Letters to the Editor
In Reply to Crapanzano:
We read with interest Dr. Crapanzano’s letter and celebrate her advocacy. We support her conclusion that longitudinal integrated clerkships (LICs) are powerful tools for addressing learners’ needs1,2 and health system needs.2–4 Indeed, Berwick and Finkelstein3 highlighted LICs as a promising trend to improve the output of the health system, and for years the literature has noted LICs’ workforce benefits.4 LICs may specifically address Dr. Crapazano’s concern about increasing the workforce of psychiatrists in particular.5 A new analysis in Academic Psychiatry concludes, “Longitudinal integrated clerkship experiences are effective and sustainable; they offer particular strengths and opportunities for psychiatry education, and may influence student choice of specialty.”5
David Hirsh, MD
Director and cofounder, Cambridge Integrated Clerkship, Harvard Medical School, Cambridge Health Alliance, Cambridge, Massachusetts; firstname.lastname@example.org.
Todd Griswold, MD
Psychiatry liaison/director, Cambridge Integrated Clerkship, Harvard Medical School, Cambridge Health Alliance, Cambridge, Massachusetts.
1. Hirsh D, Gaufberg E, Ogur B, et al. Educational outcomes of the Harvard Medical School–Cambridge integrated clerkship: A way forward for medical education. Acad Med. 2012;87:643–650
2. Hirsh D, Walters L, Poncelet AN. Better learning, better doctors, better delivery system: Possibilities from a case study of longitudinal integrated clerkships. Med Teach. 2012;34:548–554
3. Berwick DM, Finkelstein JA. Preparing medical students for the continual improvement of health and health care: Abraham Flexner and the new “public interest.” Acad Med. 2010;85(9 suppl):S56–S65
4. Verby JE, Newell JP, Andresen SA, Swentko WM. Changing the medical school curriculum to improve patient access to primary care. JAMA. 1991;266:110–113
5. Griswold T, Bullock C, Gaufberg E, et al. Psychiatry in the Harvard Medical School–Cambridge integrated clerkship: An innovative, year-long program. Acad Psychiatry. 2012;36:380–387