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Still, the need for physician-scientists keeps growing. Biomedical research is virtually exploding with complex discoveries that cry out for clinical applications, while a long list of clinical questions awaits answers from laboratory scientists. And as the Federation of American Societies for Experimental Biology (FASEB) has stated (in The Physician-Scientist: Career Issues and Challenges at the Year 2000 ), “[Physician-scientists] are distinct from the growing number of pure researchers . . . because they are trained to ask clinically relevant questions in a health research environment –questions that lead to the development of research projects that link basic and clinical sciences.” Combined MD/PhD programs can strengthen this link, FASEB reported. A special FASEB committee, co-chaired by Nicola C. Partridge, PhD, professor and chair, Department of Physiology and Biophysics, found that such programs provide the most effective training ground for physician-scientists. Since World War II, for example, half the Nobel Prizes in physiology and medicine have been awarded to physician-scientists – strong evidence for the effectiveness of MD/PhD programs. The success rate is even greater among MD/PhDs who earn their doctorates under Medical Student Training Program (MSTP) grants from the National Institutes of Health (NIH). They make up only 2.5 percent of the medical school graduates each year, yet they hold about a third of the NIH grants awarded to physicians. Creating a Research PowerhouseResponding to the need to reinforce the ranks of well-prepared physician-scientists, Harold L. Paz, MD, dean, UMDNJ-Robert Wood Johnson Medical School , recently announced an extraordinary expansion of the school“s MD/PhD program. “The expansion was driven by our missions in research and clinical care,” says Dr. Paz. “One cannot succeed without the other.” At RWJMS, the MD/PhD combines a medical degree with a doctorate in biomedical sciences or public health. Starting next year, the program will also offer participants the opportunity to earn a doctorate in the Department of Molecular Biology at Princeton University . This raises to three the number of graduate schools in the school“s 14-year-old program: the Graduate School of Biomedical Sciences (GSBS) at RWJMS; Rutgers , The State University of New Jersey ; and now Princeton University . “The combined strengths of the three schools create a research powerhouse,” says Dr. Paz. “In addition, this new affiliation is an important milestone in our evolving relationship with Princeton .”
Adding Princeton as a cooperating partner allows RWJMS to double the number of MD/PhD candidates inthe program. Furthermore, Dr. Paz announced, the school will triple the stipends for MD/PhD candidates, bringing the annual amount to $20,000, while continuing to pay their full tuition for the four years of medical studies. “The [RWJMS] program consistently attracts excellent young scientists,” says Victor Stollar, MD, professor of molecular genetics, microbiology, and immunology, who has chaired the MD/PhD Admissions Committee since 2001. Dr. Stollar believes that the added prestige of Princeton “s faculty and facilities, along with competitive tuition support, will raise the program“s profile, attracting a nationwide pool of outstanding applicants. They will also make the program more competitive for an MSTP grant. The benefits of the expansion are not limited to the MD/PhD program, says David Seiden, PhD, professor of neuroscience and cell biology and associate dean for admissions and student affairs. He believes that the enhanced program will also increase the number and caliber of accepted students who matriculate at RWJMS – even if they are coming for the medical program alone. “Students rank medical schools based on impressions, not just on hard data,” says Dr. Seiden. “They decide where to apply and where to go based on what they read, see, and hear. So when you have academic affiliations of this quality, it can“t help but enhance a candidate“s impression of the school.” Together, RWJMS, Rutgers , and Princeton provide students with a wide range of basic science, engineering, and clinical disciplines. The three institutions offer research opportunities at a wide range of interdisciplinary institutes and centers. These include the extensive clinical facilities of RWJMS and its major institutes, such as The Cancer Institute of New Jersey, the Child Health Institute of New Jersey, the Cardiovascular Institute of New Jersey, the Center for Advanced Biotechnology and Medicine, the Environmental and Occupational Health Sciences Institute, and the Stem Cell Institute of New Jersey. In addition to the last three institutes, which are jointly operated with Rutgers , other participating centers will include the Center for Agricultural Molecular Biology, the New Jersey Center for Biomaterials, and the Waksman Institute of Microbiology at Rutgers , and the Lewis-Sigler Institute for Integrative Genomics at Princeton . Enriching the Mix“ Princeton “s world-class scientists will enrich the RWJMS-Rutgers mix,” says Michael J. Leibowitz, MD, PhD, professor of molecular genetics, microbiology, and immunology, associate dean for GSBS at RWJMS, and director, MD/PhD program. Dr. Leibowitz, who earned his dual degree at the Albert Einstein College of Medicine, says, “The new affiliation is a big, positive step for all three schools, and will help move the RWJMS program to the forefront in training academic physicians and biomedical scientists.”
Ira B. Black, MD, professor and chair, Department of Neuroscience and Cell Biology, says, “An outstanding MD/PhD program is the mark of an outstanding medical school.” Dr. Black says he is “blessed” to have two MD/PhD candidates in his laboratory, adding, “Since we are all students in a way, these very special students are a priceless resource to everyone in the school.” “The partnership [with Princeton ] will combine our basic science and clinical approach with Princeton University “s scientific background, expertise, and achievement,” says Dr. Black. “By partnering with us, Princeton , which has no medical school, becomes part of the biomedical-scientific sphere.” Princeton University “s Elizabeth R. Gavis, MD, PhD, associate professor of molecular biology, was instrumental in developing the expanded agreement and will help administer the program at Princeton . A dual-degree graduate of Stanford University School of Medicine, Dr. Gavis says, “The clinicians“ emphasis on understanding molecular science as a solution for disease is a reality check for our scientists. It shifts the focus from pure science to the goal of treating or preventing disease.” RWJMS has already graduated 33 MD/PhDs, and 19 students are now in the program. They include Paul Lizzul, MBA, PhD, who will earn his MD in 2005. He performed his doctoral work with Céline Gélinas, PhD, professor of biochemistry and resident member, CABM, researching NF-kB transcription factors; his thesis characterizes the inhibitory activity of a targeted new gene. Dr. Lizzul“s doctoral work was supported by a James J. O“Connel Fellowship and an NIH training grant. He is completing his clinical studies while studying the gene pathways of psoriasis at the Clinical Research Center . The Research-Friendly EnvironmentJay A. Tischfield, PhD, MPH, Duncan and Nancy Macmillan Professor and chair, Department of Genetics, Rutgers University , also holds appointments at RWJMS as professor of pediatrics and psychiatry. Dr. Tischfield, who has been involved in MD/PhD programs at three other medical schools, says, “Ours is the best . . . distinguished, in part, by the school“s insight into researchers“ needs and the nature of the PhD process. “In some MD/PhD programs, the rules are for the benefit of the school“s scheduling needs,” he adds. “But here, the program is for the students, encouraging them to get the most out of the experience.” The MD/PhD program at RWJMS, one of 119 such programs nationwide, accommodates the achievement-driven nature of research, says Dr. Leibowitz, adding, “Unlike medical school, which is driven by a defined curriculum, research requires flexibility.” For this reason, RWJMS structures its MD/PhD program so that most candidates begin their doctoral work after completing the second year of medical school. Most can fulfill their doctoral requirements in three years, offering the MD/PhD candidate a further advantage: normally, at least nine years would be necessary to earn both
a medical degree and a doctorate, but the combined degree usually takes only seven. Many MD/PhD candidates perform several semesters of research before being admitted to the combined-degree program, and PhD candidates complete at least two laboratory rotations before identifying their thesis adviser. Furthermore, science courses in the first two years of medical school fulfill other doctoral requirements, and the PhD thesis research fulfills medical school elective requirements. At RWJMS, students with a strong interest in research have several alternatives to the MD/PhD program. For example, the Distinction in Research Program offers research-oriented students the opportunity to graduate with special honors. (See News article, [create link?].) Now in its second year, the program was initiated by Susan Rosenthal, MMS “75, MD, clinical associate professor of pediatrics and assistant dean for student affairs. Students are eagerly vying to earn this honor in 2005, says Dr. Rosenthal. In addition to the Distinction in Research Program, several student scholars are selected each year to participate in one- and two-year basic science and clinical research programs, such as those sponsored by the NIH, the Howard Hughes Medical Institute, and Duke University. These students may also apply for the honor of graduating with distinction in research. Eyes on the Prize: Translational ResearchThe RWJMS commitment to the MD/PHD program reflects the priorities of the NIH“s 2003 National Roadmap , which called for accelerating the rate of discoveries in the life sciences. The NIH report emphasized that “to transform scientific knowledge into tangible benefits for people,” the pathway of discovery should run two ways: carrying the researcher“s discoveries to the patient and delivering the physician“s perceptions of patient needs to the laboratory bench.
“[Physician-scientists] are the ones with their eyes on the prize,” says Dr. Black. He and other doctoral mentors find that MD/PhD candidates add a sense of mission to the school“s research teams because of their ingrained passion for healing, reinforced by two years of studies in the basic sciences. One of them, Thomas Coyne, a first-year student who did research in Dr. Black“s laboratory before entering medical school, will return to the lab next year to begin his doctoral studies. Dr. Black is also advising Akiva Marcus (see sidebar [create link]), whose doctoral research shows promise for future stem cell treatments for brain disorders. Hilary Vernon, MD, PhD “04, wrote her thesis on gene expression pathways involved in kidney stone formation. Mentored by Dr. Tischfield, she also worked with Amrik Sahota, PhD, professor of genetics, Rutgers University , who directs the molecular diagnostics laboratory at Robert Wood Johnson University Hospital . “Hilary possesses the excellent researcher“s skills of exceptional organization, a very good grasp of the subject, and self-motivation,” says Dr. Tischfield. “We had the project, and she ran with it. She knew when to proceed on her own and when to go for help, and she could maximally benefit from the diversity of people and skills in the group.” Before beginning a residency program in pediatrics and genetics, Dr. Vernon is doing post-doctoral research on cystinuria, another kidney stone disease. She also is initiating a new project on Tourette“s syndrome, with support from the Tourette Syndrome Association. Who Will Write the Book of Man?Among the most forceful advocates for MD/PhD programs is Leon Rosenberg, MD, professor of molecular biology, Princeton University , a member of the Board of Overseers, RWJMS, and a former dean of Yale University School of Medicine. In the Journal of Clinical Investigation in 1999 , Dr. Rosenberg reflected on the future of “the [physician-scientist] species.” He wrote: “When we have mapped and sequenced the entire human genome, who is going to make the long-sought connections between these genes and sick people if there are no physicians engaged in answering tomorrow“s questions about the role that genes play in virtually all medical problems? It is the diversity in backgrounds of MD and PhD scientists that will make reading this ‘book of man“ so exciting.” |
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