Pathways and HST
In order to participate in clinical courses at the Harvard affiliated hospitals and clinics, all students must complete certified training sessions in Mask Fitting (annual), Basic Life Support (BLS; recertify every two years, see more below) HIPAA and OSHA requirements; have an annual TB test; and provide certification that required immunizations are up-to-date. Students may need to meet other hospital-specific requirements as well, such as mandatory flu vaccines. Students in the Pathways curriculum must meet these requirements prior to beginning the Practice of Medicine course. Students in the HST curriculum must complete these requirements prior to beginning the Introduction to Clinical Medicine course.
The following courses must be passed prior to progressing to the Principal Clinical Experience (PCE) and as requirements for the MD degree at Harvard Medical School. For questions about preclerkship curriculum course requirements, please contact the Registrar’s office (firstname.lastname@example.org). See also Section 2.19 Satisfactory Academic Progress.
Pathways Curriculum (Cannon, Castle, Hinton, Peabody)
Preclerkship Course Requirements
Health Sciences and Technology (HST) Curriculum (London Society)
Thesis required. Due by the first Monday in February of Year IV.
Principal Clinical Experience (PCE) Phase Requirements Pathways and HST
In order to participate in clinical courses at the Harvard affiliated hospitals and clinics, all students must complete certified training sessions in Mask Fitting (annual), Basic Life Support (BLS; recertify every two years), HIPAA and OSHA requirements; have an annual TB test; and provide certification that required immunizations are up-to-date. Students may need to meet other hospital-specific requirements as well, such as mandatory flu vaccines. Students in the Pathways curriculum must meet these requirements prior to beginning the Practice of Medicine course in the second week of August, Year I. Students in the HST curriculum must complete these requirements prior to beginning the Introduction to Clinical Medicine course in January of Year II.
For students who are unable to start their PCE clerkship rotations in October (Pathways) or April (HST), attendance at the longitudinal sessions is required beginning in October for Pathways and in April for HST and returning MD-PhD students (beginning with orientation to the PCE and including the multidisciplinary PCE course). It is anticipated that all students will satisfactorily complete the PCE core clerkships prior to entering the Post-PCE phase of the MD program (see Section 2.19: Satisfactory Academic Progress).
All core clerkships must be completed no later than November following the PCE. PCE core clerkships are the prerequisites to advanced electives; in the rare instance that a student is missing a core clerkship, the student will be required to complete the core clerkship prior to enrolling in the advanced elective (i.e., core psychiatry is a prerequisite to any of the advanced psychiatry electives).
Because the PCE is designed as a continuous, longitudinal block, every effort will be made by the faculty to help students complete the full 12 months of clerkships in sequence. Occasionally however, academic or personal issues may result in interruption of the PCE. In such cases, the following guidelines apply:
Students are required to complete the Primary Care Clerkship and all components of the PCE longitudinal curriculum. Arrangements for meeting these requirements will depend on the length and timing of the interruption and will be made in conjunction with the PCE director and the HMS Registrar.
- If a student misses up to 3 months of the PCE, generally (and with the permission of the PCE Director), the student can re-enter the PCE with his/her class. The months of clerkships missed (but not the longitudinal curricular components of the PCE) will be made up at the end of the PCE, preferably at the original PCE site, if space is available. If the interruption occurs during a four-week or six-week clerkship, the entire clerkship must be repeated. If the interruption occurs during a 12-week clerkship, the student will re-enter at the beginning of a 4-week block of the 12-week clerkship, depending on when the interruption occurred. For example, if the interruption occurs during the second 4-week block, the student would re-enter at the beginning of the second 4-week block.
- If a student misses 4-5 months of the PCE, a committee of PCE leadership will consider the optimal approach for the student to fulfill core clerkship and PCE requirements and will design an alternative schedule that ensures fulfillment of the educational requirements for the MD degree. The guidelines for up to 3 months will apply.
- If a student misses more than 5 months of the PCE, re-entry is not an option, and the student will be required to restart the longitudinal components of the PCE during the next class cycle. Clerkships that were completed before the interruption need not be repeated unless there is an academic reason to do so. The guidelines for up to 3 months will apply in such cases as well.
Post-PCE Phase Requirements
Pathways and HST
- Medicine II - (Required Subinternship, 4 weeks): Fall entry PCE students should complete by the July before graduation, and Spring entry PCE students by the August before graduation. The only exception is for surgical subspecialty applicants whose residencies do not expect Medicine Subinternship performance in evaluating their residency application – those students may extend completion of Medicine II to September or October, in consultation with their Society Advisor and the Registrar. All students are required to complete Medicine II by October at the latest as a requirement for graduation the following May.
- Clinical Electives - (12 weeks; must be completed at an HMS clinical affiliate)
- Scholarly Project - Pathways - (Minimum of 2 months)
- Advanced Integrated Science Courses (AISCs) – Pathways* - 2 months (at least 1 must be taken in Year III) – offered October, January, February, March, April
- Essentials of the Profession II – Pathways - 1 month (October or every other March of Year III or Year IV)
- Clinical Capstone - 1 month in March or April of Year IV or graduation year
During the Post-PCE phase, students must maintain full-time enrollment status, which requires a minimum of twelve-week equivalents (generally, this is three 4-week equivalent clerkships) per semester. See Section 2.07 for more information about requirements for full-time status.
*HST students and Pathways MD-PhD students are not required to complete AISCs.
NOTE: Students are limited to no more than two clinical electives representing the same course in the same medical/surgical discipline. Students who choose to take more than two will not receive additional academic credit to meet clinical elective requirements.
Basic Life Support (BLS) Certification Requirement
Basic Life Support (BLS) training and certification is required for all MD students participating in patient care. Students must be BLS-certified prior to starting the Practice of Medicine course (for Pathways) and Introduction to Clinical Medicine course (for HST). Students must recertify in BLS every two years as long as they are participating in clinical courses such as clerkships, electives, sub-internships and the Clinical Capstone. Students are responsible for keeping their certification current and should anticipate when recertification is due in order to complete their requirement prior to beginning clinical work. The PME provides initial training and recertification opportunities for students on campus at only three different points during the year:
- Early August—initial certification for Pathways students beginning Practice of Medicine
- Late September—recertification for students who have completed the PCE
- Mid-December—initial/recertification for HST students and students entering the PCE in April
Examination Requirements for Graduation
HMS Comprehensive Clinical Skills Exam - (OSCE) [Summer following the PCE -see Academic Calendar for dates]
- United States Medical Licensing Examinations (USMLE)**
USMLE Step 1
Students are required to pass Step 1 in order to graduate. Students in Pathways and HST take USMLE Step 1 following completion of the PCE – no later than December 31 of Year III for Pathways students, and no later than April 30 of Year III for HST students. Pathways students must have individual meetings with their Society advisors to discuss the advantages and disadvantages of various scheduling options and are strongly encouraged to schedule one credit-bearing month during the three-month post-PCE period (i.e., a clinical elective, a core subinternship, Essentials II, research for the scholarly project requirement, or a non-clinical elective) during the quarter following the PCE. Students entering a PhD program after 9 months of the PCE (Pathways) or after 3 months of the PCE (HST) are required to take Step 1 prior to beginning the PhD.
USMLE Step 2 – Clinical Knowledge (CK)
Students are required to pass Step 2 CK in order to graduate. Because of limitations in the availability of test slots and the extended reporting timeline for Step 2 test results, students are required to complete Step 2 CK by December 31 of their final year.
Test scores must be reported to the HMS Registrar in order to receive the MD degree. If a student’s passing scores are not reported to the HMS Registrar before the last date of attendance in the graduating year as published on the academic calendar, that student will not receive the MD degree at graduation. Because failure to receive an MD degree will have an impact on a student’s ability to start postgraduate training, the Academic Societies require students to confirm their test schedules as they prepare the MSPE (Medical Student Performance Evaluation, or Dean’s Letter). More information about resources available to help with study strategies, exam taking, etc., can be found on the Office of Learning Resources and Support website and on the Office of Disability Services website.
Students should check directly with the residency programs for specific Step Exam requirements. For the USMLE Reporting Schedule, please refer to www.usmle.org/Examinations.
Last updated 7/7/2022