[ Winter 2008 ]
In her installation speech as President of Harvard University in October, Drew Faust reflected on the special quality of universities, stating that “The essence of a university is that it is uniquely accountable to the past and to the future—not simply or even primarily to the present.” Obviously, the clearest representatives of the future are our students. With all the important research we do at the School, from fundamental science, to population health, to social and policy sciences, it is important to recognize how central our students are to the mission of the Harvard School of Public Health (HSPH), and how vital to our intellectual and community life.
This was brought home to me when, in the final week of Ramadan, I had the privilege of being invited by the School’s Muslim students to participate in the last Iftar, the traditional feast at the end of the day of fasting. In addition to finding it a wonderfully moving and rewarding experience, I was also deeply gratified that students from 16 countries on four continents, now studying and training not only at HSPH but also at the Harvard Medical School and its affiliated hospitals, had chosen to come together at our School for prayer, reflection, and a shared community experience. The spirit of Ramadan was beautifully explained by one student, and the occasion provided a special opportunity for informal and extended conversation, in which I was impressed with the eagerness of every student to make a difference in the world. Once again I was struck by the profound seriousness of our students, by their appreciation of the opportunity that they have received to study here at Harvard, and by the sacrifices they have made to come to our School, in many cases traveling great distances, interrupting careers, and temporarily leaving families behind.
Financial aid: A top priority
Non-loan forms of financial aid—that is, scholarships and federally funded training grants, which students need not repay—have increased an average of five percent a year for the last five years at HSPH. Still, fewer than half of all HSPH students now receive such aid, and the average total higher-education debt per graduating student is $68,000.
HSPH’s financial aid goals for this decade are:
To guarantee full tuition and a stipend to the top 10 percent of doctoral and masters degree students;
To meet the financial needs (after considering student resources) of masters and doctoral degree students from developing countries; and
to meet the financial needs of socio-economically disadvantaged masters and doctoral degree students from the United States.
Rethinking our curriculum
This year we have devoted a great deal of thought to our students and our educational programs. Among the new initiatives is a rethinking and revision of the curriculum as well as modes of teaching and learning. We have unified all educational programs under a single office led by two co-associate deans for Educational Programs and extraordinary teachers, Nancy Kane, professor of management, and Nancy Turnbull, senior lecturer in health policy.
For accreditation purposes, our curriculum has long required that professional students satisfy five major course-distribution requirements, specifically epidemiology, biostatistics, environmental health, social behavior, and health policy and management. However, the Institute of Medicine has urged schools of public health to consider an additional set of competencies, including informatics, communications, cultural competency, global health, policy and law, and ethics, all of which we at HSPH work hard to integrate into our training. There is, I believe, one overarching competency more important than any of these, and that is real-world problem-solving.
Albert Einstein once defined education as “what remains after one has forgotten what one has learned in school.” What I most hope students will acquire at HSPH is the ability to solve new and emerging problems in public health and beyond. We are committed to introducing more active problem-solving into our curriculum, adopting in some courses the “case method” used so successfully at Harvard’s business and law schools. In this approach, already used in a number of courses, students are asked to tackle actual problems of public health by analyzing conflicting data, debating points of view, fostering teamwork among people who think differently, and making timely, difficult decisions on the basis of incomplete information while also learning to exercise leadership. This is an exciting educational experiment.
Engaging in the World
If problem-solving is a top priority, then clearly we must enable our students to travel to the “real world,” taking advantage of internship opportunities in order to see and to engage in the major problems of public health around the world today. Such travel has been made possible through the expansion of Winter Session faculty-led trips, with destinations that this year that will include Bangladesh, Brazil, Chile, China, and India.
An important gift received in 2005 by HSPH from the Michael and Louisa von Clemm Foundation is providing support for traveling fellowships for our students. Last summer, these funds enabled 29 students to engage in research in 20 countries. All returned to the School this fall greatly energized by intensive, often life-changing learning experiences that included, for example, combating HIV/AIDS at the Meheba Refugee Settlement in Zambia, evaluating the cost-effectiveness of intermittent preventative treatment for malaria in pregnant women in Mozambique, improving maternal and child health in Kabul, Afghanistan with the Harvard Humanitarian Initiative, and combating the sex trafficking of women and girls in Bangladesh.
Bank loans, financial crises
A few more words about our students—and their sacrifices. When we compare admissions statistics across all U.S. schools of public health, it is gratifying to find that, of students admitted to HSPH and other leading schools, at least two out of three choose to pursue their studies with us. Currently HSPH has 834 students in five degree programs. Of those in our MPH program, all have, or will have, a medical or other advanced degree. In addition, 175 are enrolled as PhD candidates through the Graduate School of Arts and Sciences. About 250 students will receive the MS degree, while a similar number will earn DSc or DPh degrees. In this year’s fall class, 35 percent of our students are international, coming from about 60 countries. To make all of this possible, we have set a high priority on increasing financial aid and scholarships to as many top students as we can. While I am pleased to say that this year, we have increased financial aid from School and University sources by 21 percent, I regret that School funds could provide grants to fewer than half of our students. The support we provide represents, on average, only about half of tuition costs.
Each year we receive many letters from students all over the world expressing both appreciation for their having been admitted, and profound regret that they cannot afford to enroll. Others come to Harvard already heavily laden with debt. This was the case with one medical school graduate from China, who took out a bank loan to come to Harvard. Fortunately, what she describes as a “financial crisis” was relieved when she was named a Cabot International Scholar, thanks to the Cabot family, which has funded scholarships at HSPH since 2002. Another Chinese student informed us that, although he was pleased to have been accepted by HSPH, he was obliged instead to weigh offers from six other universities that were more attractive financially. Fortunately, we succeeded in bringing him to Harvard with a Martignetti Fellowship, established by Carmine and Beth Martignetti to attract top students who simply could not otherwise afford to train here.
Unfortunately, the burden of debt—often tens of thousands of dollars—is a sacrifice many of our students must make, and of which we are painfully aware. It is my view that if we aspire to be the best school of public health in the world, we must attract the very best of all students—those most likely to make a difference in the world. And that will require significantly greater resources than we currently have for financial aid.
Friends of the School often ask me why they should invest in the Harvard School of Public Health, given that Harvard University is so well endowed. My answer is invariably this: we are asking them to invest, not in Harvard, but in our shared future. Reflecting on Albert Einstein’s famous statement that compound interest was “the greatest mathematical discovery of all time,” it is my view that there is no compound interest ultimately as rewarding as education. I would also add that few academic pursuits make as great a difference in as many people’s lives around the world as does public health.