Physician-Scientists
Mukesh K. Jain MD FAHA
Ellery Sedgwick Jr. Chair & Distinguished Scientist
Professor of Medicine
Director, Case Cardiovascular Institute (CVRI)
CWRU School of Medicine
Scientific Director
Harrington Discovery Institute
Chief Research Officer
Harrington Heart & Vascular Institute
University Hospitals Case Medical Center
President-elect ASCI
September 2013
American Society for Clinical Investigation (ASCI)
• Established in 1908 to represent scientific elite in medicine
• Goals: Support physician-scientists
Encourage scientific engagement by medical trainees
(MD-PhD)
Oversees the Journal of Clinical Investigation (JCI)
• Members – 3,147 (117 outside USA)
19 Nobel Laureates
31 Lasker Awardees
537 Elected in the National Academy of Sciences/Institute
of Medicine
September 2013
Physician-Scientist
Transforms fundamental knowledge
into therapies
Establish new standards for the
practice of medicine
Able to move from bench to
bedside and back
Physician-Practitioner
Implements standards of
care into the community
September 2013
Physician-Scientist Impact
• 1971 Sutherland (hormone signaling)
• 1982 Bergstrom, Samuelsson & Vane
(prostaglandins)
• 1985 Brown & Goldstein (cholesterol)
• 1989 Varmus & Bishop (oncogenes)
• 1994 Gilman & Rodbell (G-proteins)
• 1997 Pruisner (prions)
• 1998 Murad (nitric oxide)
• 2003 Agre & McKinnon (channels)
• 2005 Marshall & Warren (PUD/H. Pylori)
• 2010 Edwards (IVF)
• 2011 Beutler (Toll-receptors)
• 2012 Yamanaka & Gurdon (stem cell)
• 2012 Lefkowitz & Kobilka (GPCR)
September 2013
Impact of MD-PhD Program
• Differentiating factor for academic medical centers and
medical schools
• Attract premier students and faculty
• Attract patients who seek cutting edge, advanced or
experimental therapies
• Enhanced research productivity, publication output and
access to research funding
• Increase National/International Academic Recognition
September 2013
Case Western Reserve University
• First M.D./Ph.D. program (1956) in the U.S.
• Integrated program of biomedical research and clinical
training
• 92 current students and 276 alumni
• 2 Nobel laureates (Gilman, G proteins; Murad, nitric oxide)
• Former U.S. Surgeon General and Director of the Center for
Disease Control (D. Satcher)
• Current leadership:
Cliff Harding MD PhD- Director
Geroge Dubyak PhD – co-Director
September 2013
Case Western Reserve University
MD/PhD Program
Not NIH Supported, U.S. and non U.S. Citizens
Medical Scientist Training Program
NIH Funded and Audited, U.S. Citizens/permanent residents
Medical school (4 years): supported by NIH grant
Research (4 years) - student tuition plus stipend ($15,000-$20,000/year)
paid by advisor through independent NIH funding
~12 students accepted per year at CWRU MSTP
September 2013
Student Accomplishments
• Research recognition at national and international
meetings
• Graduate with average of 2.8 first-authored & 5.3
total papers
• ~80% match into their 1st-choice residency (past
15 years)
• 85% of our alumni remain in biomedical
research/academic medicine
– 71% are faculty in medical schools (not including
clinical adjunct faculty)
– 2% at NIH or other research foundation
– 12% in biotech, pharma, industry
4 years
September 2013
CWRU Programs for MSTP students
Biochemistry
Biomedical Engineering
Cancer Biology
Cell Biology
Epidemiology
Genetics
Pathology
Molecular Biology
Molecular Virology
Neurosciences
Nutrition
Pathology
Pharmacology
Physiology and Biophysics
Systems Biology and
Bioinformatics
September 2013
MSTP Curriculum: First 2 years
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University Program MD curriculum
Starts in July
Graduate school credit (IBIS courses)
Flexible afternoons
Problem based learning (Case Inquiry- “IQ groups”) + other small group instruction,
lectures
Integration of graduate school components
Graduate school courses (flexible afternoons)
Laboratory rotations (3 required) in summers or during fall or spring semesters
Accelerated entry into Ph.D. phase
M2 curriculum ends late Feb/early March of year 2
Spring yr 2: grad course, M2 curric transitions to PhD lab, USMLE part I
September 2013
MSTP Curriculum: Ph.D. phase
• Graduate Program requirements:
– Additional coursework (minimized by credit for MD curriculum plus grad
courses in years 1&2)
– Qualifying exam and/or thesis proposal
– Original research
– Publications (average 5-6 total & 2-3 first author; 1 first-authored paper
required)
– Thesis defense
– Duration: Goal: 3-4 years (average 4 years)
– Total program time 8.0 yrs
• Integration of clinical training: MSTP Clinical Tutorial (longitudinal, 1 year
required, 2 encouraged)
September 2013
MSTP Curriculum: years 3-4
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Enhance clinical skills during Ph.D. phase to prepare for Med year 3
MSTP Clinical Tutorial
MSTP Clinical Refresher (optional)
Clinical electives prior to clinical core block
• Start Med year 3 at beginning of July, August (elective), September,
October, November
– Other start dates possible but are not advantageous in schedule
• Can start non-core clinical electives at other flexible times.
September 2013
Beyond MSTP:
Clinical and Translational Scientist Training Program (CTSTP)
MD-PhD : Medical doctor + PhD
DMD-PhD: Dental doctor + PhD
DNP-PhD: Nursing + PhD
September 2013
MSTP/MD-PhD International
Partnership Models
(1) CWRU provides technical expertise and oversight
(full MD/PhD curriculum abroad)
(2) Hybrid Model (“Sandwich Program”) – MD or PhD
component at CWRU
(3) Establish full MD-PhD program at CWRU
September 2013
Muito obrigado!
September 2013
A World-Class Institution
CWRU ranked 13th among private
institutions in federal
expenditures for science and
engineering research and
development (2012)
September 2013
A World-Class Institution
Graduate/Professional Rankings:
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#14 in Biomedical Engineering
#5 in Health Law
#14 in Pediatrics
#16 in AIDS
#12 in Family Medicine
#15 in Nursing
#9 in Social Work
#3 in Organizational Behavior (Financial Times)
#13 in International Law
U.S. News & World Report (2012)
September 2013
Partnerships with Ohio based world-class
corporate and cultural institutions
Cleveland Clinic Foundation
Cleveland Museum of Art
Cleveland Orchestra
Dollar Bank
Eaton Corporation
Forest City Corporation
Medical Mutual
NASA Glenn Research Center
Rock and Roll Hall of Fame
Sherwin Williams
Swagelok Company
Time Warner Cable Business Class
Timken Company
University Hospitals of Cleveland
September 2013
Partnerships with International Corporations
China National Off-Shore Oil Company (China)
Arcelor Mittal (Luxembourg)
AstraZeneca (United Kingdom)
BP (United Kingdom)
Boehringer Ingelheim GmbH (Germany)
Kyocera Corporation (Japan)
Luxottica Group, S.P.A. (Italy)
Petrobras (Brazil)
Philips Electronics (Netherlands)
Rolls Royce Fuel Cell Systems (U.K.)
Siemens AG (Germany)
September 2013
A World-Class Institution
Case Western Reserve University School of Medicine
Diversity
MD
•46% women
•12% underrepresented groups
Graduate (MS and PhD)
•55% women
•20% international
•11% underrepresented groups
Recruitment Efforts
•Summer Medical Dental Education Program (SMDEP)
•Summer Undergrad Research Internships with SOM Faculty
•Postbac Research Education (PREP) Program
September 2013
Definitions of Physician-Scientists
• A medical practitioner that engages in research to change
standard of care.
• Several models
Dr. Jain – 10% clinical; 80% basic research
Dr. Costa – 50% clinical; 40% translational research
Dr. Ponsky – 50% clinical; 20% clinical research
September 2013