History – Past and Present
Since 1956, the University of Florida’s College of Medicine (UF-COM) has had a long and proud tradition of training physicians by placing its focus on producing the next generation of specialists, scientists, clinical researchers and health policy leaders who not only place their expertise in the service of individual patients but also significantly impact the health and well-being of populations and societies. To this end, the MD-PhD Training Program at UF-COM is at the forefront of this College’s mission.
The MD-PhD Program at the University of Florida has been training clinician-scientists continuously for over 30 years through intramural funding. This program trains clinician-scientists for a career in academic medicine with the full expectation that our MD-PhD students will become future leaders at academic medical centers worldwide. Since Dr. Thomas A. Pearson arrived as the new Director of the MD-PhD Program, the program has undergone a major restructuring and secured an increased budget to promote growth in both content, size, scope and diversity.
Innovative Curriculum in Clinical Translational Science
As a reflection of the organizational principle and paradigm of Clinical Translational Science (CTS) , the MD-PhD Program now offers virtually unlimited options for combining an MD curriculum with PhD dissertation work. In addition to traditional disciplines that advance the “bench to bedside” component of the CTS paradigm such as molecular and cell biology, genetics, physiology, pharmacology and neuroscience, applicants with an interest in medical anthropology, sociology of medicine, epidemiology, health and human services, bioethics, and other social, population-based and/or computational sciences are encouraged to pursue their thesis work in these “non-traditional” disciplines that are critical to advancing the “bedside to community” components of the CTS paradigm. Opportunities to do thesis work in other institutions are also possible.
In the predominant model, students spend the first two years of medical school taking the basic sciences classes as other medical students. For those trainees whose research areas require significant prior clinical training (e.g. health policy, health economics, epidemiology, etc.), students may complete their third year clinical clerkships before embarking on their PhD thesis work. During this period MD-PhD students identify potential research mentors and select a dissertation project that will commence during the third year (2-3-2 model) or fourth year (3-3-1). After completing their dissertation research. Students return to medical school for completion of their clinical training. The MD-PhD program was restructured during the 2008-09 academic year as an integral part of the Clinical and Translational Science Training Program at the University of Florida. Efforts are ongoing to establish a new Clinical Translational Science (CTS) Core Curriculum to be taken in the summer between the first and second year of medical school. Introduction of the basic principles of CTS at this early entry point is intended to provide the foundational knowledge and experience that will allow MD-PhD trainees to make more informed decisions about how to choose the discipline, mentor and laboratory tailored to their backgrounds, interests and sense of “calling” as future clinician-scientists.
MD-PhD students generally face two difficult transitions. The first is when they begin graduate training after the first two years of basic science work. The second comes when they return to medical school after their dissertation is completed. We ease these passages by assigning a mentor who serves on the MD-PhD Advisory Board for each MD-PhD student from the very start of matriculation. These clinician and clinician-scientist faculty help students maintain patient skills (by attending ward rounds and clinics) and discussing the clinical applications of their doctoral research. We ensure that students hit the ground running with respect to their graduate research projects by arranging research opportunities in the summers after their first and second years of medical school (some students will also opt to do lab rotations in the summer before the first year; we maintain this as an option since this transitional summer may be the last free summer they will have for some time). Students are also encouraged to attend lab meetings of prospective mentors, to begin to design their research projects before actually entering the lab, and to attend a course that will prepare them to apply for extramural funding (e.g. an NIH F30 grant to support MD-PhD students) in the summer following their first year in their chosen mentored lab. Regular one-on-one and monthly group meetings throughout the academic year between the trainees and the MD-PhD Program Director ensure that the progress of trainees is closely monitored at each stage and translational event during the course of their training. This mechanism will be tightly integrated with a newly implemented oversight and approval process through the MD-PhD Advisory Board. Dedicated workshop and a “Distinguished Lecturer” seminar series will provide additional structure and dedicated content to the trainee experience. Regular group social events throughout the year will foster a sense of identity and culture for this group of trainees who are being prepared to take on a special mission and who are expected to make a unique and valuable contribution to advancing biomedical research and clinical translational science for the benefit of the patients and diverse populations served by national and international healthcare systems.
PhD Training Years
Three to four years are usually required to undertake and complete a PhD program. Thus, MD-PhD students typically require seven to eight years to obtain their combined degree. We do not feel that onerous course requirements or administrative burdens are the best way to achieve this goal. The dissertation Supervisory Committee is selected by the student and mentor and plays a major role in setting the academic requirements for the PhD degree beyond those stipulated by the Graduate School. The Committee determines specific course requirements, administers the written and oral qualifying exam, and decided when the student graduates. Most importantly, the Committee provides research and career advice throughout the period of graduate education. At least one member of the MD-PhD Advisory Board must be a member of each student’s Dissertation Committee.