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Fellowships:
Behavioral Health Fellowship - Preparing mental health professionals to work effectively with a variety of treatment modalities in a managed behavioral health care practice
Sharon Steinberg
The Behavioral Health Fellowship is a yearlong multidisciplinary fellowship that places between 7-8 post-doctoral psychologists and masters-prepared mental health nurse clinical specialists and social workers in a Behavioral Health Department at Harvard Vanguard Medical Associates. The fellows practice under the guidance of a supervisor, gain skill in time-sensitive models of care, and learn to use innovation and creativity to adapt to managed care practice. Fellows also can develop experience in specialized areas such as group therapy, couples treatment, substance abuse, and/or psychopharmacology. A weekly seminar at the DACP supports the learning in the clinical placement and promotes cohesion and shared experiences among the fellows. This program is co-directed by Jim Donovan, PhD, and Sharon Steinberg, RN, MS, CS and has been in existence for 25 years - having successfully adapted to meet the continually changing environment of mental health practice.
Fellowship in Pharmaceutical Policy Research-
Stephen Soumerai
This Harvard Medical School Fellowship in Pharmaceutical Policy Research places one fellow per year at the DACP Drug Policy Research Group. The training is intended to help new investigators to produce rigorous research relevant to pharmaceutical policies in both the private and public sector. Suggested topics for research projects are access to care, particularly for vulnerable populations; cost-containment; insurance coverage; outcomes and quality of care; ethics; and economic incentives. Fellows actively participate in research projects under the guidance of experienced DACP investigators and participate in regular DACP-based seminars that highlight ongoing pharmaceutical policy research or reviews of key pharmaceutical policy topics. Stephen Soumerai is Director of the Program and Anita Wagner is Co-director. Joyce Cheatham provides coordination for this fellowship.
Harvard Pediatric Health Services Research Fellowship Program - Training the next generation of researchers in child health
Jon Finkelstein
The Harvard Pediatric Health Services Research Fellowship Program trains beginning investigators to conduct research that improves health care for children and families, including disadvantaged and minority populations. DACP is one of three sites and hosts two to three of the 12 fellows in this two-year fellowship. Fellows at DACP complete research projects under the guidance of DACP and other faculty members, participate in a structured fellowship curriculum, and complete a Masters in Public Health. The fellowship is funded by federal training grants from the Agency of Healthcare Research and Quality and the Health Resources Services Administration. Most fellows are either general pediatricians or pediatric sub specialists. DACP fellows have studied key issues in pediatric care such as variations in asthma care in children, access to immunization services, and socioeconomic disparities in care for children. Dr. Jonathan Finkelstein serves as the DACP site director for this program, Dr. Tracy Lieu is the site director for the Children's Hospital site, and other DACP faculty frequently mentor fellows.
General Internal Medicine Fellowship: Training the academic internists of the future
Matt Gillman
DACP is one of five teaching institutions participating in Harvard's General Internal Medicine and Faculty Development Fellowship Program. Each year about ten fellows are selected from a national pool of applicants, one to two of whom are based at DACP. Fellows are funded by federal grants for two years of study. They attend classes at Harvard School of Public Health in the Clinical Effectiveness track, specifically designed for physicians, and complete a Masters in Public Health. Most of their time is spent conducting epidemiologic or health services research under the guidance of a DACP faculty mentor. Fellows also participate in curricula in medical education and in caring for the underserved, see patients at a Harvard Vanguard Medical Associates clinical site, and teach in courses directed by DACP faculty. Nearly all graduates go on to academic careers in general internal medicine. Matthew Gillman is DACP site director of this program.
Thomas O. Pyle Fellowship
Richard Platt
Teaching Programs:
Clinical Epidemiology and Population Health: Helping medical students find and interpret the evidence they need to support clinical practice.
Steven Simon
This DACP-directed course helps students develop the skills to select and interpret the scientific literature that will help them make clinical decisions. There is an enormous amount of information available to clinicians today about the course, diagnosis and treatment of illness. In order to become effective doctors and policy makers, medical students need to be able to assess the validity of these sources of evidence. This course teaches students about scientific methods used in medical studies and how to interpret whether specific methods will yield dependable results. Students also learn how to use evidence to assess the appropriateness of screening tests for clinical conditions; how to search the PubMed and other databases for relevant, high quality articles; and how to select and apply the best sources of information for issues in their clinical practices. In addition, the course will familiarize them with the role of national and local practice guidelines and the evidence that underlies these guidelines. By the end of the course, students have an appreciation of the factors they need to consider when making decisions about health screening and treatment and when making recommendations to patients about health-related-behavior changes. Steven Simon is the Director of the course. The following DACP faculty teach in this course: Jonathan Finkelstein, Tracy Lieu, Grace Lee, Emily Oken, Elsie Taveras, Alison Galbraith, Matthew Gillman, Richard Platt, and Mandy Brown-Belfort.
Introduction to American Medicine and Medical Education. Creating international alliances in medical education.
Toni Peters
This course was designed as part of an alliance with Ludwig-Maximillians Universitat (LMU) in Munich, Germany. The aims of the program are to provide training in educational skills that prepare students for careers in academic medicine, and, in so doing, to develop a new generation of faculty for LMU; and to let students, based on experiences at a foreign medical school, generate new ideas to improve teaching and learning at LMU. The medical education course is composed of didactic sessions, active exercises and a team-based project (to design a curricular component for LMU). These include case writing, tutoring, microteaching, student assessment, program evaluation, giving feedback, observational techniques, small group process and curriculum development. Upon their return to LMU, most students work as tutors or bedside instructors; many serve on curriculum planning groups. All proposed designs have been implemented, sometimes exceeding expectations. For example, the students' guide to interviewing and physical exams has been published and serves as the text of choice in many German medical schools. Gordon Moore and Antoinette Peters designed the course in 1997; other DACP faculty, such as Steven Simon, and several fellows have also designed and taught parts of the course.
Introduction to Psychiatry: Teaching students the basics of mental health and psychosocial medicine
Joseph McCabe
Psychiatry 700 MJ is a required Harvard Medical School second-year course that teaches students the basics of psychopathology. The course meets for three hours weekly for three months. Sessions alternate between large lectures at HMS and small sections at clinical practice sites. At DACP, students review the material from the previous week's lectures. They meet in small groups with a psychiatrist and interview patients. Interviewing skills, differential diagnosis and how to present patients in writing are taught in the small groups. Patients are drawn from the psychiatrists' practices or from inpatients at the Arbor Hospital on the days the students visit the hospital. Joseph McCabe, a psychiatrist at Harvard Vanguard Medical Associates, is the Course Director.
Nursing and Physician Assistant Teaching Programs - Preparing advanced practice clinicians to work in an interdisciplinary multispecialty group practice
Sharon Steinberg
Each year more than 80 nurse practitioner and physician assistant students from many of Boston's academic programs have clinical placements with advanced practice clinicians at Harvard Vanguard Medical Associates and DACP. These placements offers students an opportunity to experience a collaborative interdisciplinary team approach to patient care that encompasses the spectrum of health care from promotion and prevention through illness and chronic care management. Students are exposed to a state-of-the-art information system and to a focus on continuous quality improvement through research and evidence-based decision-making. They also have an opportunity to develop new collaborative interdisciplinary education, research, and practice initiatives. This program is directed by Sharon Steinberg, RN, MS, CS.
Preventive Medicine and Nutrition: Learning about the connection between nutrition and health
Helen Delichatsios
This HMS course teaches second-year students the basic concepts of nutrition, disease prevention, and health promotion. They learn about screening for disease, counseling patients for constructive behavior change, immunizations, the role of nutrition in the formation and prevention of disease, and how to evaluate dietary practices. A primary focus of the course is having students evaluate and improve their own dietary and health practices. Students meet in small group tutorial sessions to discuss specific cases that illustrate course topics. These talks are supplemented by lectures by HMS faculty and fellows who often find that the course provides them with useful information for their own practices. By the end of the course, students have a thorough understanding of how nutrition and health and lifestyle behaviors contribute to disease and how they can be modified to prevent disease. Helen Delichatsios is Director of this course.
"Partnerships for Quality Education" (PQE) - Training Clinicians in the Critical Skills to Lead in Redesigning Health Care
Gordon Moore
PQE's goal is to identify and help teach the skills clinicians need in the evolving world of health care where quality and cost really count (www.PQE.org). Supported by the Robert Wood Johnson Foundation, PQE assists academic medical centers to teach these competencies. In operation since 1996, PQE's most recent effort is Achieving Competence Today (ACT). ACT is a web-based, self-directed curriculum to enable residency and nurse training programs to teach systems and practice improvement. The ACT curriculum consists of four modules: " The health care system and how it affects the care residents and nurses provide. " Who pays for care and why it matters. " Managing patients, populations and practices for better outcomes. " Designing and carrying out a practice improvement project and teaching others about systems. ACT is used both as an educational intervention and to activate quality improvement in academic health centers. The quality improvement component guides ACT's students to develop collaborations with hospital management. To date, 24 institutions and over 300 residents and graduate nursing students have participated in ACT. ACT increased knowledge and self assessed competency in systems and quality improvement. Learners also made a distinctive contribution to the quality improvement efforts of their academic health centers. Gordon Moore directs PQE. Other DACP Faculty and staff who work on this program are Mary Joan Ladden, Antoinette Peters, Joseph Kimura, Elizabeth March, and Melissa Manolis.
Patient Doctor I: Teaching students the foundation of patient/doctor communication.
David Krieger
Patient Doctor I is a required course for first year Harvard Medical Students that teaches students skills they need to form successful doctor/patient relationships. Students learn to listen and communicate effectively with patients, conduct an interview and write up a complete medical history. The course utilizes patients at Harvard Vanguard Medical Center. Harvard Medical School sponsors faculty development courses throughout the year detailing teaching content and strategies. David Krieger is the Course Director.
Patient Doctor II: Giving students their first opportunity to examine patients.
John Whyman
Patient/Doctor II is a required course for second-year Harvard Medical School students that builds upon the interviewing skills learned during Patient/Doctor I. It provides instruction and practice in advanced interviewing skills, oral case presentation, and patient write-ups. The course utilizes patients at Brigham and Women's Hospital and Harvard Vanguard Medical Associates. There is close interaction with faculty and 4th year HMS students who act as tutors for learning physical exam skills. This course prepares students for their third-year experience in clerkships. John Whyman is course Director. Olga Lutz provides DACP-based support for the course.
Primary Care Clerkship: Placing students in real-world primary care settings
Harvey Katz
The Primary Care Clerkship is a required 9-month longitudinal clerkship that introduces 3rd year HMS medical Students to the real world of primary care. It is the first time that students can apply what they have learned in Patient Doctor 1 history taking and Patient Doctor 2 physical examination to the care of ambulatory patients. Students, working under the close supervisor or practicing primary care physicians in internal medicine, pediatrics, and family practice care for patients who present with undifferentiated complaints and problems common to primary care in the context of their family, culture, psychosocial background and environment. Each student is assigned to an experienced community-based primary care physician as their preceptor where they are provided the opportunity to develop relationships with their preceptor and patients over the 9-month duration of their experience in office based practice. Harvey Katz is Director of this program.
Primary Care Clerkship-Community Oriented Care Elective
Harvey Katz
The one month elective, "Community Oriented Primary Care: Integrating Cross-Cultural Care and Population Sciences into the Primary Care Clerkship" is an enhancement to the Primary Care Clerkship which extends the student's experience caring for the individual patient into the wider population of the patients' community served by the preceptor's office practice during the clerkship. A subset of PCC students elect to engage in this service learning program where they identify a community partner and develop a project, working with their preceptor, to improve the quality of an aspect of health care which addresses an unmet need within the community. During the clerkship, students attend a monthly tutorial to learn the principles and methods of community- oriented care. The goal is for students to gain the knowledge, skills and attitudes to provide culturally responsive, community oriented care in diverse communities. Harvey Katz, MD is Director of this program.
Primary Care Division: The home for primary care programs at Harvard Medical School.
Harvey Katz
The HMS Primary Care Division is the inter-institutional home for primary care in general internal medicine, pediatrics, medicine/pediatrics, and family medicine for the Harvard Medical School affiliated academic institutions. The goals of the division are to increase the visibility of Primary Care at HMS and enhance faculty and medical student interest and engagement in primary care programs. The component programs of the Division are the Primary Care Mentorship Program for first year students; the annual faculty retreat for the all primary care clinician-educators; the Cabot Lecture series highlighting topics of great current interest, Family Medicine advocacy, recognition awards to senior medical students who have shown major achievements and promise in primary care activities, and the publication of the Primary Care Chronicle, a newsletter which is distributed to over 2,000 faculty and students. The Division is co-directed by Harvey Katz, MD and Dr. Laurence Ronan of MGH. Jean Fierro-McCarthy is the DACP-based Division Coordinator.
Brigham and Women's Hospital/Harvard Vanguard Medical Center Primary Care Internal Medicine Residency Program - Training future leaders in general internal medicine.
Bill Taylor
The BWH/HVMA Primary Care Internal Medicine Residency Program
offers distinctive training for residents who want to gain the clinical, analytical and leadership skills to become outstanding physicians and leaders in health care. The residents receive superb inpatient and outpatient training and learn to work within and improve systems of care in real-life clinical practices. For outpatient training, each resident is paired with a preceptor at a Harvard Vanguard Medical Associates multi-specialty health center and becomes part of a practice team with his or her own panel of patients. Outpatient training occurs at Brigham and Women's Hospital, the Faulkner Hospital, and VA Hospitals in the Boston area. DACP hosts small group seminars for the residents to supplement the clinical experience. There are weekly sessions on the doctor-patient relationship and epidemiology and prevention and shorter seminars on topics such as leadership and management, geriatrics, end-of-life care, ethics, and health care policy. In addition, a senior DACP faculty mentor helps each resident gain skills in research and population sciences and integrate those skills into clinical care. Senior residents have time set-aside to work on a research, management or quality improvement project aimed at improving the quality of care. They have access to leaders at DACP, HVMA, HPHC, and the BWH for guidance on this project. At the end of their training, residents have a broad range of skills that provide a strong foundation for many different careers in general internal medicine. The Program offers four open slots each year. Click here for profiles of current residents. William Taylor, MD, is the Program Director. He is a practicing internist and has taught Clinical Epidemiology to the residents since the Program started in 1990. Donna Asali provides is the Coordinator of the Program.
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