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MD/PhD Physician Scientist Forum

The Physician Scientist Forum (PSF) is a course designed specifically for physician-scientist training that integrates clinical medicine skills and research principles. The curriculum provides: 1) integrated clinical and research content, 2) differential diagnosis and clinical problem solving early in MD-PhD training, 3) exposure to different research approaches, 4) exposure to different clinical specialties, and 5) opportunity to develop communication and presentation skills throughout the training continuum. To mitigate the discontinuity resulting from transitions between medical school and graduate school curricula, the PSF is vertically integrated and requires the participation of all MD-PhD students at all stages of training. This has been achieved by leveraging video conferencing technology which allows participation of students and faculty from remote clinical or research settings.

The PSF is a gathering of students and faculty who meet every two weeks throughout the academic year to discuss the interface between clinical medicine and basic science and population-based research. In this course, MD-PhD students integrate their medical and research training throughout the duration of their medical and graduate studies. The PSF is designed to achieve six goals: 1) develop a customized course for training physician-scientists, 2) incorporate differential diagnosis and clinical problem solving into MD-PhD training, 3) connect clinical and research topics, 4) expose MD-PhD students to different clinical specialties, 5) provide MD-PhD students with content relevant to their long-term career goals, and 6) allow MD-PhD students to gain experience delivering content that satisfies specific learning objective.

The 1.5-hour sessions during each two-month block are structured as Thematic Modules around a clinical specialty or subspecialty and include didactic presentations by students and faculty and small group discussions. Each thematic module consists of 3 sessions: Clinical Problem Solving, Ongoing Investigations, and the Science Consult. During these sessions, attendees interactively solve clinical cases, learn about current research being done by students in the program, and comprehensively examine a specific disease treated by that clinical specialty or subspecialty.

The Clinical Problem-Solving session aims to develop student proficiency in obtaining, organizing, and interpreting clinical data and subsequently developing a differential diagnosis and a plan for clinical management. To help students formulate their diagnostic approach, this session features residents, fellows, and clinical faculty. This not only introduces MD-PhD students to clinicians, but also reciprocally provides clinical trainees and faculty with the opportunity to teach and interact with MD-PhD students and develop potential clinical and research collaborations. In this session, a case is presented after which students and faculty break into three groups to discuss and develop a differential diagnosis. When the group reconvenes, each group presents its conclusions, and two students then deliver brief presentations about clinical and scientific topics related to the case. A final discussion highlights the teaching points epitomized by the case. This session highlights the similarities between the clinical diagnostic process and the scientific method.

The Ongoing Investigations session consists of a brief case presentation given by an MD-PhD student who has returned to medical school for their final clinical rotations to provide clinical context for the subsequent student research presentations. Two students, one in the early stages of their graduate studies and the other close to defending their dissertation, present their ongoing research to demonstrate research methods, hypothesis testing, and research design at different phases of training. The presentation by a student who is early in their thesis research allows them the opportunity to present developing ideas and early data and get feedback from their peers and program faculty working in similar and in disparate research areas. The presentation by a student who is nearing completion of their thesis research allows them the opportunity to present updates on their ongoing research and to obtain insights and critiques that are relevant to preparation of their dissertation. Each student presentation is preceded by a brief presentation by their primary research mentor to place the student’s research in context and to provide other students in the program with exposure to the research being conducted in the mentor’s group.

The Science Consult session is a grand rounds-style clinicopathological conference, during which a clinical case is presented by a physician-scientist faculty member or fellow and is followed by brief presentations by students about the 5 pillars of medicine as they relate to the case: clinical presentation, epidemiology, molecular and cellular pathophysiology, mitigation (prevention and treatment), and social determinants of health. The session concludes with a discussion by a physician-scientist faculty member that highlights key aspects of the case. This session provides attendees with a comprehensive and multifaceted overview of a disease and discussion of pertinent ongoing research and of unanswered questions that remain to be investigated.

The final session of each two-month block is devoted to a variety of topics including career development, professionalism and ethical conduct of research, and diversity, equity, and inclusion. Twice a year as part of the PSF, the students read and discuss a book that deals with issues of diversity and equity in medicine. These have included: “Caste: The Origins of Our Discontents” by Isabel Wilkerson, “The Immortal Life of Henrietta Lacks” by Rebecca Skloot, “Medical Apartheid” by Harriet Washington, “The Guarded Gate: Bigotry, Eugenics, and the Law That Kept Two Generations of Jews, Italians, and Other European Immigrants Out of America” by Daniel Okrent, and “The Secret of Life: Rosalind Franklin, James Watson, Francis Crick, and the Discovery of DNA's Double Helix” by Howard Markel.