Partners from three continents ally for education reform

HMI has forged an alliance with Tokyo Medical and Dental University (TMDU) that brings the Harvard approach to medical education reform to Japan for the first time, in anticipation of widespread changes in Japan’s medical education and health care systems.

The TMDU-Harvard Medical International Alliance for Medical Education was launched in July with help from faculty members at Ludwig Maximilians University (LMU) in Munich, which has been working with HMI for several years to implement significant curriculum reforms.

In response to a Japanese government mandate to privatize and modernize medical education, leaders at TMDU turned to HMI for help in changing from a traditional, lecture-based system to a small-group, interactive teaching system and producing more physician-scientists via M.D.-Ph.D. and other nontraditional programs.

Leaders from TMDU and HMI met in Tokyo to establish a partnership. Top Row, l to r, (from TMDU): Drs. Yujiro Tanaka, Takeshi Aso, Tadashi Suzuki, Hiroko Maezawa, Katsuiku Hirokawa, Hajime Karasuyama, Hidehiro Mizusawa. Bottom Row, l to r, (from HMI): Drs. Thomas Aretz, Elizabeth Armstrong. (from LMU): Dr. Frank Christ.

“By introducing the experience of Harvard Medical School into the guidelines for the core curriculum set up last year, TMDU desires to make new educational methodologies of medicine and dentistry that will fit in the Japanese educational and social climate,” said Dr. Katsuiku Hirokawa, dean of the Faculty of Medicine. “We are expecting that HMI can be very helpful for the improvement of medical education reform at TMDU.” The school is already employing problem-based learning and small group study in its clinical introductory program for 5th year students and in some 4th year courses.

TMDU will also benefit from the German experience of initiating reforms in a legally more restrictive environment that is in some ways similar to Japan’s. Since LMU reformed its own curriculum in a partnership with HMI beginning in 1996, the German university has led a movement for change within that country’s strictly regulated, tradition-bound medical education system. The “Munich-Harvard” model was an impetus for reform at other German schools and won plaudits from the country’s president.

The seeds for the three-way interaction were sown in several ways. Aretz gave a talk at TMDU a few years ago on Harvard Medical School’s New Pathway, and a TMDU faculty member spent time at LMU and learned how HMI had helped reform the German school’s curriculum. TMDU approached HMI for assistance with its own curriculum restructuring, and requested that LMU also be involved in planning and implementation.

Aretz said that the leadership course will accomplish three things: it will provide an opportunity for faculty to work together uninterrupted; it will expose the faculty to new approaches to education without dictating which path they should take; and finally, “we provide some strategic input—a little toolbox that opens up some ways to approach certain problems,” he said. About a dozen specific skills and strategies are taught, including curriculum and course design, problem-based learning theory, case writing and design, bedside teaching and tutoring, and multimedia/information technology in medical education.

A tutor training workshop is also planned for next winter. “Our aim is to provide an approach they can use to train their faculty to teach in a new way,” Aretz said. A student exchange program is also planned, based on the successful exchange between HMS and LMU students.

Dr. Elizabeth Armstrong, associate professor of pediatrics at HMS and director for education programs at HMI, noted that the partnership with TMDU may open up opportunities for innovation in the HMS curriculum as well.

“Since TMDU is looking at the possible integration of the liberal arts into the medical curriculum, they will be developing a new model that could create new possibilities for us,” she said. “HMS and other U.S. schools are examining ways to integrate the humanities into the existing curricula so that our programs can better address some of the new skills required for physicians of the future—communication, team work, systems planning, and learning for themselves, their patients and the systems within which they work.”