5.01 MD-PhD Program

Office of the Registrar

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5.01 MD-PhD Program

The overall mission of the MD-PhD Program at Harvard Medical School (HMS) 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 HST or New Pathway MD program (Sections 1.01, 1.02, 1.03, 1.04) with an appropriate graduate program, students design their own courses of study in the PhD program. 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.

Affiliate Program

Students who enter HMS as MD students and decide after admission to pursue both the MD and a PhD degree are eligible to apply for affiliate status in the MD-PhD Program. The application for affiliate status is available on eCommons via the MD-PhD Program. Students are encouraged to apply in their first year of medical school, or 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 or mentored research; application and acceptance to a graduate program; and satisfactory completion of medical and graduate school requirements.

Students who have 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 usually follows a “2-4-2” model. Cycle I students begin their training in the summer before the first year of medical school with a course entitled Molecular Biology of Human Disease, designed to introduce MD-PhD students to current disease-oriented research problems in the biomedical sciences and to develop their critical thinking skills. During the first two MD years, 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 beginning graduate school. Students then enter the graduate phase of training by first completing their PhD coursework and then pursuing dissertation research. After defending their dissertations, students enter the final two years of the MD program, including the Principal Clinical Experience year and the final, advanced year of medical school, which includes a core subinternship and clinical elective rotations. The return to clinical experiences 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. This course is strongly encouraged for all returning MD-PhD students but is required for students who have been away from medical school for 5 years or longer.

The MD-PhD program also provides many enrichment and paracurricular activities to supplement the core educational training of the dual degrees and to foster community, provide career development, and facilitate the integration of patient care and research. 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.

Summer Zero

Molecular Biology of Human Disease - ME728

This course brings together the entering cycle I MD-PhD students 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. Occasionally, affiliate students are approved to participate.

Lab rotation/mentored research

Provisional affiliation with graduate program

Year I

Preclerkship Curriculum Course Requirements: New Pathway Program or London HST Program (See Section 1)

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

Summer 1

Lab rotation/Mentored research

Year II

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

Formal application to graduate program (note: social science cycle I students completed this step at the time of their HMS applications.)

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

Summer 2

Anchoring clerkship

New Pathway and HST students may complete an anchoring clerkship following the Year II preclerkship curriculum. This one-month clerkship in Medicine or Pediatrics allows students to consolidate preclerkship course work 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.

Lab rotation/Mentored research

Year III

Graduate course(s)

Final laboratory rotation (fall) if thesis lab is not yet chosen/Mentored research

Preliminary Qualifying Exam (PQE), spring

Dissertation research begins

The central portion of the MD-PhD program focuses on full-time dissertation research. Nevertheless, there are a number of opportunities for students to maintain exposure to clinical medicine during this period. Please refer to our website for the full list of current clinical offerings: http://www.hms.harvard.edu/md_phd/events/clinical_offerings.html.

Students should have core preparation in subjects relevant to their graduate department but do not need to have fulfilled their entire graduate course requirements. 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.

Responsible Conduct in Research:

MD-PhD students 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) or by HSPH (HPM548) meet this requirement. Most graduate programs also require such a course. The MD-PhD Program office annually completes a thorough review of the students and reaches out, as needed, to ensure compliance. Students in graduate programs that do not have this requirement will be enrolled in the DMS course or its equivalent.

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 5 years or longer 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 strongly 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.
  • HMS re-entry occurs at the beginning of each month between May 1 and September 1[NB: See HMS academic calendars for actual start dates as blocks may not begin precisely on the first day of the month http://mycourses.med.harvard.edu/ResCourses/CampusWide/academic_schedules.htm]. Reentry should be 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 clerkship start date. All returning MD-PhD students must enroll in the longitudinal PCE curriculum at their PCE site at the beginning of May and attend the PCE orientation the week prior to the beginning of the PCE regardless of the start date of their first core clerkship.
  • Students are required 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 over 12 consecutive months. All MD students fulfill the core clerkship requirements through this route and are required to participate in weekly longitudinal, multidisciplinary curriculum sessions (including Patient-Doctor III) beginning in May and the weekly Primary Care Clerkship (PCC) beginning in September.

Students who are not able to complete their PhD work in time to enter the PCE in May may begin core clerkships 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 (CK and CS)

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 and a plan and timeline for completing them. 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, California has a Family Practice requirement. The Primary Care Clerkship 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. 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. For more detailed information, please refer to the HMS website Career Advising: Roadmap to Residency: http://hms.harvard.edu/departments/medical-education/student-services/career-advising-roadmap-residency.
  • All MD students are required to pass USMLE Step 1 and both parts of USMLE Step 2 (Clinical Knowledge [CK] and Clinical Skills [CS]) 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 the 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 the 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.
  • The MSPE (Medical Student Performance Evaluation or “Dean’s Letter”) is now sent out on October 1.

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/Examinations.

Deadlines for Second Cycle for enrolled MD students:

  • December 3, 2013 – Letter of Intent due
  • January 14, 2014 – Application deadline

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.

Advice on Graduate Programs

The MD-PhD Program application does not replace the formal application required for graduate school. For MD-PhD students (other than cycle I social science students) formal application to a graduate program is not usually made until the second year of the MD-PhD Program.

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. 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 may be completed prior to enrollment in the graduate program, if feasible. 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 the MD-PhD eCommons page or 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.

Leaves of Absence: Policies regarding leaves of absence (LOA) vary depending on the student’s point in training. In addition to the respective program’s approval (e.g., MD, PhD [GSAS, MIT]), approval for a LOA from the director of the MD-PhD Program is also required. Students in the graduate school phase of training should also notify their medical school society master about any extended time away. The society master will advise the student on the implications to his/her medical training and what, if any, further review or approval is needed by the Program in Medical Education.

Helpful websites:

HMS Student Handbook: Sections 2.09: Leaves of Absences; 2.07: Full or Part Time Status Requirements; 2.08: Policy on Length of Time to Complete the MD Degree

GSAS: http://www.gsas.harvard.edu/handbook/degree_requirements.php

MIThttp://odge.mit.edu/gpp/registration/changes/

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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