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Boston Globe

Does Harvard need a medical school?

While considering a response to this situation, my nine years as dean of HMS remind me that the school is an institution that is poorly understood within the Harvard community. Thus, a brief primer on the country's top medical school may be useful. Advertisement Founded in 1782, HMS is the third oldest US medical school, was Harvard's first graduate school, and has long been the HMS has a complex organizational structure. Most of the 160 US medical degree-granting medical schools are associated with universities, but relationships vary. Stanford University, Johns Hopkins University, the University of Pennsylvania, and many other universities own both their medical schools and associated hospitals. Others resemble Harvard, where the medical school is part of the university but the hospitals are independent corporate entities, linked to the school by affiliation agreements. These stipulate shared educational activities and terms by which HMS faculty employed by hospitals are appointed, promoted, and subjected to medical school policies. Advertisement The foundational goal of HMS is to educate and graduate 165 students per year who emerge with medical degrees after completing a four-year curriculum combining preclinical education with hospital-based clinical training. HMS has HMS is also internationally recognized for the research of its faculty, who are employed by either HMS or HMS-affiliated hospitals and institutes. Approximately 325 faculty employed by HMS are deployed in various departments on the HMS quad, the informal name for the Harvard-owned campus on Longwood Avenue in Boston. These faculty are recruited through highly competitive searches, and their research is kickstarted with generous startup funds. The National Institutes of Health is the largest funder of ongoing research, with approximately $234 million being awarded to HMS in 2024. Many more HMS faculty are employed by the affiliated hospitals and institutes. Most provide clinical care and education, but several thousand with MD, PhD, or MD/PhD degrees primarily conduct research, from fundamental science to research in every disease area. This occurs in hospital facilities, funded by grants awarded to the hospitals. The combined grant funding to HMS affiliates is three to four times greater than that awarded directly to all Harvard schools. A small number of affiliate-based faculty also hold appointments in quad departments. One prominent example is recent Nobel Prize recipient Advertisement This relationship allows Harvard to receive recognition for the achievements of faculty at the quad and hospitals, while hospitals and their faculty benefit reputationally from association with the Harvard brand. What accounts for many Harvard faculty being poorly informed about the medical school and its faculty? The first issue is numerical. Nevertheless, a There are other differences between HMS hospital-based faculty and those at the quad and other Harvard schools. Few of the former are hired on what is called an up-or-out tenure clock, where employment ends if professorial tenure isn't granted after a specific period. So many remain for years at assistant or associate professor ranks. In addition, when HMS affiliate-employed faculty are promoted to full professor by a rigorous Harvard-managed process, they have tenure of title, meaning they hold their title indefinitely; but unlike professors at the quad and elsewhere in the university, they lack financial tenure that provides indefinite salary commitment. These differences lead some to conclude that HMS is not really a Harvard school. Advertisement This thinking works against Harvard's interests. At a moment when medical science and health research are seen as increasingly important, the entire HMS ecosystem is, despite its organizational complexity, a critical Harvard asset. And when the fuel enabling this research is held hostage to punish the university for alleged flaws largely unrelated to HMS, questioning the importance of HMS to Harvard is a serious strategic blunder. To remain a world-renowned modern university, Harvard must continue research at HMS, its affiliates, and across the university. The humanities, many social sciences, and research-light Harvard schools might continue without external funding. But the mission of HMS and its affiliates developed over the past 70 years in collaboration with federal research funding. The focus of our common struggle should be preventing this success from being terminated by misguided government actions. To effectively defend our incredible ecosystem requires a clear-eyed understanding of what HMS is, how it contributes in multiple ways to the academic culture of Harvard and the welfare of society, and why this vital relationship must continue if Harvard wishes to remain a great university in the century ahead.