MD/PhD Combined Degree

Our Philosophy

The MD/PhD Combined Degree Program at Boston University School of Medicine is structured to train physician-scientists for productive careers as clinician-investigators in the 21st century. Our philosophy views the clinical encounter as central in the generation of relevant questions that can be best explored by scientific methodology. Therefore, we place a premium on balancing strengths in both the clinical and scientific training. This produces a physician-scientist with the capacity to construct a clinically important question, explore it in the laboratory or clinical research center, and translate the new knowledge gained into the clinical practice.

Our Approach

We provide opportunities for integrated basic and clinical training at each point in the MD/PhD Combined Degree Program. Students in the foundational science years attend specially tailored classes that challenge them to design research programs based on clinical cases. Students in the graduate years shadow working physician-scientists to learn how to integrate laboratory and clinical work with research interests. In their clinical years, students participate in seminars on translational research and clinical trial design.

Program Goals

A physician-scientist is a leader who forms the link between basic biomedical science and clinical practice. We strive to nurture, as well as mold these leaders who will build an integrated connection between what are often disparate cultures of basic biomedical research and clinical practice.

Throughout this experience, students in the program attend scientific and social events designed to foster these leadership skills, as well as encourage relationship-building and collaboration with other MD/PhD students and the academic community.

Program Overview

We strive to achieve continuity of physician-scientist training throughout the program.

Medical School Years 1 & 2 (BUSM I & II)

The Integrated Problems course has special MD/PhD sections for this clinical case-based learning program. Students study the same cases as the MD students, but MD/PhD students expand the experience by learning the format for experimental design and grant writing. Students learn to review a case and present the essential clinical material, including the chief complaint, history and physical examination, basic laboratory values and imaging data, and develop a translational research question based on the case. This exercise enables the students to learn the basic elements of a research plan, including the rationale, hypotheses, aims, the dependent and independent variables, positive and negative controls, and power analyses. Year 2 is similar to Year 1, except that students now progress from a research design to the clinical trial phase.

Laboratory Rotations (Summer Pre-BUSM I and/or Post-BUSM I)

Students complete a required eight-to-ten-week lab rotation before formally entering the research years of study, and receive a $4,000 stipend during this period.

Research Years

When students first enter the research (graduate) phase, they quickly assimilate into their chosen program of study as well as continue along the path of becoming a physician-scientist through a wide variety of opportunities during this period.

Teaching

In academic medicine, the role of a physician-scientist typically includes teaching, and our program includes ample opportunity for students to develop their skills as educators. Many MD/PhD students serve as teaching assistants in first- and second-year medical school courses, as tutors, and as instructors of undergraduate Biomedical Laboratory and Clinical Science courses. Students are also encouraged to present their research at seminars, student retreats, Student Achievement Day, and at a wide variety of scientific meetings. In addition, we are currently developing a formal course focused on teaching skills. Students will be taught techniques for teaching, and will have the opportunity to practice these techniques by presenting to small groups of students.

Graduate Phase Clinical Clerkship

The program pays careful attention to the transition back to clinical medicine, ensuring that this will be as smooth as possible. During the last year of graduate training, students shadow a physician-scientist one afternoon per week, providing a gradual return to the clinical world. At the end of this block, students complete a six-session review of basic bedside clinical skills, including history-taking, physical examination, and case presentation.

Clinical Years

In the final year of medical school (BUSM IV), a one-month course designed to reinforce skills in clinical trials design is offered to help prepare students for a future in clinical research.

Mentoring and Advising

One of the strengths inherent in a large program is a breadth of mentoring and advising by physician-scientists. There are currently three faculty advisors to the program: John H. Schwartz, MD, Professor of Medicine, who specializes in renal epithelial cell biology; Steven C. Borkan, MD, Associate Professor of Medicine, who specializes in the role of cytoprotective proteins in ischemic disease; and Irina V. Zhdanova, MD, PhD, Professor of Anatomy & Neurobiology, who specializes in circadian systems in development and aging. These advisors function as a resource to meet with students and guide them through the program. The advisors also supervise mentoring and didactic training occurring throughout the program. Some of these events include:

Monday Evening Seminars

These seminars meet every other week and contribute to the continuity of physician-scientist training throughout the program. Areas of focus include:

• Role Models

  Successful physician-scientists meet with students to discuss how they arrived at their career path and how they manage their multiple responsibilities.

• Panel Discussions

  Senior students present their perspective on key issues for junior MD/PhD students, including advice on coping with the workload in BUSM I and II, choosing laboratories, choosing clinical rotations, and applying for residencies and fellowships.

• Research Presentations

  Students from each phase of the program present their research, including those just starting out (who present research plans), those in the midst of their graduate work (research in progress), and those doing clinical work (completed research).

• Happy Hour

  This provides a venue to just kick back and socialize.

• Retreat

  MD/PhD students from each level of training attend this student-planned initiative. Students interact and learn from their colleagues. The retreat usually features an optional outdoor experience; in 2010 the students went whitewater rafting.

• Student–Advisor Group Meetings

  In an effort to continually improve and address the needs of our students, advisors and administrators meet with student representatives once a month to learn about current and evolving issues—what works, what doesn’t work, what can be improved, and any unexpected events.

Community

The large size of the program provides important advantages to MD/PhD students. Students often comment that they appreciate the camaraderie afforded from this program size. Some of the ways students may choose to get involved with the program administration include:

• Student Government

  The program is sufficiently large that the MD/PhD students organize their own Student Government, which manages social activities, speakers, communications, and interaction with the administration.

• Class Officers and Student Representatives

  Students participate as elected representatives on the MD/PhD Working Group, MD/PhD Admissions Committee, the MD/PhD Executive Committee, and the GMS Steering Committee.

• Monday Evening Seminar Series

  This occurs twice a month, typically with 30–40 students in attendance, and we provide dinner as an added incentive.

• Retreat

  The retreat allows incoming students to meet their classmates and other students in the program.

• Student Achievement Day

  Each spring, students present their research at this student-centered event, where they may present a poster or give a talk, and meet one-on-one with the keynote speaker.

Curriculum Sequence

Detailed chronological description of studies for MD/PhD students:

Summer before BUSM I

Before beginning the first year of medical school, students can begin their research by doing an eight-to-ten-week rotation in a laboratory. This work may be used to fulfill the MD/PhD program laboratory rotation requirement. It also provides an opportunity for new students to become acquainted with the campus and colleagues before beginning the first year of medical school. Choosing a laboratory for this and for later rotations is facilitated by the advisors and by the Division of Graduate Medical Sciences Office. All students completing a summer rotation earn a stipend for living expenses.

BUSM I (Med Year I)

BUSM I is the same for both MD and MD/PhD students with the exception of the Integrated Problems course. The MD/PhD students take this class together. While the format is the same for MD students, this section is generally led by a scientist or physician-scientist, allowing for in-depth discussions concerning the science behind the clinical medicine.

Summer between BUSM I and BUSM II (Med Year I and II)

In the spring of BUSM I, MD/PhD students begin planning their laboratory rotation for the upcoming summer. While many students decide quickly which investigator they will work with, other students may need to take more time. Students completing an eight-to-ten-week rotation during this summer period earn a stipend.

BUSM II (Med Year 2)

BUSM II is also the same for both MD and MD/PhD students, with the exception of the continued Integrated Problems course, in which the student will also write a mock research grant proposal. Upon completing the first two years of medical school, all students are required to take the Step 1 U.S. Medical Licensing Examination (USMLE). This examination must be taken prior to July 1, and before starting a summer research rotation.

Graduate/Research Phase

• Medical School Credit

  Students will follow the requirements of the particular department. Since MD/PhD students are considered “post-master’s” students after completing the first two years of medical school, advanced standing for medical school coursework is granted, but the details vary by department.

• Departmental Requirements

  Outside of the thesis research, each department has curriculum requirements, including courses and qualifying examinations.

• Qualifying Examinations

  The format for these examinations is department-specific. Generally, MD/PhD students take their qualifying examination after completing the first year of graduate study.

• Dissertation Committee

  The dissertation committee is formed after students have passed their qualifying examination. The dissertation committee provides guidance in research design and scope, ensuring the timely completion of the dissertation project.

• Clinician-Scientist Clerkship

  Students are encouraged to take the elective Clinician-Scientist Clerkship (GMS MD 800), which is designed for MD/PhD students within 1.5 years of completing their PhD training. The Clinician-Scientist Clerkship was designed with the goal of helping students develop some clinical skills as well as providing them with real-life exposure to the world of the clinician-scientist. Below are the details of the Clinician-Scientist Clerkship.

Transition to Core and Advanced Clinical Clerkships

• Approximately 1.5 years before the anticipated completion of graduate research, students should contact the MD/PhD administrator, who will initiate the process of linking students to the medical school registrar, curriculum, and listserv.
• At this time, students will also register for the graduate phase clinical clerkship.
• In February/March before re-entry to the medical school curriculum, students will fill out clerkship transition forms and participate in the medical school lottery for clinical rotations.
• Clinical clerkships will be administered through the medical school.
• Students may receive credit for their graduate phase work including research elective credit and the graduate phase clinical clerkship credit. Note: Students MUST request this credit—it does not automatically appear.