LHB Curriculum

COURSES FOR STUDENTS IN THE LHB PROGRAM

All BBS students, including LHB students enrolled in the BBS program, are required to take the BBS critical reading course, Microbiology 230, in the fall G1 semester. Non-BBS LHB students are required to take whatever courses are required for their PhD Program. In addition to the 3.5 required LHB courses (listed below), LHB students are required to take 1.5 elective courses in the broad area of human biology/disease mechanisms.

The following courses are required for all LHB students:

Case Studies in Human Biology and Translational Medicine (G1 January term, “quarter course”)

BCMP234. Cellular Metabolism and Human Disease (G1 Spring semester)

HT035. Principles and Practice of Human Pathology (G1 Spring semester)

BCMP235. Mechanisms of Disease: Physiology and Pharmacology (G2 Fall semester)

HB300: Case Studies in Human Biology and Translational Medicine (January G1 Year)

HB300 is a new three-week course that is required for first-year LHB students. The course meets five days a week in the morning in January. In 2009, the course starts on Monday January 5 and ends on Friday January 23. Each class lasts only for 60-90 minutes so that students can also do a lab rotation during this time. The course is held in a conference room at the New England Journal of Medicine editorial offices on the 6th floor of the Countway Library at HMS. Enrollment in HB300 is required for and restricted to students in the LHB program, and will count as a quarter-course.
Each week of the course focuses on a different “case study” in translational medicine. These case studies are selected to represent examples in which fundamental discoveries in human disease biology led to the development of new therapeutic approaches. In the process of reviewing these case studies and in the critical reading of selected papers, the LHB students will also learn some of the basics of clinical trial design and the principles of clinical epidemiology.
HB300 consists of lectures and small group discussions that focus on papers selected from the basic science and clinical literature, and which culminated in the publication of seminal papers in the New England Journal of Medicine. These papers serve as a platform for the analysis of research methods in human biology as well as providing examples of recent advances in human biology that have provided new insights into the diagnosis, prevention, and treatment of human disease. These same papers serve as a basis for teaching LHB students the fundamentals of experimental design and biostatistics in basic and clinical research. Professor Jeffrey Drazen, editor-in-chief of the New England Journal of Medicine, will serve as course director, and is joined by two NEJM associate editors and members of the HMS faculty, Drs. Caren Solomon and Mary Beth Hamel. Each of the three weeks will focus on a different case study. The first week will explore how basic discoveries in the enzymology of leukotrienes led to the development of new therapeutic agents used to treat asthma. The second week uses the example of imatinib, in which fundamental studies on tyrosine kinase signal transduction led to the development of a novel chemotherapeutic agent, Gleevec. The final week of the course explores how an understanding of the physiology of blood pressure control led to the development of the angiotensin-converting enzyme inhibitors and their validation as effective drugs for the treatment of heart failure. This course provides an essential component of the educational process for obtaining the statistical power of experimental observations in both basic and clinical investigations, for assessing the outcomes of novel therapies, and for dissecting the complexities of genetic and environmental effects

BCMP234: Cellular Metabolism in Human Disease (Spring G1 Year)

This course explores the relationships between cellular and organismal metabolism and human disease, and uses a combination of lectures, critical reading conferences, and patient encounters to explore the molecular basis for human metabolic derangements ranging from starvation to diabetes. The course meets three times per week, and includes lecture sessions (typically on Mondays), student-led critical reading conferences with expert faculty (Wednesdays), and classroom-based patient encounters and/or therapeutic correlations on Fridays. Lectures focus on key metabolic pathways, including: biochemical mechanisms for the uptake and metabolism of glucose; the transport and transformation of lipids and lipoproteins; metabolism of calcium, iron, nucleotides, prostaglandins and fatty acids; and the organismal pathways involved in starvation, satiety and obesity. Examples are drawn from human genetic and acquired diseases that involve these pathways. Critical reading conference sessions explore metabolic pathways both at the molecular and cellular level and in the context of specific organ systems and disease states. These critical reading conferences review selected research papers in human metabolism and disease states, including diabetes, hypercholesterolemia, obesity, and starvation. The connections among metabolic pathways, clinical therapeutics and human disease are also explored. The lecture and conference sessions are integrated with clinical encounters, including direct patient interactions in the classroom. These patient encounters also review the application of molecular principles to diagnostic and therapeutic strategies in the management of these metabolic disorders. Student presentations in later weeks of the course review additional metabolic pathways in human inborn or acquired metabolic diseases, the roles of vitamins as enzyme cofactors, as well as the impact of metabolic diseases on specific organ systems. Class meets at HMS on Mondays, Wednesdays and Fridays, 9-10:30 AM. Monday lectures are presented in live interactive videoconference format from HMS (Countway Library, room 403) to and from the Harvard College campus (Division of Continuing Education, 1 Story Street, room 304). Wednesday critical reading discussion sections are held at HMS and in Cambridge, with specific rooms to be determined. Friday clinical correlations are held only at HMS in the Cannon Room (Building C) and are not videoconferenced to Cambridge.

HT035: Principles and Practice of Human Pathology (Spring G1 Year)

This semester-length course in the spring term of G1 year offered by the Harvard-MIT Health Sciences and Technology (HST) Program provides a comprehensive overview of human pathology, with emphasis on mechanisms of disease and modern diagnostic technologies. Topics include: general mechanisms of disease (inflammation, infection, immune injury, host response, transplantation, genetic disorders and neoplasia); pathology of lipids, enzymes and molecular transporters; pathology of major organ systems; and review of diagnostic tools. The course has integrated lectures and labs, as well as a student driven term project.

BCMP235: Mechanisms of Disease: Physiology and Pharmacology (Fall G2 Year)

This new course presents fundamental mechanisms of human disease and the mechanisms of action of drugs and drug classes used to treat human disease. Using a combination of interactive large-group lectures, case-based small-group tutorial and critical reading discussions, and clinical presentations and large-group discussions, the course is organized around 6-7 core disease mechanisms and the therapeutic strategies used to intervene in human disease pathways. Core principles of human physiology and molecular approaches to drug discovery are also presented where appropriate, although the major focus involves systems-level physiology, pathophysiology, and pharmacology.

The course is organized as a series of two-week modules covering the major mechanisms of human disease and drug action. Examples are drawn from cancer biology, infectious disease mechanisms, autoimmune disease mechanisms, cardiovascular disease mechanisms, reproductive disease mechanisms, and degenerative disease mechanisms. The course meets three times per week, and will include interactive lecture sessions, case-based small-group tutorial and critical reading discussions, and clinical presentations and discussions. Lectures focus on key mechanisms of human disease — such as signaling derangements in cancer, host-pathogen interactions in infectious diseases, and electrophysiologic abnormalities in cardiac arrhythmias — and fundamental mechanisms of drug action — such as drug-receptor interactions, drug metabolism, and drug resistance. Small-group discussions use clinical scenarios to frame the analysis of disease mechanisms and drug action from the molecular to the systems levels, and include critical reading of selected research papers in human physiology, pathophysiology, and pharmacology. Large-group discussions will evolve from live interviews of patients in the classroom setting, and explore not only the clinical aspects and therapeutics of the diseases but also the application of molecular principles to diagnostic and therapeutic strategies used to manage these disorders. Lectures and small- and large-group discussions are supplemented with case studies focused on the discovery and development of drugs for specific therapeutic areas. Meeting time: M., W., F., 9-10:30, fall semester.

Clinical Experiences for LHB Students

Two courses will permit LHB PhD students to directly encounter the practice of medicine, from the viewpoint of a physician and a patient. One of the following two courses is required, and students can elect to take both courses. The Disease-Centered Tutorial and Clinic will take place one half-day each week during the summer between the 1st and 2nd graduate school years. Each weekly session will be organized around a clinic at one of the HMS affiliated hospitals with a one-hour tutorial (led by a physician-scientist member of the LHB faculty) that highlights the scope of medical problems being addressed in the particular clinic, after which the students will “shadow” a physician-scientist as s/he evaluates the patients in the clinic. Each week throughout the summer, up to two students will participate in a given clinic and include: AIDS Clinic (MGH), Breast Cancer Clinic (DFCI), Vascular Medicine Clinic (BWH), Metabolic Diseases Clinic (CHMC), Movement Disorders Clinic (BIDMC), Colon Cancer Clinic (MGH), and Sickle Cell Clinic (BWH), among others.
An alternative clinical experience is the Mentored Clinical Casebook Course (MCCB), to begin in November/December of Year 2 and to continue through May of Year 2. A clinical mentor selects a patient for the each student to follow closely for six months. The student learns about the patient’s disease, its biological determinants, its interplay with the patient as person, and how it effects and is affected by the patient’s environment. Students keep a journal of their encounters with the patient, including self-reflections, and select some aspect(s) of the case of particular interest. In addition, since MCCB is an elective for first year medical students, graduate and medical students are joined together in small group sessions focused on discussions of their patients. In consultation with the clinical mentor and an additional faculty advisor, students write up their case in a progressive fashion. They then present their case to course faculty and students.

Additional courses

Several new Quarter Courses and Nano Courses are being developed that are focused on specific human diseases, including courses (for example) on Diabetes, Amyloidosis, and Atherosclerosis, among others. The Quarter Course and Nano Course formats are ideal for the presentation of core concepts in specific human disease states, and for the exploration of connections between basic biological concepts and the diagnosis, treatment, and prevention of disease. Additionally, a broad range of elective courses are available that span topics from biomaterials and tissue engineering to cancer biology to advanced biostatistics. Suggestions of some electives can be found on the LHB web site, and through the web sites of the HST, HMS, DMS, and other HILS Programs. In addition, courses at MIT can be considered.

Paracurricular Activites

In addition to these courses, LHB students are involved in ongoing paracurricular programs, including a monthly dinner seminar/career planning series. Along with the Harvard MD-PhD Program, there will be a monthly dinner seminar “LHB/MD-PhD Grand Rounds” featuring a lecture and discussion led by MD-PhD and LHB students under the mentorship of LHB faculty. LHB students attend selected Medical Grand Rounds presented by investigators who pursue work using approaches related to Human Biology and Translational Medicine. Students and faculty from the LHB program may participate in an annual day-long retreat (open to all interested students and faculty) that will highlight distinct aspects of translational research in different years.