The program has many unique aspects designed to integrate MSTP education through courses such as Molecular Medicine, Methods and Analysis, Research Basis of Medical Knowledge, Grant Writing and Networking, Ethics, and Longitudinal Clinical Clerkships. MSTP students begin training to become physician-scientists from the very first week, and are well advised about possible courses and research opportunities. Courses within the medical school follow an innovative problem-based learning (PBL) curriculum, which has become a model for medical education across the country.
Summer Research Prior to Matriculation
Incoming students are required to spend the summer before medical school begins in a laboratory of their choice. This affords many benefits, including meeting potential thesis advisors and department members, fulfilling lab rotations, and establishing a routine prior to the start of medical school. Every effort is made to ensure a meaningful experience. The program provides information on the many available labs and organizes meetings with potential advisors. This summer program enables the MSTP students to form connections with their MSTP mentors, colleagues, and advisors, as well as to participate in the annual retreat. This relatively relaxed research experience prior to starting the full medical school curriculum facilitates the student's familiarity with leading physician scientists and with graduate program faculty, a process that continues to flourish throughout the first two years of the medical school experience.
To help students further define their research interest, our summer Molecular Medicine Course examines current biomedical problems from the unique perspective of a variety of disciplines.
First and Second Years of Medical School
During the first and second years of medical school, MSTP students enjoy a weekly seminar course, titled the Research Basis of Medical Knowledge, which provides a bridge between medical school coursework and the research breakthroughs detailed in the basic sciences blocks. This class provides a forum for MSTP students to present and review scientific literature among peers. The regular contact among the MSTP students fosters an intellectual and social network that provides support and a sense of community and continuity throughout the duration of the student's combined program. By working with a faculty expert prior to the class, presenting students build mastery of the topic beyond the discussion paper.
From the first day of medical school, students participate in the Patient/Doctor Relationship Block, which emphasizes patient interviewing, behavioral medicine, and public health policy. During the first year of medical school, multidisciplinary courses incorporate the major aspects of anatomy, embryology, biochemistry, molecular biology, microbiology, immunology, and the fundamental principles of pathology and pharmacology. Students begin a clinical and technical skills course toward the end of the first semester, which continues through much of the second year. In the spring of the first year, students select a summer lab rotation with the assistance of the program director, a career advisor, and other students.
Preparation for Step I of the United States Medical Licensing Examination (USMLE), taken in the spring after the second year, takes place in the second half of the second year. Several fantastic resources are available to the students. The Integrated Case Studies course—which emphasizes data acquisition, problem solving, and communication skills—precedes the exam and is taught exclusively in a small group setting to foster discussion about clinical cases. The discussion about clinical cases helps students anticipate board questions, which currently are presented in a case-based format. In addition, the academic coordinator at the medical school helps with specific advice, reading materials, mock exams, practice questions, and more.
In May and June at the end of the second year, all MSTP students complete eight weeks of clinical clerkships with their medical school classmates prior to entering graduate training. Clinical acumen engendered from this early clinical experience provides a solid foundation for the Longitudinal Clinical Clerkship of the graduate years, during which MSTP students choose a physician mentor to provide supervision in the clinical-care setting. This 20-week period includes as many as three rotations and six weeks' total elective credit. Mentors for this course have proven to be great role models and invaluable resources for our students, who return as third- year medical students possessing excellent diagnostic and clinical skills, honed during the one-on-one sessions of the Longitudinal Clinic. Just as the seminar program provides a link to research during the first two years of medical school, the longitudinal clerkship provides clinical continuity and involvement during the graduate research period.
The Graduate Research Years of the MSTP
After the first two years of medical school, each student selects a graduate program for study. With the assistance of their MSTP and graduate advisors (and often with the advice of their MSTP colleagues), the students pursue a curriculum that gives a broad foundation in their field of interest and completes the requirements of the graduate curriculum. Most students have a clear sense of their research direction at this point, as a result of their prior laboratory rotations and research exposure during the first two years of medical school. Occasionally students will elect to pursue a research path that diverges from their original plans. Such flexibility is possible, especially when they work closely with their advisory support to ensure a productive and focused agenda. Typically, students can achieve their graduate research goals within four years.
Third and Fourth Years of Medical School
MSTP students reenter their medical training when their thesis has been completed and defended. A smooth transition is ensured because students do not have to cope with the final details of their graduate program while they are immersed in the clinical clerkships. By the time the combined-degree student has completed his or her PhD studies and is ready to commit full time to completing the MD requirements, only 56 weeks of required clinical clerkships may remain. Elective rotations may include additional research or clinical experiences. Students complete all of the clinical clerkships required for licensure and graduation during the third year of medical school and all elective rotations during the early part of the fourth year. This ensures that students can expeditiously complete required clerkships for residency applications by November of the fourth year. Throughout this period, students continue to work with their MSTP advisors to plan for their postgraduate training and develop their professional career goals. A five-month MSTP postdoctoral fellowship is available for students who choose to graduate in December. This fellowship supports 5 months of productive work with a prior mentor or a new mentor in an area of clinical interest prior to residency.
MSTP Example Curriculum
Given the breadth of research and clinical programs available in the MSTP, it is impossible to define a single path through the combined degree. Although rare students have completed training in six years, the following diagram illustrates a typical path through the MSTP, highlighting the MSTP-specific courses that are taken each year.
This course is designed for entering MSTP students. The purpose of this course is to highlight contemporary questions in biomedicine and how different scientific fields approach these questions. Students are exposed to physician-scientist role models who share information about their career paths, the compelling questions in their field, how they design experiments to address gaps in knowledge and build a coherent research path within their field. The course also builds student skills in planning and presenting their work.
Methods and Analysis
This seminar style course is designed for MSTP students during the summer between the first and second year of medical school. The learning objectives of the course are to foster social and scientific collaboration between students; to expose students to different scientific methods, techniques, and analyses; to create an environment where students can voice difficulties with their research, labs or mentors and seek constructive feedback; to develop habits of daily writing/presenting. The students are required to present three times during the course and assessed on the clarity and quality of their MSTP retreat poster. Particular attention is focused on reproducibility and rigor in the conduct and analysis of experiments, appropriate data and handling and use of biostatistics, and guidelines for reporting of methods and results.
Research Basis of Medical Knowledge
This small group session is restricted to MSTP students during their first year and one half of medical school. The class meets to review primary literature linked to the current first- and second-year curricula. Before each session, a faculty member and two students meet and review the paper assigned for that week. Students learn about the research basis of medical knowledge, and how to present and critically review primary literature.
Grant Writing and Networking
This course is required of MSTP students after their second year of medical school. Career expectations are discussed and framed in the perspective of grant writing and the review process. A small amount of lecture material is linked to a series of workshops where each student composes a biosketch, specific aims, experimental plan, and training plan related to their PhD thesis. Constructive peer critiquing of grant material provides a perspective on which to build grant-writing skills.
Ethics for Medical Scientists
This course is offered to MSTP students during the first spring in graduate school. It consists of 4-5 two-hour long sessions. The introductory workshop is designed to teach participants how to apply analytical methods systematically to the evaluation of ethical dilemmas. The objective of the later three workshops is to build upon these principles within the context of a specific biomedical ethic cases. The goals of the course are to provide a framework based upon current methods and principles in ethics and to translate conceptual methodologies into practical skills for evaluating ethical dilemmas.
Longitudinal Clinical Clerkship
Taken during graduate school training, each of these two 20 half-day-per-week electives allows the students to explore their clinical interests. Students work one-on-one with an attending academic physician who oversees their learning of advance clinical skills in interviewing and physicals diagnosis. Students evaluate patients in specialty outpatient clinics, and plan and conduct appropriate evaluations and therapeutic approaches that define the need for disorders, both for evaluation of new symptoms and for health maintenance. Emphasis is placed on the role of the clinical investigator overseeing care of patients.
This discussion-based course, guided by faculty preceptors, meets 8 times per year over dinner and is attended by MSTP students from all years. Each class begins with description of a topic related to training on being a physician scientist. The topic for discussion is developed by students from different years in order to assure good representation of the challenges offered at various stages of training and ethically challenging situations with their peers; to provide a venue in which junior students can learn from senior students; to understand responsible conduct of research and medicine as a critical aspect of research training and that it remains an important concern at all levels of a research career.