NIH's Demystifying Medicine:
What makes this class so effective?

Jeffery Loo, NLM Associate Fellow
http://www.jeffloo.com
February 2005

The National Institutes of Health offers a class to explain medicine for PhD scientists. Known as "Demystifying Medicine", the course bridges the gap between biological research and their clinical application to major human diseases. Each week there is a 2-hour lecture, with a new illness for discussion. The lecture is divided between two speakers: one gives a talk on the clinical perspective, followed by another speaker's discussion of the research domain. The lectures are given by distinguished clinicians and researchers from the NIH and outside institutions.

Currently, I am taking this class, and I think it is great. I am a medical librarian without a clinical background and little experience in biological research. I was initially afraid that the lectures would be over my head. However, after my first class, I was surprised at how much I was able to learn. Though it bills itself primarily for PhD scientists and students, I believe "Demystifying Medicine" can speak to a diverse audience of clinicians, medical students, librarians, and the general public.

This class is fun and informative. I also think it serves its purpose of bridging clinical practice with bench research. Below, I outline my reasons for this class's success.

Research and clinical practice are discussed together
These two domains of treating human diseases are presented back to back in a single session. You can see their different perspectives and reflect upon their connectivity. Students may be inspired to interdisciplinary pursuits after seeing research problems from a different outlook.

Variety of interesting topics
From inflammation to transplantation and HIV to ALS, a variety of topics is covered in the 19 sessions of the class. Such diversity permits discussion of many issues in medicine and research, including clinical trials, public health, ethics, genetics, experimental design and more.

Wide spectrum of topics explored for each disease
The class provides a comprehensive overview for a disease by discussing many different topics. For example, the following topics were explored in the SARS lecture: history, virology, animal reservoirs, epidemiology, routes of transmission, diagnosis, differential diagnosis, therapy and prevention, mortality, nosocomial risk, infection control, institutional preparedness, future prospects, molecular epidemiology, animal models, vaccine efficacy, pathogenesis, and immunoprophylaxis.

Problem-based lectures with a methodology- and practice-oriented focus
In some lectures, students get a glimpse of how clinicians and research scientists problem solve in their work. You learn more than just the results of an experiment or intervention. Lecturers shed light on the thinking behind, the communication, the troubleshooting, and the feedback and consultation in their work.

For example, during the lecture on AIDS, we learned how physicians initially responded when this disease first appeared in humans. We also learned about the initial work towards treating AIDS and conducting research on the disease. In another class, we were given a detailed case report, which outlined the clinician's thinking and also identified clinical errors. From our malaria class, we learned how vaccines were discovered, and about the process towards developing vaccines.

Addressing interests in translational medical education and research
There are many who could be interested in the boundary crossing nature of this class. They include the PhD scientist seeking clinical experience, the MD interested in performing basic research, and the MD/PhD.

In addition, students can explore different medical career options through the lectures, such as the bench-to-bedside route or the 'physician-scientist' role. The demand for MD/PhDs in such positions has been high (Naturejobs 424, 1090 - 1091 (28 August 2003)).

Wide ranging and critical issues for discussion
Occasionally the class covers issues that extend beyond the usual domains of clinical practice and basic research. Ethics, legislation, funding, and policy have been explored in the lectures. From this wide range of topics, the student sees the medical efforts which exist outside of the lab and clinic.

Speakers distinguished in their fields
The speakers are experts in their field and are enthusiastic about their talks. Their expertise permits them to answer a wide range of questions.

Educational tone
The classes include more than straightforward presentations of current research and experimental results. There is an educational nature to the lectures. Speakers provide reviews of the subject, explaining to an audience who may have little familiarity. Also, students are provided a preview of the lecture through recommended readings e-mailed before class.

A moderator knowledgeable in the clinical and basic research fields
The class's organizer and moderator, Dr. Irwin Arias, is a professor of physiology and medicine at Tufts University. He is a researcher in liver biology and pathobiology, and was trained as a physician. Dr. Arias is familiar with both the clinical and research domains and offers his comprehensive knowledge in arranging the class and facilitating the question period.

A short informative introduction to the disease
The moderator begins each lecture with a brief introduction. The disease's impact is described, occasionally outlining its mortality effects, economic costs, and socio-cultural influence. The introduction highlights the need for research, and brings up related issues on public health, policy, funding, and more.

Course materials available online
A course website provides online access to the presentation slides, readings, and speaker biographies. The lectures are also recorded and available as streaming video for viewing on the web. The class is much more accessible with these online resources. It is easy to catch up if you miss a lecture, and you are able to review the material.

The Demystifying Medicine course is offered at the National Institutes of Health, through its FAES graduate school (Foundation for Advanced Education in the Sciences, http://www.faes.org). The class is based on a widely popular course created at Tufts University School of Medicine.