This headline question was posted recently on the events page of Harvard Medical School's Center for Primary Care: "What Could the Future of Harvard Medical School Look Like With Family Medicine?"
During a town hall meeting at Harvard Medical School's Center for Primary Care, medical student Diana Wohler, a key organizer of the event, greets the audience and sets the stage for the program.
The event being touted -- a town hall meeting coordinated by medical students Diana Wohler, Mark Wu, Rachael Rosales and Ashley Shaw -- was designed to foster discussion about how to develop robust family medicine education opportunities for both students and faculty. The invitation was open to students, residents, faculty and administrators from Harvard Medical School and, in fact, all of greater Boston.
Fast forward to Nov. 5, when at 6 p.m., the town hall crowd started to arrive. As close to 120 people settled into their seats, the buzz began.
"We started five minutes late because as soon as people came in they started conversing with each other," said Wohler, as she described the evening for AAFP News.
"It was nice to see the community and the connections being formed right in front of us," said Wohler, who admitted she fell in love with family medicine after attending a family medicine interest group meeting shortly after arriving on campus in 2011.
- Harvard Medical School's Center for Primary Care recently held a town hall meeting to encourage discussion about how to develop family medicine educational opportunities at the school.
- The meeting event was coordinated primarily by four Harvard medical students with a strong interest in family medicine.
- Russell Phillips, M.D., director of Harvard Medical School's Center for Primary Care, said the school was in the midst of creating new medical school curriculum, and the center is working with faculty to create a foundational experience in primary care for all students.
"We had students and admins and faculty raising their hands; my (microphone) runners could hardly keep up with the number of people who were happy to talk about their experiences as learners and teachers," said Wohler.
Attendees were encouraged to share their experiences with primary care education, including successes, barriers and lessons learned, and to talk about what they wish they could experience.
Center for Primary Care Paves the Way
Russell Phillips, M.D., has served as director of Harvard Medical School's Center for Primary Care(primarycare.hms.harvard.edu) since it opened in 2010.
Phillips, a primary care internist, told AAFP News that the center was created out of what was initially a student initiative to highlight and strengthen the role of primary care at the medical school.
"Our mission is to improve the health of our communities through transformation of primary care practice and education. And from the very beginning, there has been strong interest on the part of the medical school and center leadership to strength family medicine at Harvard," he said.
"We're one of the few medical schools that lack a department of family medicine or a required family medicine clerkship; since the center was created, we've been working hard to address both of those issues," Phillips added.
"This family medicine town hall meeting was really about recognizing that Harvard is now in the midst of creating an entirely new medical school curriculum," said Phillips. The center and the school's medical education faculty are working together to develop what will become a foundational experience in primary care for all students.
John Tudor Jr., M.D., of Falmouth, Mass., recounts at the town hall meeting how much Harvard Medical School has changed since he graduated in 1964 and before family medicine was even recognized as a specialty. Tudor served as AAFP president from 1992-1993.
"We anticipate that it will create increased opportunities for students to work within family medicine practices," said Phillips. He noted that even in the absence of a family medicine department, Harvard routinely sees eight or nine graduates out of class of about 160 match into family medicine.
Participants Provide Perspective
Town hall organizers recorded comments from participants, and those voices revealed a common thread of passion for family medicine.
For instance, Josh St. Louis, M.D., a first-year family medicine resident at the Lawrence Family Medicine Residency in Lawrence, Mass., told the audience he came into medicine knowing he wanted to do primary care. "But I thought that meant sitting in an office not being able to do much. I quickly learned the breadth of different things you could do as a family medicine doctor," said St. Louis, who graduated from Tufts University School of Medicine in Boston.
"Although Tufts is not a primary care institution, they know you have to base your experience in primary care, because primary care is the foundation of good medicine," he added.
Family Medicine Still Absent at 10 U.S. Medical Schools
Ten U.S. medical schools do not yet include a department of family medicine within their institutions. In addition to Harvard Medical School, those institutions are
- Yale University, New Haven, Conn.;
- George Washington University, Washington, D.C.;
- Stanford University, Stanford, Calif.;
- Johns Hopkins University, Baltimore;
- Washington University in St. Louis (Mo.);
- Columbia University, New York, N.Y;
- Weill Medical College of Medicine at Cornell University, Ithaca, N.Y.;
- New York University, New York, N.Y.; and
- Vanderbilt University, Nashville, Tenn.
Kirsten Meisinger, M.D., a family physician and regional medical director for the Cambridge Health Alliance, told the town hall audience that medical education in family medicine is unique. "We do relationships. We are systems thinkers. Our work is way too complicated to memorize things about everyone. We are amazing delegators, we love the big picture and we do family, patient and the community," said Meisinger.
"I am not capable of seeing a patient in the room and not seeing where (he or she) is located in the world," she added.
FP Kathe Miller, M.D., of Somerville, Mass., serves as the family medicine adviser for Harvard Medical School. She took the microphone to make this point: "What I see that students find the most engaging and interesting -- and that family doctors do really well -- are the longitudinal relationships with patients and team-based patient care."
Looking Forward to the Future
So, will Harvard Medical School someday boast a department of family medicine?
"I think it will happen," said Phillips. But he cautioned that based on the experiences of other similar institutions, it likely would be a five-to-10 year process.
"It takes time, and that's not meant to devalue any of the work that's going on, but just to recognize the complexity of creating new departments at a place like Harvard Medical School," he said.
As for Wohler, she said next steps include collecting the names and email addresses of people who indicated a willingness to be preceptors for expanded family medicine opportunities. Furthermore, Wohler and her medical student colleagues intend to engage in ongoing dialogue with faculty and administrators.
"We feel strongly about taking this message, these voices, these names, these e-mails and going forward and saying, 'Here are the people who are willing to help and want to support this. Here are the students at Harvard who want this, and this is what we'd like to see in our education going forward,'" said Wohler.
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