In the late 1990s, students at the School of Medicine approached Howard P. Forman, M.D., M.B.A., to ask if a joint degree program could be initiated with the School of Management. Medical students were already pursuing joint degrees in law, divinity, and public health, but to obtain an M.B.A. they had to go through a separate program. At that time, Forman, an assistant professor of radiology, was also teaching in the economics department. “The students came to me, most likely, because I recently earned my M.B.A. from Wharton and was a young vice chairman of a department,” said Forman.

In August of 2000 the first students entered the new program. Since then more than 35 students have received dual degrees in medicine and management. Through classroom course work, internships at hospitals, corporations, and government agencies, and seminars with leading policy makers, medical students learn how to be successful decision makers and to navigate the increasingly corporate world of medicine.

“An M.B.A. helps medical graduates analyze the broader implications of health care policies and procedures on the economy as a whole, optimize their own practices, and serve effectively in academic administrative roles,” said Sara Nayeem, M.D. ’06, M.B.A. ’06, now with New Enterprises Associates, a venture capital firm that structures investments in biopharma companies.

Jesse C. James, M.D. ’07, M.B.A. ’07, said there is an assumption that training in management would prepare a physician primarily to make sound financial decisions. “The decisions more often involve prioritizing use of limited resources, time, and information,” said James, who is in his last year of a joint residency in preventive medicine and internal medicine at University of North Carolina Hospitals.

In Yale’s M.D./M.B.A. program School of Medicine students study with management students. Each year since its inception, up to six medical students have joined the program, which takes five years to complete.

Among the program’s key components are summer internships in such agencies and corporations as The World Bank, Pfizer, and Merrill Lynch. Students learn in small-group discussions in healthcare leadership seminars with policy makers including former Treasury secretary Paul O’Neill and the director of international government relations at Merck. In January, Ezekiel Emanuel, M.D., Ph.D., special advisor on health issues to the Obama administration, spoke with students.

Victoria Zalkin, M.D. ’07, M.B.A. ’07, now at The Boston Consulting Group, credits these seminars with stretching students’ thinking by introducing them to the people who are running the organizations that Yale M.D./M.B.A. graduates may be called upon to lead. “Challenges confronting the health care system, opportunities outside of clinical practice, and management opportunities within clinical practice were made tangible by the opportunity to speak with seminar guests,” she said.

Although some have gone into business, more than 90 percent of graduates remain in clinical medicine or a related health care profession, said Forman. “We have done a good job of selecting students who become clinical leaders,” he said.