September 2013

September 2013

Mukesh K. Jain MD FAHAMukesh K. Jain MD FAHAEllery Sedgwick Jr. Chair & Distinguished ScientistEllery Sedgwick Jr. Chair & Distinguished Scientist

Professor of MedicineProfessor of MedicineDirector, Case Cardiovascular Institute (CVRI)Director, Case Cardiovascular Institute (CVRI)

CWRU School of MedicineCWRU School of Medicine

Scientific Director Scientific Director Harrington Discovery InstituteHarrington Discovery Institute

Chief Research OfficerChief Research OfficerHarrington Heart & Vascular InstituteHarrington Heart & Vascular Institute

University Hospitals Case Medical CenterUniversity Hospitals Case Medical Center

Physician-Scientists

President-elect ASCI

September 2013

• 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) 19 Nobel Laureates31 Lasker Awardees537 Elected in the National Academy of

Sciences/Institute of Medicine

American Society for Clinical Investigation American Society for Clinical Investigation (ASCI)(ASCI)

September 2013

Physician-ScientistPhysician-Scientist

Transforms fundamental knowledge

into therapies

Establish new standards for thepractice of medicine

Able to move from bench tobedside and back

Implements standards of care into the community

Physician-Practitioner

September 2013

• 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)

Physician-Scientist ImpactPhysician-Scientist Impact

September 2013

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

• 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

Case Western Reserve University

September 2013

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 residentsMedical school (4 years): supported by NIH grantResearch (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

Case Western Reserve University

• 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

• 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)

Student Accomplishments

September 2013

4 years

September 2013

Biochemistry Biomedical Engineering

Cancer BiologyCell Biology

EpidemiologyGeneticsPathology

Molecular Biology

CWRU Programs for MSTP students

Molecular VirologyNeurosciences

NutritionPathology

PharmacologyPhysiology and Biophysics

Systems Biology and Bioinformatics

September 2013

• 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

MSTP Curriculum: First 2 years

September 2013

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

• 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.

MSTP Curriculum: years 3-4

September 2013

MD-PhD : Medical doctor + PhD

DMD-PhD: Dental doctor + PhD

DNP-PhD: Nursing + PhD

Beyond MSTP:Clinical and Translational Scientist Training Program (CTSTP)

September 2013

(1)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

MSTP/MD-PhD International Partnership Models

September 2013

Muito obrigado!

September 2013

CWRU ranked 13th among

private institutions in federal

expenditures for science and

engineering research and

development (2012)

A World-Class Institution

September 2013

A World-Class Institution

Graduate/Professional Rankings:

• #14 in Biomedical Engineering• #5 in Health Law• #14 in Pediatrics• #16 in AIDS • #12 in Family Medicine• #15 in Nursing• #9 in Social Work• #3 in Organizational Behavior (Financial

Times)• #13 in International Law

U.S. News & World Report (2012)

September 2013

Partnerships with Ohio based world-class

corporate and cultural institutionsCleveland Clinic FoundationCleveland Museum of ArtCleveland Orchestra Dollar BankEaton CorporationForest City CorporationMedical MutualNASA Glenn Research CenterRock and Roll Hall of FameSherwin WilliamsSwagelok CompanyTime Warner Cable Business ClassTimken CompanyUniversity Hospitals of Cleveland

September 2013

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

A World-Class Institution

Case Western Reserve University School of Medicine

DiversityMD•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

• 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

Definitions of Physician-ScientistsDefinitions of Physician-Scientists