1.03 Course and Examination Requirements for the MD Degree (Pathways and HST)

For more details, please refer to the HMS MD Academic Calendars and Sections 1.04: Student Assessment in the MD Program and 2.19: Satisfactory Academic Progress.

Preclerkship Requirements

Pathways and HST

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 also 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 phase course requirements, please contact the Registrar’s office (registrar_hms@hms.harvard.edu). See also Section 2.19 Satisfactory Academic Progress. 

Pathways 

As outlined in Section 2.9 of the student handbook--Satisfactory Academic Progress--all courses in the preclerkship phase must be completed with a grade of Satisfactory for progression to the PCE phase. In addition, students must take the USMLE Step 1 exam prior to the PCE. During the Pathways preclerkship phase, students who receive Unsatisfactory grades are required to complete re-examinations and all other passing requirements for courses at four specific points to progress within the phase:

  • Year 1: By the end of the third week after Winter Recess: ITP, Foundations
  • Year 1: By the end of PDW1: IHPI, Essentials
  • Year 1: By the end of the fourth week after IHPIII: IHPII, PDW1, IHPIII, POM
  • Year 2: By theend of the second week after BRIDGES: PDW2, IDD, MBB, BRIDGES

Students who have not completed all passing requirements for the preclerkship phase by the end of the second week after BRIDGES will have a delayed start to the PCE (April).

Pathways Curriculum (Cannon, Castle, Hinton, Peabody; beginning with the Class of 2027)

 

Preclerkship Course Requirements

IN555 Introduction to the Profession

PWY100 Foundations

POM100 Practice of Medicine (POM)

PDW101 & PDW102 Professional Development Weeks

PWY132 Integrated Human Pathophysiology I

PWY133 Integrated Human Pathophysiology II

PWY134 Integrated Human Pathophysiology III

PWY120 Essentials of the Profession

PWY110 Immunity in Defense and Disease (IDD)

PWY140 Mind, Brain and Behavior (MBB)

PWY210 BRIDGES 

See this link for more information on the new Pathways curriculum map.

 

Pathways Curriculum (Cannon, Castle, Hinton, Peabody; Class of 2026 and earlier classes)

 

Preclerkship Course Requirements

PDW100 Professional Development Orientation (longitudinal, August)

IN555 Introduction to the Profession

POM100 Practice of Medicine (longitudinal September-July)

PWY100 Foundations of Medicine

PWY110 Immunity in Defense and Disease

PWY120 Essentials of the Profession: Evidence, Ethics, Policy and Social Medicine

PDW101 Professional Development Week 1

PWY130 Homeostasis I

PDW102 Professional Development Week 2

PWY131 Homeostasis II

PWY140 Mind, Brain and Behavior

PWY150 Transition to the Principal Clinical Experience (PCE)

Health Sciences and Technology (HST) Curriculum (London Society)

 

Preclerkship Course Requirements

Year I

PDW100 Professional Development Orientation (longitudinal, August)

IN555 Introduction to the Profession

HT016 Artificial Intelligence in Healthcare I

HT022 Integrations & Innovation in Medical Sciences I

HT146 Biochemistry and Metabolism

HT190 Introduction to Biostatistics

HT010 Human Anatomy

HT030 Pathology

HT160 Genetics in Modern Medicine

HT162 Molecular Diagnostics and Bioinformatics

HT175 Immunology

HT020 Musculoskeletal Pathophysiology

HT016 Artificial Intelligence in Healthcare II

PWY120 Essentials of the Profession: Evidence, Ethics, Policy and Social Medicine

HT024 Integrations & Innovation in Medical Sciences II

HT060 Endocrinology

HT080 Hematology

HT090 Cardiovascular Pathophysiology

HT100 Respiratory Pathophysiology

HT110 Renal Pathophysiology

HT199 Research

HT220 Introduction to the Care of Patients

Year II

HT040 Mechanisms of Microbial Pathogenesis

HT070 Human Reproductive Biology

HT120 Gastroenterology

HT130 Neuroscience

HT199 Research

HT194 Epidemiology

HT150 Principles of Pharmacology

IN710 Introduction to Clinical Medicine (ICM)

PS700M.J Psychopathology & Introduction to Clinical Psychiatry

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.

Core Clerkships

Medicine I (12 weeks)

Surgery (12 weeks)

Obstetrics and Gynecology (6 weeks)

Pediatrics (6 weeks)

Neurology (4 weeks)

Psychiatry (4 weeks)

Radiology (4 weeks; longitudinal at BIDMC)

Primary Care Clerkship (longitudinal; varies by site)

Principal Clinical Experience (PCE) course (longitudinal)(including The Developing Physician II -tDP; longitudinal)

Students whose entry to the PCE is delayed should consult with their Society Advisory Dean or Advisor and the HMS Registrar regarding their PCE schedule and a plan for fulfilling their requirements for the MD degree.

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): January entry, PCE students should complete the medicine sub-internship by July before graduation, and spring entry PCE students by August before graduation. The only exception is for surgical subspecialty applicants whose residencies do not expect Medicine Subinternship performance in evaluating their residency application – such January entry PCE students may extend completion of Medicine II to October, and spring entry students may extend to February before graduation, in consultation with their Society Advisor.
  • 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 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.

 

Student Requirements

In order to participate in clinical courses at Harvard-affiliated hospitals and clinics, all students must complete certified training sessions in Mask Fitting (annual) and basic Life Support (BLS; recertify every two years; see more below) and comply with all required immunizations and vaccinations as stipulated by Harvard University and Harvard Medical School.

Basic Life Support (BLS) Certification Requirement

Basic Life Support (BLS) certification is mandatory for all MD students participating in patient care. Students must be BLS-certified before 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, clinical electives, Core II Medicine Sub-internship, and the Clinical Capstone. Students are responsible for keeping their certification current and should anticipate when recertification is due in order to complete the requirement prior to beginning clinical work. The Office of Medical Education (OME) provides initial training and recertification opportunities for students at the following points during the year:

  • Mid-August - initial certification for Pathways students beginning Practice of Medicine
  • August → September - recertification for students during their PCE year
  • Mid-December - initial/recertification for HST students and students entering the PCE in April

Initial BLS training for first-year students takes place in groups at HMS with skilled trainers, while recertification training will be held individually at BWH in the STRATUS center via an RQI cart containing manikins, valve mask bags, and a tablet.

School-sponsored training dates are published on the academic calendar. Returning or off-cycle students who are due for recertification may contact the OME (ome_curriculum@hms.harvard.edu) for information on how to register for an upcoming BLS offering. If students are unable or elect not to participate in a school-sponsored training session, they must enroll in a course at their own expense at an American Heart Association training center and provide documentation to the Registrar’s Office upon completion. Reimbursement will not be provided to students for off-site training and certification.

 

Respirator Mask Fit Testing Requirement

Respirator mask fitting for an N95 mask is required annually for all MD students participating in patient care. Students must be mask fitted before starting the Practice of Medicine course (for Pathways) and the Introduction to Clinical Medicine course (for HST). Students must be re-fitted annually as long as they participate in clinical courses such as clerkships, clinical electives, Core II Medicine Sub-internship, and the Clinical Capstone. Students are responsible for keeping their mask fit current and should anticipate when a re-fitting is due to complete their requirement prior to beginning clinical work. The OME provides an initial fitting and re-fitting opportunities for students on campus at the following points during the year:

  • Mid-August—initial mask fit for Pathways students beginning Practice of Medicine
  • Mid-August—mask fit for pre-clerkship students prior to the PCE year
  • Early August—mask fit for students during their PCE year
  • Mid-December—initial mask fit for HST students and students entering the PCE in April
  • Mid-August, Mid-December, and Mid-January—mask fit for post-PCE students

Mask fittings will take place at HMS, and the Office of Medical Education (OME) will communicate fit testing opportunities broadly. Students who cannot use an N95 mask or complete mask fit testing for medical or religious reasons will need to use a Powered Air Purifying Respirator (PAPR) instead. PAPRs are made available at affiliated teaching hospitals. Such students will need to complete the PAPR training track that is part of the required online respirator training, module IHS107. PAPRs are made available at affiliate teaching hospitals, but access and availability are dependent on the clinical setting. 

Students requesting a medical exemption must provide the necessary documentation from their health care provider. Students requesting a religious exemption must provide documentation from a religious leader in their faith tradition. Students whose exemptions are approved will not need to submit documentation again during their time as an MD student. For more information, please email the Office of Medical Education (ome_curriculum@hms.harvard.edu) with the subject line: “Seeking Exemption for N95 Respirator Use” or “Respirator Exemption.”

If a student elects not to participate in school-provided mask fit testing sessions, they must complete the requirement through an external vendor before expiration. Completion outside of the scheduled HMS sessions is on the student’s own time and at their expense. Students may not start any new courses or clerkships if they have not completed the annual fit testing requirement.

 

Examination Requirements for Graduation

The following examinations must be passed to receive the MD degree:

  • HMS Comprehensive Clinical Skills Exam - (OSCE) [Summer following the PCE -see Academic Calendar for dates]
  • United States Medical Licensing Examinations (USMLE)**

**Step 1, Step 2 Clinical Knowledge (CK)

**USMLE examinations are scheduled by, and are entirely the individual student's responsibility.

Learn more about the USMLE requirements in section 2.06 Licensure: USMLE (United States Medical Licensing Examination)

 

For more information about Assessment and Evaluation requirements, please refer to Sections 1.04 and 2.03.

 

Updated 3/2/26

Reviewed and Approved by the EPCC. 

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