Training The Next Generation of Physician Scientists

Sylvia Corvera, MD Philip Feinberg

Multidisciplinary and collaborative research aimed at ameliorating human disease has been pursued by physicians and scientists for many years. The COVID-19 pandemic has raised awareness of the value of these collaborative efforts; we’ve all seen firsthand what rigorous collaborations across the health care ecosystem can do. They resulted in the rapid identification of the pathogenic virus, established diagnostic tests, developed and improved standards of patient care, guided resource allocation, and paved the way for the development of several highly effective vaccines. We have seen how necessary it is to have experts that understand clinical medicine and have the research skills to identify and move evidence-based practices forward. And, we have seen how important this was, and remains, to patient and public safety. At the intersection of medicine and research sits the physician scientist, a professional with focused training in both areas and uniquely suited to bridge the divide between bench and bedside.

While many avenues to become a physician scientist exist, the dual degree MD/PhD program is one that combines medical and scientific training for a continuous, on average, eight-year period. At the University of Massachusetts Medical School, MD/PhD students are enrolled in both the School of Medicine and the Graduate School of Biomedical Sciences, learning alongside traditional single-degree students, while integrating medical and research knowledge. The National Institutes of Health awards a competitive Medical Scientist Training Program grant to the most successful MD/PhD programs in the United States, which are trusted to “develop and implement effective, evidence-informed approaches to integrated dual-degree training.” The UMMS MD/ PhD program successfully competed for MSTP status in 2013, a clear testament to how the quality of our program is perceived nationally. The growth of the program is another testament to its relevance. In 2004, when the program opened its enrollment for the first time to applicants from outside the Commonwealth, it received 43 applications. In 2021, the program received 263 applications, from which 11 applicants were selected to join a robust program of 76 students.

The core components of physician-scientist training at the UMMS campus take place in basic science laboratories, clinical research labs, and inpatient and outpatient settings – all of which give students access to a rich environment in which they can develop their skills as physician scientists. A strength of the UMMS MD/PhD program is the recognition by program leadership and students of the changing needs in society and of the fast evolution of medical research technologies which must be met by a dynamic training model. We therefore work together to constantly refine the program to meet the distinct career goals, motivations, academic identity and preparedness of aspiring physician scientists. This involves addressing areas not included in the traditional single degree programs, such as simultaneously learning how to use best-practice guidelines to diagnose and treat a disease while remaining open to posing further questions and designing research studies to answer them. We have developed a specific program, the Physician Scientist Forum, to help students identify knowledge gaps in our understanding of diseases and the most current research tools and concepts that can be leveraged to fill these gaps.

The COVID-19 pandemic demonstrated just how activities such as the Physician Scientist Forum can rapidly help address an emerging health crisis. In the early weeks of the pandemic, when case and mortality numbers were on the rise in our community, a significant volume of COVID-19 research had not yet undergone the normal and trusted peer-review process. There was confusion about what it all meant for treating patients or protecting ourselves, our loved ones and our community. The MD/PhD program arranged three 90-minute campus-wide virtual Physician Scientist Forums to address what we knew in five primary areas, each fundamental to understanding the nature of the pandemic. We refer to these areas as “pillars of disease”, and they are: clinical presentation; epidemiology; molecular pathophysiology; mitigation, which includes treatment and prevention; and justice, which includes impact of health disparities. Current students, with related expertise derived from their clinical and research focus were selected to present in these forums. Additionally, basic science and clinical faculty experts were available to provide their own insights and to answer audience questions. Through this experience, we helped educate our community during an emerging health crisis and gave our students an opportunity to further their skills in communicating science to general audiences. Moreover, several of our students rapidly pivoted their efforts into developing tools and clinical research strategies specifically to help mitigate COVID-19.

Our community was rocked by more than just COVID-19 in 2020 and 2021. In the aftermath of George Floyd’s murder, and a national conversation about racism in America, we began our own reckoning as an MD/PhD program asking what role physician scientists have in achieving healthcare equity. By pursuing both medical and scientific training, we are committed to providing our patients of today with the best possible care while remaining steadfast in our goal to provide patients of tomorrow with better outcomes through collaborative research and innovation. As such, we agreed that we have a duty to understand the broad impact that racism has on various aspects of health and began an initiative to incorporate discussions on racism and justice into our Physician Scientist Forums. Over this past year, we held four 90-minute sessions on racism in medicine and focused each session on specific minority populations in the U.S. We discuss the diverse ways that racism and injustice exist within the health care field, how we can be better providers to patients from minority communities and what role research plays in either perpetuating or correcting health disparities. We believe that learning about how racism contributes to medical injustice, we can contribute to eradicating it through our collective careers by applying best practices at the bench and bedside.

As we look to the future, our goal remains to provide the next generation of physician scientists with the tools required to make a mark on healthcare discovery and innovation. We welcome any members of the Worcester medical community to contact us if interested in collaborating on local projects or participating in our Physician Scientist Forums.

Silvia Corvera, MD, is professor of molecular medicine, endowed chair in diabetes research and director of the MD/PhD program at the University of Massachusetts Medical School. Email: silvia.corvera@umassmed.edu.

Philip A. Feinberg is a student in the MD/PhD program at the University of Massachusetts Medical School working on understanding and treating neuropsychiatric disorders. Email: Philip.feinberg@umassmed.edu.

References:

1. Medical Scientist Training Program. Accessed July 27, 2021. https://www.nigms.nih.gov/training/ instpredoc/pages/predocoverview-mstp.aspx