Of all the professions, learning medicine requires the greatest time commitment. After four years of medical school, doctors undertake at least three years of internship and residency before beginning their specialty training. At least two additional years are required to become a surgeon; if the career goal is heart surgery or neurosurgery, add two more years.
But for the one out of 10 students who enroll at the School of Medicine in the Medical Scientist Training Program (MSTP) each year, these numbers tell only half the story. These students aim to earn both the M.D. and Ph.D. degrees, embarking on a long academic journey that combines the rigors of medical education with deep research experience in the basic biology of human disease.
The dedication of these students has received special recognition from a donor who wishes to remain anonymous in the form of a $2 million bequest to sustain and expand upon Yale’s longstanding commitment to the MSTP, known on campus as the M.D./Ph.D. program.
“Yale has an outstanding program with a long tradition and a fantastic success rate in training successful physician-scientists,” Dean and Ensign Professor of Medicine Robert J. Alpern, M.D., says. “This very generous gift will allow us to maintain and even improve on the program’s excellence.”
All told, earning the M.D./Ph.D. takes about eight years, after which most students begin a medical residency, a step long since completed by peers in their entering class. “There’s a huge amount you have to learn with clinical rotations just for the M.D., and you can’t have a half-baked Ph.D. in molecular biology and expect to do good research,” Program Director James D. Jamieson, M.D., Ph.D., says. “There’s no shortcut.”
A 1964 federal initiative created the MSTP to increase the number of physician-scientists. But despite the explosion of medically relevant knowledge in molecular and cell biology during the past three decades, federal funding for the MSTP, administered by the National Institute of General Medical Sciences (NIGMS), has lagged behind overall funding for the National Institutes of Health (NIH), requiring the 42 NIGMS-approved programs at medical schools across the nation to rely on other sources to support students for the duration of their studies.
Yale’s program, now 37 years old, has generally only been able to directly support students for five or six years of their training, says Jamieson, who hopes to use some of the funds generated by the new gift to supplement the NIH training grant that provides the bulk of support to M.D./Ph.D. students. Also, because these grants are only available to U.S. citizens, the new gift may give the program the flexibility to consider talented foreign-born applicants.
About a quarter of the 200 alumni of Yale’s M.D./Ph.D. Program are faculty members in basic science departments across the country, and almost three-quarters are on clinical faculty; the remainder work in private industry.
The alumni roster includes Susan J. Baserga, M.D., Ph.D., associate professor of molecular biophysics and biochemistry, genetics and therapeutic radiology, and Michael J. Caplan, M.D., Ph.D., professor of cellular and molecular physiology and cell biology, who administer the program under Jamieson’s direction along with Professor of Medicine Frederick S. Gorelick, M.D., and Gerald I. Shulman, M.D., Ph.D., professor of medicine and Howard Hughes Medical Institute investigator.
Noting that the School of Medicine has required research experience and a thesis of all its students for more than 150 years, Caplan says that Yale provides particularly fertile ground for training future physician-scientists. “Yale is unique as a medical school in its desire to devote a significant portion of its effort toward training future academic leaders,” Caplan says, “and I think this program stands at the vanguard of that.”
Jena Giltnane, a fifth-year student in the MSTP, says that she interviewed at several institutions, but was ultimately attracted by the Yale program’s small scale and open-door culture, which have afforded her close interaction with School of Medicine scientists.
Now studying protein expression profiles in breast cancer in the laboratory of Associate Professor of Pathology David L. Rimm, M.D., Ph.D., Giltnane says that her combined experiences in bench science and patient care in the M.D./Ph.D. Program will forever inform her perspective as both scientist and physician.
“I feel very gratified when I present my research to someone who’s practicing medicine in the field. They understand where I’m coming from, and they can see the impact it will have on their day-to-day work,” says Giltnane. “The questions I’m asking will affect the way breast cancer is treated, and that’s something I’m really passionate about.”