New Rx for doctors: Go back to school

What do doctors — who have spent years studying complex sciences and enduring sleep-deprived hospital nights — do in their spare time? Some of them, improbably, go back to class.

This year six doctors are pursuing a one-year master’s degree at the Harvard Graduate School of Education (HGSE). The students are all part of the School’s flexible Special Study Program that allows them to design their own curriculum and tailor it to their individual interests.

Rather than planning a career change, the doctors, who hail from a wide range of backgrounds and specialties, are looking to supplement their education, and in large measure, develop their teaching techniques. They intend to use the knowledge they gain to enhance and broaden the educational components of their current medical professions.

For the past several years, administrators at the School said they have noticed a rise in doctors enrolling in the program. Some say the up-tick in the number of physicians at HGSE reflects a national trend of institutions devoting more time and resources teaching doctors to be effective teachers.

“Nationally, there is more support within the field of medicine to strengthen this third leg of the professional stool of medicine, [which includes research and clinical care],” said Robert Kegan, the William and Miriam Meehan Professor in Adult Learning and Professional Development at HGSE, who advises students in the program.

Kegan said the trend is evident at Harvard where programs like the Harvard Macy Institute, a collaboration among the Harvard Medical School (HMS), the Harvard Business School (HBS), and HGSE, promotes innovative change in health care education. The Academy Center for Teaching and Learning at HMS also strives to improve medical education. Formed in 2001, its mission is to support the School’s teaching faculty through a series of educational programs.

“These programs are perfect examples of the efforts medical schools have been making in recent years to be more mindful and supportive of what they do in medical education,” said Kegan. “[This] recent trend is what leads to greater numbers of doctors showing up in our master’s program.”

Traditionally, a large portion of medical training takes place in the “see one, do one, teach one” method. While there is classroom instruction for aspiring doctors, much of the learning involves this hands-on approach. The theory is that students are shown a procedure by residents (doctors only two or three years ahead of them in their training), then they repeat it themselves, and finally, after having mastered the technique, become the teachers, imparting the information to the next generation of students.

While the time-tested method is an effective one, it’s a role-model-based system that, some argue, is often only as good as the individual mentor’s skill as a teacher. Thus, some students interested in further developing their abilities as educators have taken the next step, and, as if four years of medical school and multiyear residencies weren’t enough, they’ve hit the books again.

Such is the case for Jennifer Kesselheim, a third-year pediatric hematology-oncology fellow at the Dana-Farber Cancer Institute in Boston. On break from her hectic schedule, she chatted recently in the hospital’s busy lobby about her life as a doctor, new mother, and full-time graduate student. Unlike most of the other doctors in the program, Kesselheim is continuing her clinical work while taking classes at HGSE.

With a father who is a rabbi, Kesselheim said she learned early on that “you have to find a way to make an important contribution.”

For the young mother, that contribution has come in the form of helping others, not only patients, but also other doctors. Kesselheim, who also holds a master’s degree in bioethics, is committed to educating doctors about the ethical dilemmas that are a daily part of practicing medicine. She has helped develop a curriculum at Children’s Hospital Boston for medical residents that involves the study of ethics, humanism, and professionalism in pediatric care. In addition, she’s conducted national ethics surveys and led workshops for other pediatricians around the country. But getting more involved with the educational component of ethics made her feel she needed more.

“As I started thinking about what I had been working on so far, … it became clear to me that my goal really did lie within ethics education,” she said, “and that what I really needed was a formal training in education itself and that’s how I ended up pursuing a master’s in education at Harvard.”

Courses in the philosophy of education have helped tie her interest in ethics and education together, she said, and statistics and research methods classes have fine-tuned her data analysis and organizational skills. Through the master’s program, Kesselheim said she has been able to investigate how adults learn and develop. After graduation, she intends to continue to conduct ethics research while training other doctors in the field.

“I am really trying to come up with new and different ways that I can take what I learned in my master’s and apply it to more teaching.”

Master’s student Regina Husa, who defected from the Czech Republic with her family when she was 11, never wanted to be anything but a doctor. She was also always interested in teaching. Today she is an assistant professor of medicine at McGill University in Montreal and director of the cardiac intensive care unit and the clinical teaching unit in cardiology at the Sir Mortimer B. Davis Jewish General Hospital, a teaching hospital connected to McGill.

“I’ve always been interested in education and medical teaching and understanding how we learn,” said Husa, “[But] I had zero [teaching] credentials.”

She said it has been her longtime goal to attend Harvard to learn how to become an effective educator.

“To understand not just what you should teach but exactly how you should teach it is [something], I think, you need expert instruction for.”

Husa, who is interested in simulation training — using mannequins on which to practice medical techniques before moving to actual patients — designed an acute care curriculum for cardiology fellows at McGill and is teaching a pilot version to medical students at Harvard as part of her master’s program.

Robin Basu Roy, a pediatrician from England who will work in North London both doctoring and teaching after graduation, said he appreciates the flexible nature of the Harvard program that allows an interdisciplinary approach.

His specialized degree includes a course at HBS as well as one at Harvard’s Department of the History of Science where his class on the history of medicine examined the changing nature and perception of disease by patients and by doctors. That class, he said, “added a whole extra level of appreciating the complexity of the arena in which we work.”

Through the program Basu Roy said he has enhanced his teaching skills and can more effectively pass on his enthusiasm for the subject.

“I’ve always found that a good teacher really conveys how fascinating and amazing medicine is.”