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September 2013

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

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September 2013

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  1. 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

  2. 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) • 19Nobel Laureates • 31 Lasker Awardees • 537 Elected in the National Academy of Sciences/Institute of Medicine September 2013

  3. Physician-Practitioner Implements standards of care into the community Physician-Scientist Transforms fundamental knowledge into therapies Establish new standards for the practice of medicine Able to move from bench to bedside and back September 2013

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 4 years September 2013

  10. 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

  11. MSTP Curriculum: First 2 years • 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

  12. 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

  13. MSTP Curriculum: years 3-4 • 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

  14. 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

  15. MSTP/MD-PhD International Partnership Models • 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

  16. Muito obrigado! September 2013

  17. A World-Class Institution CWRU ranked 13th among private institutions in federal expenditures for science and engineering research and development (2012) September 2013

  18. A World-Class Institution U.S. News & World Report (2012) September 2013

  19. 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

  20. 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

  21. 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

  22. 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

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