Overview

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

Presented by

This meeting is part of our Translational Medicine Initiative, sponsored by the Josiah Macy Jr. Foundation and The Mushett Family Foundation.

Resources

Websites

Information on the Yale University School of Medicine thesis requirement.

Yale's Summer to Advance Research Training (START@Yale) program.

Harvard Medical School Scholars in Medicine program.

Mount Sinai School of Medicine's Medical Student Research Office

University of Pittsburgh School of Medicine Scholarly Project.

Stanford University School of Medicine MedScholars Program.

Brown Alpert Medical School Scholarly Concentration Program.

UCSF School of Medicine Research Training Programs.

NIH Clinical Research Training Program.

Howard Hughes Medical Institute Medical Research Fellows Program.

Books & Reports

Schafer A. The Vanishing Physician-Scientist? Ithaca: ILR Press; 2009.

Blumenthal D. Training Tomorrow's Doctors: The Medical Education Mission of Academic Health Centers. The Commonwealth Fund; 2002.

Scientific Foundations for Future Physicians. American Association of Medical Colleges and Howard Hughes Medical Institute; 2009.

Journal Articles

Bierer SB, Chen HC. How to measure success: the impact of scholarly concentrations on students—a literature review. Acad. Med. 2010;85(3):438-452.

Boninger M, Troen P, Green E, et al. Implementation of a longitudinal mentored scholarly project: an approach at two medical schools. Acad. Med. 2010;85(3):429-437.

Cooke M, Irby DM, Sullivan W, et al. American medical education 100 years after the Flexner report. N. Engl. J. Med. 2006;355(13):1339-1344.

Dyrbye LN, Cook D. Does the duration of a scholarly concentration affect medical students' productivity? Acad. Med. 2011;86(1):2-3; author reply 3.

Dyrbye LN, Davidson LW, Cook DA. Publications and presentations resulting from required research by students at Mayo Medical School, 1976 – 2003. Acad. Med. 2008;83(6):604-610.

Laskowitz DT, Drucker RP, Parsonnet J, et al. Engaging students in dedicated research and scholarship during medical school: the long-term experiences at Duke and Stanford. Acad. Med. 2010;85(3):419-428.

Rhyne RL. A scholarly research requirement for medical students: the ultimate problem-based learning experience. Acad. Med. 2000;75(5):523-524.

Schor NF, Troen P, Kanter SL, et al. The Scholarly Project Initiative: introducing scholarship in medicine through a longitudinal, mentored curricular program. Acad. Med. 2005;80(9):824-831.

Siddiqui ZS, Jonas-Dwyer DRD. Twelve tips for supervising research students. Med. Teach. 2012.

Zier K, Coplit LD. Introducing INSPIRE, a scholarly component in undergraduate medical education. Mt. Sinai J. Med. 2009;76(4):387-391.

Organizers

Erica S. Friedman, MD

Mount Sinai School of Medicine
e-mail | website | publications

Erica Friedman is Professor of Medicine and Medical Education, Associate Dean for Education Assessment and Scholarship and Associate Director for Research and Mentorship of the Institute for Medical Education at Mount Sinai School of Medicine (MSSM) overseeing programmatic assessment and faculty mentorship and scholarship. She is the Medical Director of the Morchand Center for Clinical Competence that uses Standardized Patients (SP) to assess clinical skills. She was co-PI for the AAMC "Enhancing Education about Chronic Illness," and for the New York Community Trust grant on "Assessing Medical Student Communication Skills: Focus on Cultural Competence," Co-Investigator on the Attorney General's Prescriber Education Program Grant, "Data smog and marketing fog: A critical skills curriculum to educate health professionals about rational prescribing," and PI on the Mannix Award from the Medical, Educational and Scientific Foundation of New York titled "Recognition and communication of medical errors: a three-year curriculum for Internal Medicine Residents." In addition, Friedman is an Internist/Rheumatologist and teaches medical students, Internal Medicine residents, and Rheumatology fellows. Her interests include enhancing physician–patient communication, promoting effective health care teamwork, and educating about osteoporosis and chronic illness management.

David Muller, MD

Mount Sinai School of Medicine
e-mail | website

David Muller received his BA from Johns Hopkins University and his MD from New York University School of Medicine. He completed his Internship and Residency in Internal Medicine at the Mount Sinai Medical Center, where he spent an additional year as Chief Resident. Upon completing his training Muller co-founded and directed the Mount Sinai Visiting Doctors Program. Visiting Doctors is now the largest academic physician home visiting program in the country. In May 2005 Muller was appointed Dean for Medical Education and Chair of the Department of Medical Education. His recent honors include the Jacobi Medallion (2011), Founder's Award, Mount Sinai Visiting Doctors, Departments of Medicine and Geriatrics (2010), the AMA Pride in the Profession Award (2009), Department of Medicine's Ruth Abramson Humanism in Medicine Award (2005) the Alexander Richman Commemorative Award for Humanism in Medicine (2005), induction into the Gold Humanism Honor Society (2004), and the Casita Maria Community Builder Award (2002). Muller is Professor of Medicine and Medical Education and is a Fellow of the New York Academy of Medicine.

Karen Zier, PhD

Mount Sinai School of Medicine
e-mail | website | publications

Karen Zier is Professor of Medicine, Medical Education, and Immunology and the Associate Dean for Medical Student Research at Mount Sinai School of Medicine. She received her PhD in Microbiology and Immunology from the State University of Buffalo, having carried out her thesis research under the mentorship of Fritz Bach at the University of Wisconsin in Madison.

Zier is the author of over 70 publications in cancer immunology and medical education. She has served on numerous NIH study sections and received a gubernational appointment to the New York State Health Research Science Board. She is committed to the development of strongly mentored research programs that provide medical students with opportunities for original scholarship. Zier is Principal Investigator and Program Leader of the Doris Duke Clinical Research Fellowship Program for medical students, Program Director of PORTAL (a 5-year MD/Masters in Clinical Research dual degree program), and co-Director of INSPIRE (a 12-week scholarly program in the 4th year). She also serves as director of the first year Immunology course.

Sonya Dougal, PhD

The New York Academy of Sciences
e-mail

Monica L. Kerr, PhD

The New York Academy of Sciences
e-mail

Moderator

Karen Zier, PhD

Mount Sinai School of Medicine
e-mail | website | publications

Panelists

Don Hoang

Yale University School of Medicine
e-mail | publications

Don Hoang earned a BS degree in Biological Sciences from Stanford University. During his undergraduate career he dedicated three years to researching cancer resistant mechanisms in an oncology laboratory at Stanford's school of medicine. Recruited by Amgen Inc., he conducted research on cancer signaling pathways in the industry setting as part of his last year of college. He subsequently enrolled in medical school at Yale University, where he has been involved in teaching medical school courses, mentoring pre-medicine undergraduate students, and undertaking multiple clinical and basic science research projects. He was awarded a Wilbur Downs Global Health Research Fellowship where he completed a cross-sectional clinical investigation assessing the knowledge and perceptions regarding HIV/AIDS and antiretroviral medications of HIV-infected patients in Ho Chi Minh City, Vietnam. Furthermore, he took a dedicated research year to complete a thesis on a novel signaling pathway and to earn a Masters degree in clinical health sciences research. Funded by a competitive NIH Clinical Translational Science Award Fellowship and supported by his world-renowned mentor, Deepak Narayan, he pursued independent medical research, conducted prospective clinical studies, communicated findings to the scientific community, acquired a $100,000 research grant, and participated in innovation of the plastic surgery field through patent technology.

Samuel Vanderhoek

Mount Sinai School of Medicine
e-mail | website

Samuel Vanderhoek is a fourth-year medical student at Mount Sinai School of Medicine in New York. An avid runner, swimmer, and David Sedaris fan, Vanderhoek received a Bachelor of Arts from Columbia University. From 2010 – 2011, he studied the TNF Receptor-Associated Periodic Syndrome in Richard Siegel's laboratory at the National Institutes of Health as part of the Howard Hughes Medical Institute Research Scholars Program. Vanderhoek's research interests lie at the intersection of immunology and cell biology, particularly how misfolded protein aggregates in the cell can lead to profound inflammatory sequelae. He credits multiple research experiences during medical school with instilling in him a passion for scientific inquiry as well as enhancing his understanding and practice of clinical medicine.

Edward Vazquez, MD

New York Presbyterian Hospital–Columbia Campus
e-mail | publications

Edward Vazquez is a 2nd year anesthesia resident at the New York Presbyterian Hospital Columbia. He graduated with a dual major in Economics and Studio Art from Tufts University in 2002. Upon graduation, Edward became interested in the medical sciences and pursued his postbacculeaurate training at both Tufts and Harvard University. He attended Mount Sinai School of Medicine in New York, NY and graduated with an MD in 2010. While a medical student, Edward spent a year at the National Institutes of Health as a fellow in the Clinical Research Training Program under the leadership of Frederick Ognibene and Richard Cannon.

Annie Wang

The Warren Alpert Medical School of Brown University
e-mail | publications

Annie R. Wang was born in China but spent most of her growing years in the U.S., in Connecticut, Illinois, and Rhode Island. She was accepted into the Program of Liberal Medical Education (PLME), Brown University's 8-year medical program, from which she received her Bachelors of Science with Honors in Human Biology from Brown University in 2007. After completing her first semester of medical school at the Warren Alpert Medical School of Brown University, she took a year off during which she spent months at home helping her family take care of her terminally ill grandmother while participating on smaller research projects during her spare time. Through her personal experience and interaction with the elder population, Annie became interested in the integration of geriatrics content in medical school and enrolled in the Scholarly Concentration in Aging. She has worked on various papers and scholarly products including a Pathophysiology in Aging pocket reference card. She continues to engage in smaller research projects in her final year of medical school and plans to start residency later this year.

Adrienne J. Burke

Adrienne Burke is a freelance business and technology journalist based in Easton, CT. She is a regular contributor to Forbes.com, Techonomy Media, and Yahoo Small Business and has written for Technology Review, Seed Magazine, Yale Engineering Magazine, and the Yale Alumni Magazine. She was previously the executive editor of the New York Academy of Sciences Magazine, founding editor of Genome Technology Magazine, editorial director of GenomeWeb. com, and a managing editor at the Walt Disney Company.

Sponsors

Presented by

This meeting is part of our Translational Medicine Initiative, sponsored by the Josiah Macy Jr. Foundation and The Mushett Family Foundation.