Steven Pearson, MD, MSc
Senior Scientist, Department of Bioethics, National Institutes of Health
1978-1982, BA in History and the Honors Program in Humanities, Stanford University
1983-1987, MD, University of California San Francisco School of Medicine
1987-1990, BWH/HVMA Primary Care Residency Program
1990-1992, MSc, Harvard University School of Public Health and Fellow, Harvard Medical School Faculty Development Fellowship in Internal Medicine
2004-2005, Senior Visiting Fellow, Atlantic Fellowship in Public Policy, National Institute for Clinical Excellence, London, England
Senior Scientist, Department of Bioethics, National Institutes of Health and Special Advisor to Medicare on Technology and Coverage Policy
Associate Professor of Ambulatory Care and Prevention, Harvard Medical School
My relationship with the BWH/HVMA residency stretches from the first day of its existence (and of my internship) in 1987, through intervening years when I taught in the residency and eventually became its Director, to the continued defining influence it exercises on my career and indeed my life. Briefly stated, I can say that the program has always breathed a sense of innovation, of real leadership, and of a focus on a future of population-based health care that is yet rooted in the absolutely primary relationships: relationships between patient and doctor, between resident and preceptor, and among the residents themselves. The residency helped me LOVE taking care of patients as their primary care doc; taught me how to do it well and how to enjoy it. Practicing side-by-side with my preceptor was the greatest learning experience I had in residency.
The residency also opened my eyes to the emerging research and policy development associated with quality of care within health systems, and with the clin epi and Leadership and Management seminars I felt particularly well prepared to enter the Harvard Gen Med research fellowship, leading to a research faculty position in the DACP at Harvard. My early research included studies of clinical guidelines and evolved toward considerations of managerial and ethical concerns of health systems trying to set priorities and allocate resources within limited resources. I was extremely proud to add the role of Director of the residency program to my activities when the opportunity arose.
After several years I made the very difficult decision to leave my role as Director in order to take advantage of an Atlantic Fellowship, moving to London for a year with my family to work in health policy with senior leaders of the British National Health Service. As an outcome of that work I was asked to come to Washington and serve as a Special Advisor to Medicare and the NIH on coverage policy for new medical technologies. I remain in Washington on leave from my position in the DACP, but continue to feel closely linked both to the department and to the residency. The BWH/HVMA program trained me, cared for me, and started me off in a career of exploring the links between caring for patients and caring for populations. I honestly don't think there was, or is, another program in the country that offers so much.
Thomas Sequist, MD, MPH
Assistant Professor in Medicine, BWH and Harvard Medical School
Primary Care Physician, HVMA
Assistant Professor in Health Care Policy,
Harvard Medical School, Department of Health Care Policy
1991-1995, Bachelor of Science, Cornell University
1995-1999, MD, Harvard Medical School
1999-2001, Primary Care Residency, BWH/HVMA Primary Care Program
2002-2004, Fellow, Harvard Medical School General Internal Medicine Fellowship
2004, MPH, Harvard School of Public Health
Primary care physician, Harvard Vanguard MedicalAssociates (Kenmore Square practice)
Assistant Professor in Medicine, Brigham and Women's Hospital, Harvard Medical School
Assistant Professor in Health Care Policy, Harvard Medical School, Department of Health Care Policy
I had a wonderful learning experience as a primary care resident at the Kenmore Square practice. I feel that I learned what it was truly like to practice as a primary care physician, receiving the complete support of my mentor during these important three years. I am extremely pleased with my choice of residency program, as it has allowed me to grow both personally and professionally. The biggest advantages that this program offers are the ability to practice "real world" primary care medicine, combined with the opportunity to experience a culture of medicine that is truly innovative, where everyone in the system actively participates as part of a team to improve patient care using inventive methods.
My current position is primarily a joint research appointment working with the Brigham and Women's Hospital Division of General Medicine, Harvard Medical School Department of Health Care Policy, and Harvard Vanguard Medical Associates. I am primarily interested in quality improvement and health disparities, and enjoy the diversity of the patient panel that I care for at the HVMA Kenmore Square practice. My patients come from a variety of backgrounds, with many languages spoken, and the complexity of diseases is always challenging. HVMA has provided a continual learning source for me since residency graduation, and serves as a model for how large health care systems can effectively manage a diverse patient population with complicated medical problems.
I am actively involved in federally funded research efforts at HVMA to understand how to improve health care for all patients, regardless of background. I plan to continue this work for many years to come.
Thomas Lee, MD
VP Product Management, Epocrates
President, Metropolitan Medical Group
1986-1990 BS in Biology, Yale University
1990-1994 MD, University of Washington School of Medicine
1994-1997 BWH/HVMA Primary Care Residency Program
1997-1999 MBA, Stanford University Graduate School of Business
VP Product Management, Epocrates, San Mateo, CA
Former Chief Medical Officer, Editor-in-Chief, Epocrates (1999-2001)
President, Metropolitan Medical Group, San Francisco, CA
More than any other factor, the BWH/HVMA residency helped to define my ultimate career path. I had originally selected the program because I felt the training would shape me into an excellent primary care physician - one utilizing a unique blend of evidence-based rigor with community-based practicality. Though the program certainly met those expectations, the faculty also opened my mind to new concepts I had previously not considered important to the delivery of care. We were encouraged to think more deeply about issues related to interpersonal dynamics and systems of care. During our weekly afternoon sessions with faculty and peers, we discussed issues ranging from "the complicated patient" to "the idealized clinic," - concepts that ultimately inspired me toward my current career path.
After finishing residency, I decided to attend the Stanford Graduate School of Business, hoping to learn more about building better systems of care using information technology. After helping to start a handheld software company called ePocrates, I began focusing my attention toward building better primary care practices. My first medical group called Metropolitan Medical Group is a paperless, completely redesigned general medicine practice based in downtown San Francisco. Over the next few years, we expect to refine our operational and business model, ultimately hoping to build other "21st century practices" in California and, perhaps, nationally.
Kathy Rexrode, MD, MPH
Former Director, BWH/HVMA Primary Care Residency Program
Assistant Professor, Department of Medicine
Havard Medical School.
Brigham and Women's Hospital
1982-1986 BA in Religious Studies/Ethics, Haverford College
1987-1991 MD, Case Western Reserve School of Medicine
1991-1994 BWH/HVMA Primary Care Residency Program
1994-1996 Epidemiology Research Fellowship, Division of Preventive Medicine, Brigham & Women's Hospital.
MPH, Harvard School of Public Health
Primary care medicine (25%); Research and Teaching (75%)
Research on prevention of cardiovascular disease in women, with a special interest in the role of estrogens and androgens in cardiovascular risk among women.
Published widely on cardiovascular disease in women, including in JAMA, Circulation, and Stroke.
Trudy Bush Award for Cardiovascular Research in Women's Health
Married with two children
I very specifically chose the HVMA program for my training because I felt it offered unique opportunities in clinical training through attention to small group learning and specific curricular offerings. I loved my practice at HVMA Copley where I was really treated as part of the practice. Bill Taylor's clinical epidemiology course deeply influenced my own career in epidemiology research. The learning in small groups was key, as were the close bonds with the residents in my program--relationships that continue to this day.
My interest in women's health grew directly from my clinical experience at HVMA trying to provide evidence-based recommendations for my female patients and finding a lack of data. This drove my decision to develop research skills through a research fellowship to tackle issues related to prevention of cardiovascular disease in women. I would never have predicted that I would have found research so compelling, but the balance of clinical practice, teaching, and research has made my work immensely fulfilling. Co-leading the patient-physician relationships seminar has been one of my favorite activities ever since I started; I cannot think of another forum where such a range of topics are discussed. The sessions always leave me thinking about my own clinical practice and experiences. I am honored by the opportunity to be Program Director of this program-and am committed to maintaining a tradition of innovation, creativity and flexibility with a commitment to excellent clinical training.
Jamie Winshall, MD
In Memoriam - September 2005
Associate Physician, Division of General Medicine,
Brigham & Women's Hospital
Assistant Professor of Medicine, Harvard Medical School
1983-1987 BA Biology, Brown University
1988-1992 MD, Case Western Reserve University
1992-1995 BWH/Harvard Community Health Plan Primary Care Residency Program
Hospital-based primary care (50%); teaching (residents and medical students), administration, and other professional activities (50%), including:
Senior Editor, Harvard Health Publications
Chair, BWH Quality Assurance and Risk Management Committee
Clinician Advisory Committee, Harvard Pilgrim Health Care
Married to Gail Levine (an internist and former BWH primary care resident) with three kids.
Attend on the General Medical Service for four to six weeks each year.
Former duties include: Medical Director, BWH General Medical Service and Short Stay Unit; Associate Program Director, BWH/DGM Primary Care Residency Program; Member, Medical Residency Selection Committee
When my wife and I came to BWH as medical residents in 1992, there was only one residency program - the categorical program, with an optional primary care "track." People who chose this track were assigned to either the hospital-based clinic (BIMA/DGM) or what was then known as the Harvard Community Health Plan (HVMA). My wife chose BIMA/DGM, so I chose HVMA. I guess I haven't looked back since.
I worked in the Medford Center with several excellent internists as my preceptors -- Brian Casserly, Paul Feiss, Barbara Covey, Steve Paskal, Gio D'Ambrosia. I still think about things that they taught me - I find myself quoting them to residents that I now teach myself. Most of my preceptors managed to strike a great balance between academic rigor and a practical approach to patient care. In retrospect, I'm grateful for the fact that they were genuinely excited to share their knowledge and insights with me, but also for the fact that they treated me more like a junior colleague than like a trainee.
I developed great relationships with my patients, and the Medford support staff were always very friendly and helpful. Other residents thought I was crazy to drive out to Medford, but I never minded -- it was a pleasure to get away from the hospital. By the time I finished residency, I think I was better prepared to practice primary care than most of the people whose outpatient training was based at BWH.
One of the things I enjoyed most about the BWH/HVMA residency was the close relationship I developed with the other HVMA-based residents. We had a lot of fun, but we also took our education very seriously. I think the fact that we relied on each other to prepare most of the didactic sessions made us all better teachers, and learners too. I still keep in contact with many of the residents who were based at HVMA in the mid 90s.
Nassim Assefi, MD
Novelist and part-time Clinician-Teacher, Refugee Women's Health, Seattle, WA
1988-1991 BA in Biological Chemistry,
1992-1997 MD, University of Washington School of Medicine
1997-2000 BWH/HVMA Primary Care Residency Program
2000-2004 Junior Faculty in Women's Health, Departments of Internal Medicine and Obstetrics/Gynecology, University of Washington School of Medicine
My first novel, Aria has just been published by Harcourt. I'm currently working on my second novel, while volunteering at Harborview Medical Center's women's Clinic. From 2004-2006, I managed national health training programs in Afghanistan with NGO, Management Sciences for Health, with which I continue to work in an advisory capacity. Professional interests include health care of vulnerable women, including immigrants and refugees, survivors of domestic violence, sex workers, and women in the developing world. Hobbies include salsa dancing and writing fiction (held writing residencies at Hedgebrook and the Whiteley Center; my novel Aria was published in May).
The BWH/HVMA residency allowed me the freedom, support, and confidence to further explore areas in medicine that are on the fringes of primary care: international/refugee health, complementary and alternative medicine, and reproductive health (including training in pregnancy termination). HVMA is the perfect residency to facilitate the clinical and intellectual training of maverick physicians who think outside the box and envision careers beyond the conventional. Though HVMA is the residency for self-starters, it also provides solid primary care training for those who want to become community-based internists, academicians, or health care managers. It's graduate school-esque small seminar style maximizes the diversity of adult learning and creates an environment where strong friendships are instantly formed.
I have studied acupuncture and Xi Gong in China, meditation in Tibet, and Reiki in Boston. I subsequently became involved in many public health projects from Central America to the Middle East. After joining the University of Washington, I led two NIH-sponsored studies (acupuncture and Reiki for the treatment of fibromyalgia and chronic fatigue) and served as the Complementary and Alternative Medicine Liaison to the University.
Charles Morris, MD
Brigham Circle Medical Associates,
Brigham and Women's Hospital
1988-1992 BA, Princeton University
1995-1999 MD, Case Western Reserve University School of Medicine
1999-2000 Residency in Internal Medicine, BWH/HVMA Primary Care Program
2002-2003 Program for Clinical Effectiveness, Harvard Medical School
2002-2004 MPH, Harvard School of Public Health
2004-2005 Chief Resident, Department of Medicine, Brigham and Women's Hospital
Primary Care Residency Experience
My experience in the primary care program has a tremendous learning environment with emphasis on small group learning and small group teaching, a unique facet I didn't appreciate fully until I started in the program. My exposure to clinical epidemiology sessions in particular sparked my interest in quantitative methods and health services research, which I then pursued after residency. I appreciated the ability and flexibility to structure my senior year research experience longitudinally, setting the stage for a 2-year research position immediately following residency. I was richly rewarded with superb mentorship from my faculty preceptor who became my teacher, consultant, advocate and confidante.
After my residency training, I participated in the Program for Clinical Effectiveness and subsequently obtained my MPH at Harvard School of Public Health. I was a Fellow at the Academy at Harvard Medical School, where I was involved in several projects focusing on educational initiatives and reform at the clerkship level. I joined the faculty at the Brigham in the Division of Pharmacoepidemiology and Pharmacoeconomics doing health services research that focused on quality of care at the inpatient/outpatient transition and examining the interplay between pharmacoepidemiology and medical education. From 2004-2005, I returned to the residency program to serve as a Chief Medical Resident.
Following my Chief year, I joined the Brigham Circle Medical Associates as a general internist, and also have worked as an Assistant Program Director for the Internal Medicine residency program. Clinically, I practice as an Internist in the Brigham Circle group, as a teaching attending on the GMS services, and as a clinic preceptor in the ambulatory setting. I also remain involved in several medical education initiatives particularly around the intersection of medical education and information technology. In July 2008, I will assume new administrative responsibilities as I begin work as the Program Director for the Division of General Medicine Primary Care track, and become the Director of Ambulatory Education for the broader residency program.
Mary B. Barton, MD, MPP
Scientific Director, United States Preventive Services Task Force, Agency for Healthcare Research and Quality
1981-1985, BA in English, Yale College
1986-1991, MD, Harvard Medical School
1989-1991, Masters in Public Policy, Kennedy School of Government, Harvard University
1991-1994, BWH/HVMA Primary Care Residency Program
1994-1997, Fellow, Harvard Medical School Faculty Development Fellowship in Internal Medicine
Scientific Director, United States Preventive Services Task Force
I came through the Kenmore Center as a first year medical student, taking part in what was a new longitudinal introduction to clinical medicine curriculum. From that time on I was intrigued by the challenge of balancing stewardship of the health of a population with what is now called ‘patient-centered’ care. My experience as a primary care resident in the BWH/HVMA program gave me the chance to flesh out that challenge and explore what primary care within a health system could and should comprise. I relished each week the opportunity to leave the hospital walls (the smell of disinfectant, the bright lights) and spend a few hours with my preceptor, and ultimately with my own patients, in the Copley Center where primary care was the focus of the physical environment, the main concern of my colleagues, and the most important administrative priority.
My experience in the HVMA residency (both the formal teaching experiences and the clinical environment) was directly responsible for my next step, as a general medicine fellow in the Harvard program, located at what was then the brand new Department of Ambulatory Care and Prevention. As a fellow, using data from the computerized medical record system in use within HVMA, I learned about population research and epidemiology, while my ongoing clinical practice at the Copley Center brought me deeper and more meaningful relationships with patients. The value of the supportive teaching atmosphere of my clinical experience at Copley is impossible to overstate. When I joined the research faculty in the DACP, I was fortunate to be able to maintain my practice at Copley while I pursued research on breast cancer screening and other prevention-related topics.
I was lured to leave Boston and HVMA by a unique opportunity to work at the Agency for Healthcare Research and Quality with the US Preventive Services Task Force. My role with this expert group is to examine evidence and facilitate the creation and dissemination of evidence based recommendations on clinical preventive services. As part of the federal enterprise I am able to work with colleagues at the Centers for Disease Control and NIH to forward the research and policy agenda related to clinical prevention. As I look back, the special impact of my HVMA training and experience was in the unique combination of structure and freedom: the structure to provide relevant and educational clinical experience, and longitudinal exposure; and the freedom to learn from a variety of models, our own experiences, from our patients and from each other.
Shiva Chandrasekaran, MD
Assistant Professor of Medicine andDirector, Internal Medicine Residency Primary Care Program
Temple University School of Medicine
1992-1996, BS Biology and Philosophy of Science, University of Pennsylvania
1997-2001, MD, University of Michigan Medical School
2001-2004, BWH/HVMA Primary Care Residency Program
Assistant Professor, Medicine
Director, Internal Medicine Residency Primary Care Program
Temple University School of Medicine
I found the BWH/HVMA program after searching all over the country for a place where I could train in internal medicine and become a skilled primary care physician. In Boston, I found people that have influenced me in more ways I could have imagined. The combination of the Brigham inpatient experience and the unique practice model of HVMA were perfect for me. At my practice site, I felt like a “real doctor” from day one. The relationship I developed with my patients and my preceptor stay with me as I care for patients and teach today. The team approach to patient care at Kenmore was inspiring and effective – I learned that medicine is much more than doctors and patients in a room for a few minutes. As important as the clinical training was the informal curriculum of being “around the table” with my fellow residents and dedicated faculty members week in and week out. In conferences like Patient-Doctor and Clinical Epidemiology, I and my co-residents shared clinical and personal experiences that delved into the profound issues – ethical, social, spiritual, economic – that make medicine such a meaningful career. I became as comfortable with the concepts of value, suffering, harm-benefit ratio, end of life care, and clinical significance as I did with differential diagnosis, procedures, and prescriptions. After residency, I came to Philadelphia and joined the faculty at Temple University where I spend about half my time doing clinical work in general internal medicine and the other half teaching. I find myself quoting my preceptor and BWH/HVMA faculty facilitators on a regular basis – their wisdom is the foundation of my teaching. In 2006, I designed and implemented a primary care program at Temple based in many ways on the BWH/HVMA model of continuity – with patients, colleagues, and faculty. I co-direct the categorical medicine residency ambulatory block, one component of which is a unique systems based practice curriculum. I am also actively involved in our practice plan’s transition to an electronic medical record based on my experiences using HVMA’s state of the art system. The program gave me all the tools necessary to be a primary care doctor today while working to change the system to take better care of patients tomorrow.
Yvette Roubideaux, MD, MPH
Assistant Professor, College of Medicine, The University of Arizona
1981-1985, BA, Harvard University
1985-1989, MD, Harvard Medical School
1989-1992, BWH Primary Care Internal Medicine Residency Program
1996-1997, MPH, Harvard University School of Public Health and Commonwealth Fund/Harvard University Fellowship in Minority Health Policy
1997-1998, Senior Fellow, University of Washington School of Medicine
1998-2000, Native Investigator Program Native Elder Research Center, University of Colorado Health Sciences Center
Assistant Professor, College of Medicine, The University of Arizona
Co-Director, Coordinating Center, Special Diabetes Program for Indians Diabetes and Cardiovascular Disease Prevention Demonstration Projects
Director, Indians Into Medicine (INMED) Program, The University of Arizona and Inter Tribal Council of Arizona
Director, Student Development Core, American Indian Research Center for Health
Chair, American Diabetes Association Awakening the Spirit Native American Team
My career goal has always been to try to improve the quality of care for American Indians and Alaska Natives. The Primary Care Internal Medicine Residency Program at Brigham and Women’s Hospital was an important part of my early career development. I was in the first class of fellows, and shared the excitement of participating in a new and unique program. The primary care focus allowed me to experience training that I would need to be prepared to work as a clinician in the Indian Health Service after residency. Even though I was trained in Internal Medicine, I needed to learn how to take care of clinical problems outside of this area, including orthopedics, emergency medicine, pediatrics, OBGYN, and minor surgery. Harvard did not offer a family practice residency program and I was primarily interested in Internal Medicine, so this residency program was perfect for my unique interests. I also greatly benefited from the leadership training in the program. I still use skills learned during the program in my everyday work, including meeting facilitation, interviewing, negotiation, communication and supervision. Most of all, I benefited from the relationships with and support from my mentors in the program.
After the residency program, I felt confident that I could handle working in the Indian Health Service in a rural hospital/clinic. I immediately used the skills I learned in the program and was grateful for the extra training in other medical and surgical specialties that I was allowed to have since I immediately had to take care of patients with a wide range of ages and health conditions. I initially worked at the San Carlos Apache Reservation Indian Health Service Hospital in rural Arizona in a setting of a shortage of doctors and old, outdated facilities and equipment. I was offered the position of Clinical Director at the end of my first year, and compared to the other physicians, I was the only one that had any leadership or administrative training and was willing to do the job. I enjoyed learning the administrative and management side of medicine, but struggled with the challenges of working in a health system that was extremely underfunded and not able to meet all the medical needs of its patients. After 3 years at San Carlos, I transferred to the Gila River Indian community south of Phoenix AZ, and learned as a clinician about the severe epidemic of diabetes in that community of Pima Indians. I realized solutions to the health problems faced in American Indian/Alaska Native communities were going to require a public health approach and could not be solved solely in the clinic.
After working in the Indian Health Service, I went back to Harvard to get my MPH and training in minority health policy. I realized that many of the problems with the quality of care in the Indian Health Service were undocumented, and it was difficult to promote policy changes without adequate documentation of the problems. I then changed direction and focused on a career in research on the quality of diabetes care for American Indians and Alaska Natives, and education about Indian health policy issues. I have had a number of leadership positions and opportunities to help improve Indian health programs, and I continue to build upon the skills I learned in the residency program. I currently Co-Direct the Coordinating Center for a congressionally funded 66-site national demonstration project in Indian Health Service and tribal health programs to learn how to best translate diabetes prevention and cardiovascular disease prevention programs in Indian communities. I also work to increase the number of American Indian/Alaska Native students who enter the health professions and consider research careers. I teach in a number of venues about the Indian Health Service and American Indian/Alaska Native health disparities. I am grateful to the residency program for providing me a solid foundation of diverse skills that have allowed me to follow a career path in which I look forward to my work everyday and know that I am fulfilling my wish to work to help improve the quality of healthcare for American Indians and Alaska Natives.
Anne Pereira, MD, MPH
Program Director, Internal Medicine Residency, Co-Program Director, Emergency Medicine-Internal Medicine Residency, Hennepin County Medical Center, Minneapolis, MN
1985-1989, BA in English Literature, Vassar College
1991-1995, MD, University of Minnesota
1995-1998, Hennepin County Medical Center Internal Medicine Residency Program
1998-1999, Chief Resident, Hennepin County Medical Center
1999-2001, MPH in Clinical Effectiveness, Harvard School of Public Health
1999-2002 Fellow, Harvard Medical School, Department of Ambulatory Care and Prevention
Academic General Internal Medicine Fellowship
Program Director, Internal Medicine Residency, Co-Program Director, Emergency Medicine-Internal Medicine Residency, Hennepin County Medical Center, Minneapolis, MN
My relationship with the BWH/HVMA began shortly after I began my academic general internal medicine fellowship at Harvard Medical School – Department of Ambulatory Care and Prevention. While I had chosen to pursue fellowship training in a clinician investigator track, I knew that I needed to continue in teaching and mentoring activities that I had come to value during my chief residency year. This conviction led me to contact Dr. Jeannette Shorey, a member of my department and the then Program Director of the BWH/HVMA primary care residency. Her enthusiastic welcome of my participation in some of the didactic efforts of the program enabled me to continue to pursue this professional interest while pursuing my MPH degree and clinical investigative work.
My involvement in the residency led Dr. Steven Pearson to offer me the position of Associate Program Director when he took over program leadership in 2001. Over the next two years, I had the opportunity to work with the residents as they learned clinical epidemiology, professionalism and communication skills, and clinical ambulatory medicine. I remain unsure whether I taught more than I learned – I frankly think not. This way of teaching young physicians helped me recognize the opportunities inherent in carving out time for them to reflect, to develop their own curiosities and passions, and then to allow them to teach the rest of us, faculty and residents alike.
While I had anticipated continuing on for many more years at the BWH/HVMA program, in 2003 I was offered the position of program director of the internal medicine residency at Hennepin County Medical Center in Minneapolis, where I had completed my residency training. My commitment to the patient population and mission of this institution proved too deep to ignore, and we made the difficult decision to return to Minneapolis. However, my experience as associate director of the BWH/HVMA program has certainly influenced my work here. One example of this is our recent acceptance into the Review Committee – Internal Medicine of the Accreditation Council of Graduate Medical Education’s Educational Innovations Project. We are one of 21 programs in this national project allowing us to innovate and help to shape the next generation of internal medicine residency program requirements. It was my experience at HVMA/BWH that made me recognize the vital importance of innovation in residency program training.
This page was last modified on 9/18/2015