Harvard Medical School’s HMX: An Online Intro to Medicine

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I was recently contacted about a fascinating new program at Harvard Medical School called HMX Fundamentals. I wanted to learn more, and I’m delighted to have AST listeners learn more along with me since I’m talking today to Dr. Michael Parker, Harvard Medical School’s Associate Dean for Online Learning and Faculty Director of HMX.

Dr. Parker earned his Bachelor’s and master’s degrees in electrical engineering and computer science from MIT. He then worked in the software industry and studied exercise physiology at the University of Colorado. He went to medical school at the University of Colorado and did his residency in internal medicine in Boston. Today, when he’s not combining his technology and medical backgrounds to create innovative, ground-breaking educational programs, he is a practicing physician in the Division of Pulmonary, Critical Care, and Sleep Medicine at Beth Israel Deaconess Medical Center and an Assistant Professor of Medicine at HMS. Welcome!

Can you give us an overview of HMX? [1:45]

HMX refers to foundational online courses covering medical topics for people potentially interested in careers in healthcare, or individuals who simply want to know about these topics in greater depth.

It might be useful to have some background on why Harvard and why now. About two years ago, we were going through a curriculum reform, thinking about how to get students into clinics earlier. This involved the compression of the preclinical years from two years to 14 months – the material has to go somewhere. How do we prepare students for this rapid start? We also recognize that we get students from a broad range of backgrounds – how do we level the playing field?

We were thinking about what students struggle with, and what areas are vital for the future of medical practice – such as genetics and immunology. We came up with starting with four foundational courses: Genetics, Immunology, Physiology, and Biochemistry.

We thought of a fresh approach that would be beneficial for our own students and helpful for students outside.

For the last two years, the entering class at Harvard Med has been given access to these classes.

Was there always a vision to offer this curriculum more widely? [6:05]

Yes, there was always a vision to offer it more widely – that was part of the initial brainstorming process. If we were putting in this amount of effort and care, it made sense to offer it up more widely.

What makes HMX special as an online learning experience? [7:10]

People have a concept of what online learning is – watching lecture videos, etc. There are three major differences in what we’re creating:

1. The degree of clinical applications: we go into the hospitals and film with doctors and patients in authentic settings. Student see how doctors interact with patients and use the foundational knowledge students are learning.

2. High degree of active learning. Students have to engage with the material. For example, there are over 300 assessment questions in the Immunology course – this takes advantage of learning science.

3. Rich biomedical visualizations – including graphics and animations. We want to help students understand the mechanisms.

Do these elements take the place of labs? [10:50]

There’s still a need for labs, certainly for the experiential aspect.

And the course is all online – no residential component? [11:40]

Right – students can take the course from any device.

In the first group of Harvard med students who went through the course, students logged on from over 80 countries!

How long does HMX last, and how many hours per course? [12:55]

Each course is ten weeks. They can definitely be taken concurrently, up to four courses, but that can be a significant time commitment. Students can expect to spend three to five hours per lesson, with ten lessons per course. The time they spend per lesson depends on outside reading, how much they participate in the “ask a question” forums, etc.

Lessons are released approximately weekly, but once a lesson is released it stays open. We advise working in order.

You mentioned “Ask a Question.” Are there opportunities for student interaction, mentors, etc? [14:40]

All of the above. We’ve oriented it towards asking specific content questions – there’s a forum associated with the course, and we have experienced Harvard Med students staffing the forums. We see rich discussions going on.

What if a student is struggling? [15:30]

Typically that’s what the “Ask a Question” forum is for – it’s an interactive way to get help.

When one applies to HMX, there is no MCAT or GRE, no interview and there is a fairly straight-forward application. What are you looking for in the application? Whom do you want to admit? Whom will you decline? (Next app due date: May 30 is the next regular deadline. May 23 is the scholarship deadline) [16:30]

The goal is to put the experience in reach of many people rather than restrict it – but we are looking for certain prereqs: basic bio, basic chem, basic physics. And we ask people about their motivations and goals.

I saw that tuition ranges from $800 for one course to $1800 for four courses. If you sign up for 4, do you have to take them all at the same time? Or can you take two simultaneously and then 2 at a later time? [19:20]

If you sign up for four courses, we expect you to take them concurrently – but we know people may want to space them out, so in the future there may be an option to spread them out at the same cost.

There are scholarships available – what are they based on? [19:55]

We consider it based on need – we don’t have a rigid set of criteria. We look at people’s backstory on a case-by-case basis. Our concern is how to make it accessible to people who can benefit but might not be able to afford it.

Does HMX reflect Harvard Medical School’s approach to medical education? [20:40]

I mentioned the curriculum reform – the first class after that reform started in August 2015. Our goals included active learning and critical thinking, along with earlier clinical exposure. What we’re doing with HMX is consonant with that. We definitely focus on critical thinking – one of our professors says: We teach you what you can’t google. And with regard to earlier clinical exposure – making the material more relevant is definitely what we’re doing.

Do med students start clinical exposure right away at HMS, or after those first 14 months? [22:45]

They get some clinical exposure immediately through courses like “Practice of Medicine.” And we’re also incorporating clinical examples by video.

It seems that the program is aimed either at current college students and maybe even high school students who want to get a basic intro to medicine or perhaps at recent graduates or working professionals who wants to test the healthcare waters before contemplating a career change. Is that a fair assessment? [25:10]

I would stress that it’s more than a basic intro – there’s definitely some rigorous material, and students have to be committed.

What feedback have you received from medical schools? [26:50]

We see this as a serious credential that demonstrates commitment and in the process lets students explore a lot about the practice of medicine.

We’ve run courses with outside med schools (including international programs) for incoming students, and have been able to point to significant learning gains. So we hope data like this sill show how successful it is.

What is the most memorable feedback you have received from those who have completed HMX? [30:50]

A student I spoke to two days ago is a high school science teacher who is interested in going into medicine. For him, the real world cases stood out in particular: he found them really powerful for his own learning, but it also gave him ideas for his teaching process.

Has your own journey to medicine affected the development of HMX? [32:55]

I would say, definitely. I came to med school as an engineer. Even with the pre-reqs, it felt like quite a leap that first year, and I was trying to catch up from textbooks. I learn visually, and I felt the desire to play around with the info to learn it.
It’s tremendously rewarding to help someone learn and really “get” the info.

What do you see coming next for HMX? [35:00]

Our first priority is getting it out there and serving students well.

Second, we’re looking to create new courses. Coming up soon is pharmacology – a very rich topic. We can build on the clinical apps we’re experienced with and develop greater interactivity to help students explore concepts.

Who’s on your team? [36:40]

We have a unique team – a core team of illustrators and animators with medical knowledge, along with in-house content experts, who work alongside our clinical faculty. It’s tightly integrated – nothing is farmed out. And we have a wonderful operations team.

Where can students learn more? [38:35]

On our website. Right on the front page, you can sign up for a trial, and be introduced to our faculty.

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