Program Structure: Integration, Exploration, Flexibility
The Medical Scientist Training Program (MSTP) provides a select group of medical students with an opportunity to pursue a training program designed to equip them for careers in academic investigative medicine. Individualization of the curricular and research programs of each trainee is the hallmark of the Program.
Training for a combined MD-PhD should include the same content encountered by students who pursue each degree separately, but the total time of training should be less than the sum of the time normally taken for each degree. To this end, students must plan their training carefully and commit to a rigorous and intensive period of study. The flexible curriculum at Stanford Medical School allows each student to pursue (in consultation with her/his preceptor and other advisors) a plan of study that will satisfy the requirements for the MD degree and allow performance of doctoral level research leading to the PhD degree. Each trainee pursues an independent research program under the immediate direction of a faculty preceptor and the general supervision of an advisory committee. In what follows, we provide a general outline of what to expect.
The Beginning
First-year trainees meet with the MSTP directors soon after arrival to review the structure, timeline, and expectations of the program. Most students find their first quarter occupied with medical school coursework, and some students elect to arrive in the summer prior to their first year to work in a laboratory with a candidate faculty preceptor. In addition, trainees attend the Bioscience orientation sessions for new PhD graduate students each autumn. MSTP trainees may also elect to take graduate school courses during the first few years of medical school. These experiences serve as the initial mechanisms for exposure to Stanford research, research advisors, and other graduate students.
A special program for first year MSTP students in Autumn quarter are weekly "Chair Lunches," in which the chairperson of each basic science and major clinical department meets with the first year class in an informal setting to discuss opportunities and career plans.
Choosing a PhD laboratory and thesis advisor is the single most important factor in the success of a student's training program. All faculty who are engaged in basic scientific research, and are members of the Academic Council, are eligible to serve as thesis advisors.
First-year students should acquire sufficient information to begin a concentrated search for a thesis lab during the Winter quarter of their first year, and should choose 10 – 15 faculty whose work might interest them. Meeting individually with at least 5 – 6 faculty will provide each first year student the opportunity to learn about potential research projects and opportunities in more detail. Attending the MSTP Retreat during the Winter quarter provides an additional forum to hear firsthand about other students' research, and to discuss one-on-one with both students and administrators the opportunities available in specific laboratories.
After the MSTP retreat, each first year student composes a "short list" of 3 – 4 laboratories from among which to choose a potential thesis advisor. During Spring quarter of the first year, the student meets again with these faculty, speaks individually with the members of each laboratory, attends lab meetings, and reads relevant publications. During this time, first-year students will also meet individually with the MSTP directors.
By the end of Spring quarter of the first year, MSTP students will have chosen a potential thesis advisor, and will enter the laboratory full-time in Summer quarter. The goal of the summer project is to acquire an in-depth research experience that will serve as a thorough introduction to the laboratory, and a potential platform for developing a thesis project during the second and third year as curricular coursework draws to a close and full-time research begins. During Autumn quarter of the second year, students meet individually with the MSTP directors to review their summer experience, and in Winter quarter, students present the results of their summer projects at the MSTP retreat where they have the opportunity to review and discuss how that work might be extended into a PhD thesis.
Between the summer project and commencement of full-time graduate research in Spring quarter of the second year, most second year students are preoccupied with medical school coursework, and it can be challenging to continue research through Autumn and Winter quarter of the second year. Nonetheless, most students remain involved in the laboratory at some level, so that beginning Spring quarter in the second year, students can embark full-time on thesis research and completion of their graduate course requirements. Rarely, students will decide to pursue thesis research in a laboratory different from the one that supported their summer project. In this case, students should seek advice from the MSTP directors in Autumn quarter of their second year, so that a final choice of thesis laboratories can be made by Spring quarter of the second year.
The Middle
Spring quarter of the second year is the time when MSTP students deviate from the traditional 4 year MD curriculum. The final Practice of Medicine course (INDE 206) is deferred by MSTP students until after completion of the PhD thesis and before resumption of the clinical curriculum. However, both MSTP students and students pursuing a traditional MD program take Part I of the National Board Medical Licensing Exam at the end of Spring Quarter of their second year.
From Spring of the second year to Spring of the fifth year, MSTP students pursue full-time graduate training; in many ways, third year MSTP students engage a graduate track analogous to that pursued by second year traditional PhD students. The actual coursework and thesis requirements will depend on the Departmental or Programmatic affiliation chosen by the student. With the exception of laboratory rotations, MSTP students fulfill the same requirements as other PhD graduate students. Initially, there is significant overlap of classwork and lab work, and there is no scheduled time when a student moves from one training activity to the next. However, in some cases, third year MSTP students will find it necessary to take graduate coursework that their peers pursuing traditional PhD degrees may have already taken.
The End
On average, PhD thesis research draws to a close in the fifth year of training, allowing most MSTP students to complete both degrees in 7 years. Typically students register for Practice of Medicine VI (INDE 206) Spring quarter of their fifth year, complete and defend their thesis the following summer and/or autumn, and re-enter the clinical curriculum in Winter or Spring quarter of their sixth year. The clinical curriculum requires 15 1/2 months of clerkships, so MSTP students that begin their clerkships in autumn of the sixth year will have approximately 5 1/2 months to take additional clerkships or pursue additional research projects.
Individualization of the Curriculum
The structure outlined above is a typical framework followed by most MSTP students. However, a hallmark of both medical and MSTP training at Stanford is curricular flexibility. For example, a majority of traditional MD students spread their training over 5 years, and pursue additional projects in research, public health, or community service. For MSTP students, there are a wide array of options that can be tailored to specific circumstances. Students with a research project already underway at the beginning of the program may elect to pursue that project throughout the first 2 years of the program, and spread the preclinical medical curriculum over a longer period of time, delaying part I of the National Board of Medical Licensing Exam until years 3 – 5. Students whose research project requires acquisition and/or intermittent evaluation of clinical data may integrate completion of the PhD thesis and the clinical clerkships. In each of these situations, approval and monitoring of the curriculum is required by the MSTP governance subcommittee to ensure an optimal and productive training experience.