5.01 MD-PhD Program

Office of the Registrar

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5.01 MD-PhD Program

Overview

The overall mission of the MD-PhD Program at Harvard Medical School is to train the next generation of leading physician-scientists, with representation across a variety of clinical disciplines and research areas from basic and translational sciences to bioengineering to the social sciences. The MD-PhD Program thus integrates training in both medicine and research for individuals who intend to pursue careers as physician-scientists. 

The MD-PhD Program has established a collegial environment to support the professional development and personal interests of its students. Based on the core philosophy that MD-PhD students should be educated as physician-scientists from matriculation to graduation, the program integrates training in scientific methods and research into the medical school curriculum. By combining either the Health Sciences and Technology (HST) or New Pathway MD curriculum with an appropriate graduate program, students design their own courses of study. MD-PhD advisors supervise choices, in consultation with graduate program advisors.

The MD-PhD Program is supported in part by the National Institutes of Health (NIH) through its Medical Scientist Training Program (MSTP). The MSTP grant, along with other sources, provides scholarship support, at least in part, for many of the students who are pursuing combined MD-PhD degrees. 

Basic and Translational Science students:  Students in the basic and translational sciences (BTS) may choose among basic science and engineering graduate programs offered by the Division of Medical Sciences (DMS; Section 3.18) at HMS, other departments of the Faculty of Arts and Sciences at Harvard University, the Harvard School of Public Health, and the Schools of Science and Engineering at MIT. The course of study toward the MD degree is either the New Pathway curriculum at Harvard Medical School (HMS) or the Health Sciences and Technology (HST) curriculum offered jointly by Harvard Medical School and MIT. The Program includes medical students from all five academic societies at Harvard Medical School (See Section 3.02). To qualify for the PhD, students must enroll additionally in a graduate program at Harvard University or at MIT.

Social Science students:  Students who pursue a PhD in the social sciences (SS) may choose to enroll in a doctoral program offered at the Harvard Graduate School of Arts and Sciences with relevance to health or health care, such as medical anthropology, health policy, history of science, sociology, philosophy, or psychology.

 

Affiliate Program

Students who enter HMS as MD students and decide after admission to pursue both the MD and a PhD degree in either the basic and translational sciences or in the social sciences are eligible to apply for affiliate status in the MD-PhD Program. The applications for affiliate status are available on eCommons via the MD-PhD Program. Students are encouraged to apply in their first year of medical school, as soon as they have decided to pursue this course of study. Admission to the affiliate program is on a rolling basis. Students with affiliate status are invited to participate in all MD-PhD activities.

Maintenance of affiliate status is dependent on achieving relevant benchmarks, such as completion of laboratory rotations (BTS) or mentored research (SS); application and acceptance to a graduate program; and satisfactory completion of medical and graduate school requirements.

Students with affiliate status are not funded by the MD-PhD Program prior to starting graduate school, but are eligible to apply for second cycle funding for their remaining medical school years in the winter before they return to medical school. Funding is awarded on a competitive basis, and when awarded, funding is most commonly awarded for the final two years of medical school. Cycle II applicants who are eligible for NIH F30/F31 fellowships are required to submit such an application in order to be considered for cycle II funding. The fellowship proposal is usually submitted in the second or third year of graduate school. Students should contact the MD-PhD Program office in their first or second year of graduate school to plan for this process.

 

MD-PhD Curriculum Overview

The education of MD-PhD students in both the basic and translational science and social science tracks usually follows a “2-4-2” model. Cycle I basic and translational science training starts in the summer before the first year of medical school with a course called Molecular Biology of Human Disease, designed to introduce students to current disease-oriented research problems in the biomedical sciences and to develop their critical thinking skills. MD-PhD students, along with the entering medical school class, complete the preclerkship years of medical school through either the HST or the New Pathway curriculum. During the first two years of the MD curriculum, BTS students also try to meet some of the classroom requirements for the PhD within the constraints of the preclerkship curriculum. At the end of the second year of medical school, MD-PhD students are offered a one-month summer clinical rotation before starting graduate school. Students then enter the graduate phase of their training by first completing their PhD coursework, and then pursuing dissertation research. After defending their dissertations, students perform their clinical rotations to complete the MD degree. The return to the clinics represents a potentially challenging transition point, and we offer a Longitudinal Course in Clinical Medicine as a special elective to ease this transition from bench to bedside. Additionally, the program provides many enrichment activities for the students, such as poster sessions, annual retreats, informal dinners with faculty, and the “Leaders in Biomedicine” seminar series. These activities build cohesion among all students in the program and  foster mentoring relationships between students and faculty dedicated to this particular cohort of students.

Please note that to be granted the MD degree: MD-PhD Students must complete all course and examination requirements in the New Pathway Program or London HST Program (See Section 1.03, Course and Examination Requirements for the MD degree). The MD curriculum does not permit MD-PhD students to waive any courses required for the MD degree.

Unless otherwise indicated, listing below refers to both the basic and social science tracks.

BTS = basic and translational science only

SS = social science only

Summer Zero

BTS cycle I: Molecular Biology of Human Disease - ME728

This course brings together the entering basic and translational science cycle I MD-PhD students in the basic sciences as a unit in July and August and introduces them to the concept that they are physician-scientists who must consider both basic and clinical aspects of the problems they encounter. This course is currently offered exclusively to MD-PhD students in the basic sciences.

BTS: Lab rotation

Provisional affiliation with graduate program

 

Year I

Preclerkship Curriculum Course Requirements: New Pathway Program or London HST Program (See Section 1.03)

BTS: MD-PhD students are strongly encouraged to enroll in graduate courses that will help fulfill their course requirements for the PhD. The graduate program head, or his/her designate, assists students in their selection of appropriate graduate courses, while the MD-PhD advisor acts as a facilitator to resolve scheduling conflicts. MD-PhD students are invited to participate in graduate program activities for incoming graduate students (poster sessions, journal clubs, etc). Lab rotations are also encouraged.

 

Summer 1

BTS: Lab rotation

SS: Mentored research

Social science MD-PhD students are strongly encouraged to spend this time working with advisors to seek mentored research experience that will develop research skills and identify research mentors. Additionally, throughout their training experience, social science students may apply for funding to support summer research projects. Requests for proposals are sent out each spring.

 

Year II

Preclerkship Curriculum Course Requirements: New Pathway Program or London HST Program (See Section 1.03)

BTS and BTS/SS affiliates: Formal application to graduate program

Step 1 USMLE

Students are required to pass USMLE Step 1 prior to starting their PhD program.

 

Summer 2

Anchoring clerkship

New Pathway and HST students may complete an anchoring clerkship following the end of their Year II preclerkship curriculum. This one-month clerkship in Medicine or Pediatrics allows students to consolidate preclerkship coursework with practical experience and introduces students to the culture of the wards, which facilitates the later transition from thesis to clinical work. The anchoring clerkship may also place thesis work into a broader perspective. All MD-PhD students, whether or not they participate in the anchoring clerkship, should plan to take the Longitudinal Course in Clinical Medicine (see below) in anticipation of reentry to the PCE following completion of the PhD.

BTS: Lab rotation

SS: Mentored research

 

Year III

Graduate course(s)

BTS: Final laboratory rotation (fall) if thesis lab is not yet chosen

SS: Mentored research

Preliminary Qualifying Exam (PQE), spring

Dissertation research begins

BTS: Students should have core preparation in subjects relevant to their graduate department but do not need to have fulfilled their entire graduate course requirement. Some programs (e.g., Biological and Biomedical Sciences (BBS), Neuroscience and MIT Biology) base their PQE exams on the dissertation research; students in these programs will generally take the exam within six months of joining a thesis lab. Students are encouraged to complete the PQE by the end of MD-PhD program year III.

The central portion of the MD-PhD curriculum focuses on full-time dissertation research. Nevertheless, there are a number of opportunities for students to maintain exposure to clinical medicine during this period. Students are encouraged to attend the MD-PhD-Leder Grand Rounds sessions offered throughout the year and may participate in noncredit clinical exposure courses aimed at providing an introduction to the role of physician-scientists in medical subspecialties; these courses do not require a substantial time commitment and do not limit the amount of time spent on laboratory work.

Responsible Conduct in Research:

MD-PhD students in both tracks and irrespective of funding support are required to receive instruction in general areas of medical ethics and the responsible conduct and publication of scientific research. Courses such as the one offered by DMS (Medical Sciences 300: Conduct of Science) meet this requirement. If a student’s graduate program does not offer such a course, the student should notify the MD-PhD Program office and enrollment in the DMS course will be arranged.

 

Year IV

Dissertation research and/or coursework

 

Years V – VI*

Dissertation research, writing and defense

Longitudinal Course in Clinical Medicine- ME725M.J

MD-PhD students are expected to take this course to refresh their clinical skills prior to returning to clinical clerkships. Students who have been away from the MD program for longer than 5 years are required to take this course without exception. This 8-week course runs from the third week in February to the third week in April. For more information, please refer to the MD-PhD Program website: http://www.hms.harvard.edu/md_phd/summer/lccm.html

*Students are encouraged to plan for their return to medical school one year in advance. In addition to planning to take the LCCM, students should be aware of the following considerations:

  • Cycle II funding applications are due in January for the following academic year; Students are expected to present their research at the fall retreat before graduating from the MD-PhD Program. In most circumstances, this is done during the third or fourth years of graduate school;
  • In order to proceed to the Principal Clinical Experience (PCE) all students must complete certified training sessions in Mask Fitting and Basic Life Support, HIPAA and OSHA requirements, an annual TB test, and required immunizations must be up-to-date. Students may need to meet other hospital-specific requirements as well, such as mandatory flu vaccines.
  • HMS re-entry occurs at the beginning of each month between May 1 and September 1. The PCE begins at the beginning of the May rotation and includes a three-day transition course in the week prior to the beginning of the May rotation. All students are required to participate in the transition experience and the longitudinal PCE sessions, even if reentry is delayed beyond the May rotation. Reentry should occur as close to the May 1st start as possible in order to synchronize longitudinal aspects of the PCE that begin on May 1 for all 3rd-year medical students, regardless of start date.
  • For students who are unable to start their PCE clerkship rotations in May, attendance at the longitudinal PCE sessions is required beginning in May (starting with the transition days and including the multidisciplinary PCE course). It is anticipated that all students will complete the PCE core clerkships prior to entering the Advanced Experiences in Clinical Medicine and Basic Science curriculum.
  • Students whose entry to the PCE is delayed beyond May should consult with their Academic Society and the HMS Registrar regarding their PCE schedule and plan for fulfilling their requirements for the MD degree.
  • Students are expected to successfully defend their thesis in advance of returning to medical school.

 

Year VI, VII or VIII

Principal Clinical Experience and Advanced Experiences in Clinical Medicine and Basic Science - Course Requirements (See Section 1.03)

The route of reentry into the core clinical curriculum is through the Principal Clinical Experience (PCE), which is designed to provide a longitudinal experience while fulfilling core clinical clerkship requirements. All MD students fulfill the core clerkship requirements through this route and are required to take the 8-month longitudinal Primary Care Clerkship (PCC) beginning in September and Patient-Doctor III (PD-III), which are integral longitudinal components of the PCE.

The Principal Clinical Experience (PCE) is an integrated year-long block that is completed over 12 consecutive months. All students are required to participate in the weekly longitudinal multidisciplinary curriculum sessions (including PD-III) beginning in May. Students who are not able to complete their PhD work in time to enter the PCE in May may enter the PCE as late as August in a three-month clerkship or as late as September in a one-month clerkship, in consultation with the Society Master and the HMS Registrar; such students must participate in the weekly longitudinal multidisciplinary curriculum sessions beginning in May.

Once clerkships are resumed, continuity in scientific exposure is maintained through special programs designed to bring MD-PhD students together with MD-PhD residents, fellows, and faculty in Harvard teaching hospitals.

 

Apply to residency programs in fall

Step 2 USMLE

Graduation

Requirements for both the MD and PhD degrees should be completed in an average of seven to eight years. Any student who wishes to extend their training beyond a total of nine years for both degrees will need to petition the MD-PhD Program for approval, providing appropriate justification for the extension of time needed to complete both degrees. Ordinarily a student in the MD-PhD Program will not be permitted to remain at HMS beyond 10 years (See Section 2.08, Policy on Length of Time to Complete the MD Degree). A student who has a compelling case for extending the MD-PhD beyond ten years must petition the HMS Promotion and Review Board to approve an extension and must submit at that time a detailed plan and timeline for completing the requirements of both degrees.

 

Other things to consider while planning your schedule:

  • The minimum clinical-month requirement for licensing in the state of Massachusetts is 14 clinical months. The state of California requires 18 clinical months for licensure. In addition to the clinical courses taken, Patient-Doctor II or Introduction to Clinical Medicine count for 2 clinical months in California. Lastly and very importantly, Californiahas a Family Practice requirement. The Primary Care Clerkship (AC700M.J) – a core clerkship required for all MD students - meets the Family Practice requirement. For MD licensure purposes, HMS students must be able to document four years of full-time residence in medical school. If necessary, joint registration in your last semester of PhD work between HMS and your PhD schoolmay count towards this residency requirement. Consult with the HMS Registrar if you have concerns about meeting medical school enrollment requirements.
  • Early Match programs include Ophthalmology, Urology and some plastic surgery programs.
  • All MD students are required to pass USMLE Step 1 and both parts of USMLE Step 2 in order to graduate. Because of limitations in the availability of test slots and the extended reporting timeline for Step 2 test results, students are required to complete Step 2 Clinical Skills by November 1 and Step 2 Clinical Knowledge by December 31 of their final year. To receive an MD degree, test scores must be reported to the HMS Registrar. If a student's passing scores are not reported to the HMS Registrar before graduation, that student will not receive an MD degree at graduation. Because failure to receive an MD degree will have an impact on a student's ability to start postgraduate training, the Academic Societies require students to confirm their test schedules as they prepare the Dean's Letter; failure to schedule the test before the HMS deadline will be noted in the Dean's Letter. To learn more about resources available to help with study strategies, exam-taking, etc., see Section 3.03, Office of Advising Resources.

Students should be aware that some residency programs may require that students have passing scores available for all parts of USMLE, including Step 2CS, by the rank order deadline for the residency match (late February) in order to be considered for ranking by the program. Therefore, HMS now requires students to take CS by early November to ensure the results will be posted prior to rank. Students should check directly with the residency programs for specific requirements.

For the USMLE CS Reporting Schedule, please refer to www.usmle.org .

Application Process for Funding

The MD-PhD Program welcomes applications from all qualified students, including those representing groups that historically have had few members in the MD-PhD Program. The program is committed to the enrollment of a diverse body of talented students.

Two application cyclesare available during the academic year for both the basic and translational science and the social science track, but with some variations.

Basic and Translational Science students: The first cycle is for applicants applying for simultaneous admission to the MD-PhD Program and to Harvard Medical School through either the HMS New Pathway program or the HST program. The second cycle is for unfunded MD-PhD affiliate students currently enrolled HMS New Pathway and HST students. Second cycle application forms are available on eCommons via the MD-PhD Program. First and second-year medical students are not eligible to apply for second cycle funding until the final year of the PhD. If awarded, funding, inclusive of tuition/fees and stipend, is covered for the last two years of medical school only.

Social Science students: First -cycle applicants interested in the social sciences PhD must apply to graduate school at the time of the first cycle application. Students who gain admission to a GSAS doctoral program in the social sciences - and are granted permission to defer for two years - may be considered for funding. The second-cycle process is also available for currently enrolled HMS New Pathway and HST social science students (as above). However, if awarded, support varies on availability of funds, but most frequently covers tuition only for the third year of medical school, and then tuition/fees and stipend for the fourth.

 

Deadlines

First Cycle for undergraduates:

  • October 15, 2012 American Medical College Application Service
  • October 22, 2012 Harvard Medical School Secondary Application
  • For cycle I social sciences – In addition to the above HMS deadline, please refer to the appropriate graduate programs’ websites for their admissions deadlines.

Second Cycle for enrolled MD-PhD students:

  • December 3, 2012 – Letter of Intent due
  • January 14, 2013 – Application deadline

Basic and translational science students: Evaluation of applicants for admission to the MD-PhD Program is based upon careful review of all materials submitted as part of the MD-PhD Program application. The admissions committee seeks applicants with outstanding academic ability who have demonstrated commitment to pursue careers in academic medicine and research. The most competitive applicants will have had substantial and meaningful research experience. Applicants selected for interviews will meet with two members of the MD-PhD admissions committee. Final decisions are made in March for first cycle applicants and later in the spring for second cycle applicants.

Social science students:  It is important to note that the HMS and GSAS application processes are independent. Therefore, students must follow relevant procedures for each of these applications, including meeting all admissions requirements and securing letters of reference for each respective program. Students who accept offers of admission at both HMS and GSAS are eligible to apply for Cycle I funding. In order to be eligible to apply for Cycle I funding from the Social Sciences MD-PhD Program a student is required to:

  1. Accept an offer of admission to Harvard Medical School;
  2. Accept an offer of admission to a relevant social sciences doctoral program at the Harvard Graduate School of Arts & Sciences and then also receive permission to defer matriculation until after completion of HMS years I and II.

Advice on Graduate Programs

The MD-PhD Program application does not replace the formal application required for graduate school. For all MD-PhD students in the basic and translational sciences or for affiliate students who are in the social sciences, formal application to a graduate program is not usually made until the second year of the MD-PhD Program. As previously stated, cycle I social science students must apply concurrently to a GSAS doctoral program with their application to medical school.

Requirements for admission and specific application procedures vary according to the individual graduate programs. Students are strongly advised to contact representatives of the graduate programs to consult about selection and specific requirements. Some graduate programs may require the Graduate Record Examination (GRE). In addition, some PhD student fellowships may require the GRE.

Completing as many graduate program requirements as possible is advantageous prior to officially entering a graduate program in the third academic year. The best first step is to make a tentative choice of a graduate program. Next, contact the graduate program and obtain detailed information about their requirements for MD-PhD students. Websites are also useful sources, but keep in mind that requirements for MD-PhD students often differ from requirements for other graduate students.

Course requirements vary among programs. Completing one or more graduate courses during the first two years at HMS is helpful for BTS students. Courses should be chosen in consultation with faculty from the graduate program. Occasionally, HST courses and New Pathway courses can count towards the graduate course requirement, but this type of overlap is usually limited.

During the graduate years, MD-PhD students are supported by funds available from the individual graduate programs, special fellowships, and research assistantships.  Students who do not receive MSTP support prior to beginning a graduate program are required to apply for individual fellowships offered by the NIH and other funding agencies if eligible, in order to be considered for cycle II fellowships. Administrators in the graduate program and the MD-PhD Program office are available to advise students about funding opportunities.

For basic and translational sciences students: Most graduate programs require at least two laboratory rotations, usually with faculty members associated with their program (i.e., rotations with other faculty may not “count” toward the program rotation requirement). These can be completed prior to enrollment in the graduate program. One rotation will be in the lab that the student ultimately chooses for thesis work. Lab rotations, which may be done at any time during the year, typically involve at least a 25% time commitment to a lab for a period of 6–14 weeks. To get credit for a rotation in DMS, a student must complete a rotation form, which must be signed also by the rotation advisor. The form can be found on eCommons or can be requested from the MD-PhD Program office. Formal application is made to the graduate program by the middle of the second academic year at HMS. Deadlines vary among programs. Basic and translational science MD-PhD students who enter the program as cycle I applicants are highly competitive for admission to participating graduate programs.

For further information, please contact:

MD-PhD Program, Harvard Medical School

260 Longwood Avenue, TMEC, Room 168

Boston, MA 02115

Telephone: 617-432-0991

Fax : 617-432-2791

E-mail: mdphd@hms.harvard.edu

Website: http://www.hms.harvard.edu/md_phd/

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