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Creation of a Novel, Interdisciplinary, Multisite Clerkship: “Understanding Lupus”

Nambudiri, Vinod E. MD, MBA; Newman, Lori R. MEd; Haynes, Harley A. MD; Schur, Peter MD; Vleugels, Ruth Ann MD, MPH

doi: 10.1097/ACM.0000000000000142

Few medical school electives include longitudinal patient care across clinical specialties and environments. Systemic lupus erythematosus represents a disease process with complex pathophysiology for students to learn from providers across medical fields, including dermatology, rheumatology, nephrology, and cardiology, in both pediatric and adult patients. Diagnosis, understanding, and management of lupus also rely heavily on basic science and clinical immunology, providing a link to the preclinical curriculum. In 2009, Harvard Medical School introduced a one-month elective course “Understanding Lupus: A Multidisciplinary Approach to Systemic Disease,” designed to provide students with both outpatient and inpatient care experiences in dermatology, rheumatology, and multidisciplinary clinics at Brigham and Women’s Hospital and Boston Children’s Hospital. Core components of the elective include a continuity experience that allows students to attend one patient’s multiple specialist visits; didactics from dermatology, rheumatology, and immunology covering evidence-based medicine and basic sciences; and clinical immunology laboratory exposure to teach serologic and auto-antibody testing methods. The authors provide lessons learned in the development of this interdisciplinary, multi-institution elective rotation, which may serve as a model at other medical schools for incorporating basic sciences into the clinical curriculum and using multidisciplinary care and varied educational settings.

Dr. Nambudiri is a resident, internal medicine and dermatology, Brigham and Women’s Hospital Department of Medicine and Harvard Combined Dermatology Program, Boston, Massachusetts.

Ms. Newman is principal associate in medicine, Harvard Medical School; and director, Office of Professional Development, the Center for Education, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Dr. Haynes is professor of dermatology, Harvard Medical School; and vice chairman of dermatology, Brigham and Women’s Hospital, Boston, Massachusetts.

Dr. Schur is professor of medicine, Harvard Medical School; and codirector, Lupus Center, Division of Rheumatology, Allergy, and Immunology, Brigham and Women’s Hospital, Boston, Massachusetts.

Dr. Vleugels is assistant professor of dermatology, Harvard Medical School; associate director for education and director, Connective Tissue Disease Clinic, Brigham and Women’s Department of Dermatology; and codirector, Rheumatology-Dermatology Clinic, Boston Children’s Hospital, Boston, Massachusetts.

Funding/Support: The support of the Rabkin Fellowship in Medical Education at Beth Israel Deaconess Medical Center and Harvard Medical School is acknowledged for aid in the development of this course curriculum. Dr. Vleugels' career has been supported by a Medical Dermatology Career Development Award from the Dermatology Foundation.

Other disclosures: None reported.

Ethical approval: The Harvard Medical School institutional review board granted a waiver of IRB exemption for the use of deidentified student quotations for use in publication.

Previous presentations: This work was presented in part at the HMS Medical Education Day, October 26, 2010, Boston, Massachusetts; the Dermatology Teachers Exchange Group Meeting, October 14, 2011, Chicago, Illinois; and the American Academy of Dermatology Annual Meeting March, 17, 2012, San Diego, California.

Correspondence should be addressed to Dr. Vleugels, Department of Dermatology, Brigham and Women’s Hospital, 221 Longwood Ave., Boston, MA 02115; fax: (617) 582-6060; telephone: (617) 732-4918; e-mail:

© 2014 by the Association of American Medical Colleges