Fancy a bit of Harvard?

Welcome to (probably) the best medical school in the world. Now, let’s get on with what really matters.

“There is absolutely no difference between statistics and gambling” says Prof. John Orav. Just maybe a little bit or money…. and gambling is more addictive I believe.

Statistics class has moved from the dryness of a fine white wine to that of a biscuit barrel (assuming there’s a log regression for that).

However, one cannot criticise the teaching dedication, availability or detail. EVERYTHING is worked through step by step, no assumptions, no brushing over. I think that’s where much statistic teaching leaves people only half way. Not here though with two hours of statistics everyday. For such a clever guy he is really happy to spell it out.

“…and so why is it important to understand this derivation of the F-distribution in testing if (sigma)x = (sigma)y ? ….. it’s not….. just make the right decision regarding the degrees of freedom and let SAS do the rest.”  Hey, still nice to know.

For those who couldn’t give a monkeys but would like to sound they do – here’s today’s statistic tips for continuous data:

a. Validity before Power. That applies to politicians too.

b. Normality is a relative term. Don’t assume anyone or anything is normal. When you run Shapiro-Wilk you will find nothing is normal.

c. Central Limit Theorem deals with everything if n is large anyway. Wahey. (If n>200 the T distribution will be essentially  Z. Yeah, 200 is a great number. I love 200 man).

d. N is small? Wilcoxon gets you home  and dry for a two way analysis (okay, you may have dropped a bit of power on the way but you are home and dry)

They take research seriously here and the publications prove it. No less on the teaching.

Many of the lectures are observed by the other course directors and the major modules have ‘office hours’ every day – open access to discuss with the lecturers any thing you want plus individual 1:1 slots bookable online with practically everyone on faculty so you can get someone to pull your project apart before actually standing up. Granted, some of the associate professors look like they are 18 but a review of their publications soon dispels this. I kind of like it how they often use their own publications to prove the concepts – New England Journal of Medicine…..of course.

The Program for Clinical Effectiveness is essentially the fundamentals of f 1/3 of the Masters in Public Health. You want to do research out here? You need an MPH or PhD or you won’t get a look in. MPH is not what I thought back home. That probably explains why this building is 10 floors at the heart of the medical school and not some poxy department no one has ever seen before.

This is where you learn the tools for clinical research. Lots of the faculty are profs at Brigham and Womens, Mass General and Beth Israel.  No surprise then that 75% of the guys on this course are from the surrounding Harvard hospitals about to start or complete their specialty fellowship. A lot have funding from their department to complete the MPH. Anyone got a bit of spare wonga and I’ll be more than happy to finish the remaining modules.

A common theme. “So what do you do then?”  “Well I’m a Paediatric Neurological Oncological Pharmacologist. What do you do?” “Oh, I’m a GP.” The only GP in this entire building as far as I can see.

Specialists rule here but people are beginning to realise the shortage of GPs means the ship is starting to keel. Hey, one more GP and the risk ratio will be (just about) halved.

What is helpful is the assignments are really applied and you get to find out what everyone else is doing. In fact the idea is after you have got your grant proposal assignment sorted, you get the grant, do the research and publish it. A lot of it’s pretty niche specialised stuff but the methodology and analysis applies across the board.

Next class, measuring patient centred health outcomes. If you don’t know the difference between an SF36 and EQ5D then go and grab a cup of tea.

What it’s really like in Boston

Apparently Boston ranks the 3rd snobbiest in the USA, has the best baseball team, regularly produces presidential candidates and is usually under 4 feet of snow for most of the winter.

For the newbee to town though it’s the tube or “The T” (for transport not tube) that best reflects Bostons true nature. Every other advert is literally a university or a health related trial. “Do you have a persistent issue about your appearance? Are you always thinking about how you look? Then please consider signing up to our study on body image at Massachusetts General”. Funnily enough I don’t have that problem but would be happy to help spend your excess research money on a less vain cause. Commuters are clearly more polite than in London and stand in line reading books I never go near including plato, latin for beginners, reaching your inner self and the odd novel. The tube driver may amicably coach passengers at peak time and can be heard in the train AND on the platform. “Patient folks, let the guys off first, we gotta packed train so move on down. Have a 5 star Friday and don’t let anyone get ya down”.

 

The average Bostonian looks about 29, is well groomed, wears smart casuals

 

Harvard College

Harvard College (Photo credit: Wikipedia)

 

and looks pretty healthy. It’s Brighton meets Oxbridge – an eclectic mix of postmodern individuals and academia. No fake eyelashes here and if you are wearing North Face you are certainly no scally. Indeed there are 35 universities or colleges in the Boston area. Harvard itself was founded in 1636 – pretty old for America. An undergraduate education here is often cheaper than expected due to the large amounts of scholarships provided. Income meets expense of over $3 billion a year.  About  6,000 undergrads and 14,000 post grads so do the sums. Assuming you can speak latin, have been doing algebra from aged 5 and one’s parents have an income less than $150,000 (America – you don’t know how rich you are!) you can apply for a scholarship. More than 60 percent of Harvard College students receive scholarship aid, and the average grant this year is $40,000 meaning such parents are paying less than the  UK counterpart – averaging $11,000 a year. Those on low incomes can get through this place for nowt.

Indeed you don’t have to go far to find a ‘genius’. I attended a charity classical concert ‘thrown together by a guy who had cancer’.The people playing were pros of the highest degree (how does one get a doctorate in violin performance anyway?) and if you hadn’t completed a 30 hour triathlon that morning, played with REM or written a number of electrical engineering bestsellers too – then who the heck are you! Not a bad night out for $25.

 

Boston is ‘the walking city’ and yep, I’ve done my fair bit in between the T. As a result obesity appears less prevalent while everyone is frantically eating organic food off farmers markets and recycling. I’ve already been skinned at ‘whole foods’ – where’s Aldi when you need one?

Right now where is that Health Outcomes Research book?