested in acquiring proficiency in medical Spanish. The goal is to equip the students with the medical vocabulary and conversational skills necessary to communicate with a Spanish-speaking patient, conduct a medical interview in Spanish and learn how to effectively work with a medical interpreter. Students can take one semester or both semesters of this course. The Fall course (LN707A) will have a particular focus on taking a medical history. The Spring course (LN707B) will build on the medical history foundation and introduce a range of medical specialty assessments (such as pediatrics, mental health, oral health, nutrition). This course requires active participation in coursework, simulation sessions, opportunities to shadow Spanish-speaking faculty as well as clinical experiences at the Harvard-affiliated hospitals and community health centers. Pertinent socio-cultural issues will be included in the simulation sessions and discussed in the didactic sessions. This course will be conducted exclusively in Spanish. Course Features: 1. Interactive didactic sessions, with a focus on conversational skills 2. Vocabulary lists and quizzes 3. Opportunities to shadow Spanish-speaking physicians and interpreters at various Harvard-affiliated sites 4. End of course OSCE as an opportunity to practice what students learned during the course.

Description: This intensive medical Spanish course emphasizes conversational skills and the vocabulary necessary in conducting a physical examination and taking a medical history in Spanish. It is designed to prepare students for ME518M.41, a two-month clinical clerkship at one of various sites in Latin America. The course will also prepare students to interview Spanish speaking patients in the United States. Beginner and intermediate students are eligible. The course requires attendance 9 am to 4 pm, five days per week. It takes place at the TMEC. Attendance is required at all sessions. After an initial week of intensive classwork and drill exercises, one-on-one practice sessions with individual instructors will take place in the afternoons. Seminars and case discussions conducted in Spanish will supplement class discussions. Students are expected to re-schedule other commitments in order to attend all sessions. Evening preparation for the following day requires one to two hours. Guest speakers will include HMS faculty and former participants in ME518M.41. Enrollment is limited to 24; students enrolled in ME518M.41 will be given preference.

Description: This is an elective, 4-week block course for medical school students who have completed their clinical rotations and seek a deeper understanding of how editors make their decisions about publishing papers in the medical literature. It is an integrative and participatory elective based on the New England Journal of Medicine and taught at the editorial offices.

Description: This course provides students with a framework for understanding the spiritual dimension of issues they will confront in the practice of medicine. These include patients' struggles with questions of faith, spiritual approaches to problems such as life threatening illness or addiction, and the personal commitments that underline professionalism. Faculty will offer a model approaching these issues, lead discussion using clinical examples, and facilitate opportunities for extra- classroom experiences, such as working with a hospital chaplain or with spiritual or faith-based programs of healing. Invited presentations from chaplains, clergy and physicians will explore the implications for medicine of various religious and secular traditions, and issues surrounding the role of the clinician in responding to spiritual needs. They will also serve as resources for presentations by students to the class.

Description: The shootings in Las Vegas, NV and Parkland, FL have been recent examples of how traumatic events can lead to movements of social change. Historically, social change has been an important part of large-scale public health efforts, and often this has been driven by those in the practice of medicine. Physicians and other clinicians have historically been important advocates for social change to improve public health. For example, a pediatrician developed the child-proof cap to prevent lethal ingestions of aspirin by children. A physician was a leader in the movement towards safer cars and roads to decrease injuries and deaths from motor vehicle crashes. This 2 month elective seminar course will illustrate through expert faculty speakers and active class discussion how public health initiatives have been driven by social change, which have been and continues to be associated with the practice of medicine. Topics include firearm injuries, opioid ingestions, injury prevention, racism in medicine and the medical consequences of disasters. The course is sponsored by the Division of Emergency Medicine, Boston Children’s Hospital and is hosted by Harvard Medical School.

Description: The essential purpose of the Mentored Clinical Casebook Project is to help the student integrate all of the dimensions of clinical medicine through an in-depth study of a single patient over the course of a year. Each student will have one principal mentor with whom they will work closely throughout the project. Together with the mentor, each student will explore all of the relevant aspects of a patient's illness and experience, which will involve close, ongoing contact with the patient. The product of this project will be a multi-chapter manuscript that will be a thorough case write-up and review of all aspects of the patient, from the molecular basis of the illness to the psycho-social aspects of the patient's experience. The student will be guided by both a principal mentor and a project advisor as well as any specialists needed for consultation.

Description: This course teaches the Biodesign process, a proven methodology for innovating in healthcare that is rooted in needs finding and concept creation. The framework of biodesign focuses on human centered design and teaches students to identify and validate a need, generate solutions and screen for the most feasible solution to a problem. This is an interactive 12 week project based class taught by industry experts from the field of healthcare, entrepreneurship and venture capital. Key concepts are taught through a combination of lectures, guest speakers, and break out sessions with mentors. Students will choose a project from a list of needs that are sourced by the course co-directors. Needs will span the areas of health IT, medical devices, medtech and care delivery. Teams will be formed based on student's background and interest. During the 12 week course, students are required to spend time outside of class working on their team based project. There will be key deliverables throughout the course that culminate to a final presentation in front of a panel of expert judges. A final paper will also be required.

Description: This 9-session course (9 Fridays, 2:00-4:00) will utilize interactions with art as a means of enhancing visual diagnostic and communication skills as they relate to physical diagnosis. The course will emphasize participation in art observation sessions at the Museum of fine Arts, Boston. Students will learn a variety of approaches to exploring and describing art; simultaneously, they will learn about correlative ideas and approaches regarding observation and description in physical diagnosis through discussions led by medical practitioners. Readings and journal assignments will introduce students to both artistic concepts and their medical correlates. Students will also participate in a drawing workshop and in-patient rounds at Brigham and Women’s Hospital. As students' observational and descriptive skills develop into a foundation of visual comprehension, they will be challenged with new artistic and medical material. To inquire about enrollment, please email registrar@hms.harvard.edu. Students will be accepted on a first-come-first-serve basis for the first 30 students registering. Maximum 6 cross registrants or HMS Graduate Education students.

Description: This is a four-week elective experience aimed at introducing students to the field of Clinical Informatics. Clinical Informatics is the application of information technology to healthcare delivery, encompassing computerized order entry, clinical decision support, electronic clinical documentation, workflow improvement, big data, population health, and other technologies. Students will learn the core content of clinical informatics from our expert faculty first-hand through one-on-one experiences with various members of our faculty, focused on areas of interest. Students will also explore the unique challenge of technology implementation in the pediatric healthcare setting and explore the historical and political influences which helped establish the current state of Informatics in our health system. Learning experiences will involve direct faculty mentorship, independent reading assignments, formal lecture-based learning, and presentations to Informatics Fellows and Faculty.

Description: This course is primarily concerned with clinical therapeutics and therapeutic decision making in such areas as cardiology, infectious disease, transplantation, cancer chemotherapy, neurology, psychiatry, metabolism, and the critically ill. Emphasis is placed on clinical case discussions supplemented by more didactic lectures and panel discussions. While the orientation of the course is clinical, such pharmacologic issues as receptor interaction, pharmacokinetics and dynamics, drug interactions, specificity and selectivity will be analyzed in the context of specific organ system involvement and treatment of disease states. Issues in experimental therapeutics including analysis of the efficacy of new drugs, evaluation of clinical trials, and the design of clinical trials will also be discussed. Course Manager: Tina Sherman

Description: Psychiatrists and clinicians often have underlying conceptual beliefs which they rarely examine. These range from traditional reductionistic to postmodernist views. Some claim to be “biopsychosocial” in their approach, but they cannot describe or explain that perspective in much detail, nor do they know its roots and ramifications. Some academics outside of psychiatry use postmodernist methods to criticize psychiatric diagnosis and treatment, yet they too rarely admit or defend their underlying beliefs. Patients also have beliefs, which they imbibe from the larger culture, along the same lines as above. Sometimes such beliefs contribute to historical stigma and discrimination against concepts of mental illness. In this course, the interested student or advanced trainee will explore conceptual approaches to psychiatry. The current biopsychosocial model will be examined, interpreted, and critiqued. Its historical bases will be studied, and its relationship to other aspects of psychiatry and medicine will be assessed. The influence of 1960s/70s era postmodernist relativism will be examined in its impact on modern psychiatry, especially on the biopsychosocial model as well as in the ideology of DSM diagnosis. The impact of postmodern thinking on criticisms of psychiatry from academic disciplines, like history of science, will be analyzed. Alternative approaches to psychiatry will be studied, both classic systems, such as Freudian psychology and Kraepelinian medical models, as well as less appreciated perspectives, like the existential-humanistic work of Karl Jaspers and the medical humanistic model of William Osler. Modern interpretations of these perspectives will be examined in the works of Paul McHugh, Leston Havens, and the course director. Traditional, postmodernist, and scientifically humanistic approaches will be contrasted. The course will be conducted by guided reading, and supervised discussion of that reading material.

Description: Stories are the heart of medicine. In this course we will read, hear, watch, and write stories that can help us make sense of the experiences we confront as healers: pain, loss, fear, alienation, compassion, wonder, and transformation. Through selected short stories, poems, podcasts, essays, and other narratives, as well as through our own writing, we will reflect on the power of narrative to enlarge our empathy and sense of identity, foster connection and communication, and fortify our competence as guardians of our patients’ and each other’s stories. Authors will include short works by “classic” authors such as Kafka, Wharton, and Tolstoy as well as contemporary voices such as Roxane Gay, Ken Liu, and Nancy Mairs.

Description: The course is designed to introduce students to fundamental concepts and advanced knowledge of the radiobiology of cultured cells and organized tissues as they are relevant to the radiation therapy of cancer. Discussion will begin with the physico-chemical aspects of energy absorption and continue with the sequence of events occurring on the molecular, cellular and organized tissue level. Other topics will include: radiation response and repair of eukaryotic cells related to radiation quality and dose rate, environmental conditions, molecular genetics and signal transduction, cell cycle kinetics, tumor and normal cell population dynamics, radiation-induced carcinogenesis and mutagenesis, tumor pathophysiology and radiobiology and recent developments in radiobiology and experimental radiation oncology. Students should obtain a good understanding of the current role of radiobiology in radiotherapeutic practice.

Description: Case Studies in Global Mental Health Delivery seeks to build the foundation for practical training in global mental health delivery, as part of a new Harvard-wide network focusing on global mental health and sustainable development. The goal of this network is to foster a community of students and faculty who are passionate about promoting a broad perspective on mental health as a fundamental public good and a universal human right. This Case Studies course aims to present a diverse array of programs demonstrating how interventions for prevention, treatment and recovery across the life course are delivered in real-world settings in low-, middle-, and high-income countries. The overall goal is to demonstrate how the core principles of access, equity, evidence and scalability are addressed in each case, to understand the barriers in implementation of the intervention and the innovative strategies used to address them, and the lessons learned from the successes and failures of these efforts. Cases will cover a diverse array of mental health and substance use related programs across different life-stages, and will be presented by colleagues who have led actual implementation. For case studies in the greater Boston area, we will also offer an opportunity for the session to be conducted ‘on-site’. Classes will be primarily discussion-based, leveraging case studies specifically developed for this course, including materials in multiple formats. With a flipped-classroom approach, students will familiarize themselves with the case materials and bibliography, identifying key implementation challenges and questions before the class; during each class and after a brief case presentation, the Instructors and Case Presenters will engage the students in a semi-structured discussion aimed at co-creating knowledge by bringing together the Presenter’s experience, the Instructor’s framing, and the students’ own unique perspectives.

Description: The course is intended to cover the key role of mental health in the context of the Sustainable Development Goals, which have recognized mental health explicitly in two of the health goal targets and implicitly in several others (such as universal health coverage and conflict). The course curriculum is informed by the publication of the Lancet Commission on Global Mental Health & Sustainable Development, which has proposed a theoretical reframing of mental health and series of innovative actions to achieve the aspirations of the SDGs in relation to mental health. Along with the “Case Studies in Global Mental Health Delivery” course offered in Spring 2, 2020, this course will form the core of a proposed Global Mental Health Intensive Fellowship program at HSPH, in collaboration with HMS. This course is cross-listed at Harvard School of Public Health.

Description: There is a clear and pressing need for clinicians trained in the prevention and management of diseases found in low- and middle-income countries (LMICs). "Clinical Topics in Global Health" introduces students to the evidence-based knowledge and skills they will need to be effective clinicians in resource-limited settings. Ten evening sessions, led by Harvard faculty who practice clinically in LMICs, will orient students to the most important global health problems, explore each of these conditions with particular focus on clinical practice, and provide practical guidance for students interested in pursuing further training or careers in global health. Topics covered will include the leading causes of morbidity and mortality in LMICs, including malnutrition, malaria, diarrheal illness, perinatal disease, tropical diseases, HIV/AIDS, TB, and chronic non-communicable diseases. The elective will explore key concepts relevant to the delivery of clinical services in resource-limited settings. The elective will also include discussion of clinical issues particularly relevant to populations affected by humanitarian crisis, including refugees, internally displaced persons, and orphans. Teaching methods will be tailored to each clinical topic and will include lectures, practical skills sessions, case discussions, and ongoing reinforcement of core material. Selected guest speakers will address current innovations in global health practice.