Moderator: Karen Zier (Mount Sinai School of Medicine)
Panelists: Don Hoang (Yale University School of Medicine), Samuel Vanderhoek (Mount Sinai School of Medicine), Edward Vazquez (New York Presbyterian Hospital–Columbia Campus), and Annie Wang (The Warren Alpert Medical School of Brown University)Presented by the Josiah Macy Jr. Foundation, the Mount Sinai School of Medicine, and the New York Academy of Sciences
Reported by Adrienne J. Burke | Posted May 1, 2012
Some medical school educators say that undertaking basic research can help medical school students sharpen the analytical, creative, and critical-thinking skills that the practice of medicine demands. And in the contemporary environment of rapidly advancing science, uniting medical education with scientific research is seen as a crucial way to ensure that scientific discoveries are translated to clinical practice as expediently as possible. Exposing medical students to research might also lead some to consider career paths that include investigation—historically a rarity among medical school graduates.
On February 24, 2012, the Josiah Macy Jr. Foundation, Mount Sinai School of Medicine, and the New York Academy of Sciences presented Integrating Student Research into the Medical School Curriculum, a symposium exploring questions about the impact of students' long-term research on the quality of care they give as physicians and on their career choices, as well as the logistical challenges of incorporating research into the medical school curriculum.
Leaders of four medical research programs participated in a session that asked, "Does the research experience influence a physician's career trajectory and corresponding capabilities?" Following that session, a panel of current medical students and recent graduates shared their opinions about their research experiences during medical school to provide anecdotal answers to that question. Each presenter approached the question differently and delivered quite different answers regarding career trajectory. The physicians-in-training on the panel addressed the subject of how the research experience has contributed to their capabilities.
Edward Vasquez, an alumnus of a one-year NIH research program who completed his MD at Mount Sinai, is now a cardiovascular medicine resident at Presbyterian Hospital–Columbia Campus and is planning a career as a clinical investigator. Vasquez joined three fourth-year medical students on a panel to share the medical student perspective on research training in the curriculum. He said a year of research training reinforced an interest in research he possessed even before heading to medical school. His research year was crucial, he said: squeezing the research experience into six or eight weeks during his four-year training might be enough to pique an interest, he said, but he doesn't believe it would have been enough time for him.
Panelist Don Hoang, a fourth year student at the Yale School of Medicine, participated in a three-month short-term summer clinical project in Vietnam and was also among more than 30 Yale classmates who took a year off between the third and fourth year to pursue basic science and a clinical research project. For Hoang, mentorship was an invaluable benefit of his research experience, as was "being able to dive [into] an apprenticeship model where you're learning. Those things add up to something richer than learning it in a course."
Samuel Vanderhoek participated in the Howard Hughes Medical Institute (HHMI)-Cloister program as well as in a summer research project at the NIH. As a humanities and medicine scholar at Mount Sinai, Vanderhoek said that "doing science unconstrained" is something he would have missed. "It's very hard for med school students to know how to ask a question," he said, and research training helped him to develop a skill for thinking about and posing questions.
Annie Wang has participated in research training at the Warren Alpert School of Medicine of Brown University, where she is now in her fourth year. Asked what she would have missed if she had not participated in research, Wang said, "The longitudinal relationship with supporters has been instrumental to my ability to put together research and letters of recommendation. If I didn't have this experience I would have missed out on engaging discussions and innovative ideas." She said the experience also honed her ability to "think outside the box, pursue different ideas, and make ideas into reality."
Did these students acquire skills through research that will affect patient care? Vanderhoek said that research taught him a sophisticated approach to framing and asking questions that he believes will lead to better patient care. For instance, he said, "asking 'what do you think is going on here?'—a typical question from a medical resident supervising students with patients—is an awful way of approaching a problem." You wouldn't frame a research question that way, so why approach a patient phenotype that way?
Wang relayed a research experience that did result in better patient care: When her Grand Rounds team linked a patient's skin disorder with a radiological exposure, genetic testing was warranted. Wang said her research experience helped her identify a U.S. lab willing to conduct the testing for free.
Vasquez added that research has made him a more effective reader of scientific literature. "If you don't have analytical skills to be able to read a publication, you're doing yourself a disservice," he said. The weekly lectures and journal clubs that were part of his research experience honed those skills. Finally, Hoang said research has taught him to transcend the "valley of death" between laboratory discoveries and clinical outcomes.
Concluding with the question of the day: Do these recent beneficiaries of the research experience believe that it should be mandated by the medical school curriculum? Responses were mixed. Wang, whose undergraduate experience at Brown taught her to appreciate an open curriculum, said she believes that students who are not research-oriented should be free to pursue other opportunities to "give back."
Vanderhoek, on the other hand, experienced a rigid curriculum as an undergraduate at Columbia and sees the merits in that approach to medical school. "When you're doing this forced work it feels like you have no control, but at the end you are extremely well educated, and I feel like medical school should be the same. That will allow you very deep understanding of the material, which you can't replicate by being lectured. There's something to be said for a research project—not necessarily a whole year—but a project to get you thinking."
Hoang agreed that a year of research could be too much to ask of all students: Yale's program teaches the research basics, but to go beyond that, such as requiring a full year of research like he pursued, would not be for everyone.
Use the tab above to find multimedia from this event.
Media available from panel discussion featuring:
Don Hoang (Yale University School of Medicine)
Samuel Vanderhoek (Mount Sinai School of Medicine)
Edward Vazquez, MD (New York Presbyterian Hospital–Columbia Campus)
Annie Wang (The Warren Alpert Medical School of Brown University)
Moderator: Karen Zier, PhD (Mount Sinai School of Medicine)
To view other media from the conference please visit the Integrating Student Research into the Medical School Curriculum eBriefing
This meeting is part of our Translational Medicine Initiative, sponsored by the Josiah Macy Jr. Foundation and The Mushett Family Foundation.