Creation of a novel, interdisciplinary, multisite clerkship: "understanding lupus"

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.