Background and Introduction
The M.D.-Ph.D. Program at Yale University was established in 1969 and graduated its first students in 1973 which coincided with receipt of its first funding from the National Institutes of General Medical Sciences. The dual degree Program is meant to provide trainees with a broad exposure to human biology and medicine, and to an in-depth and rigorous training in one of the scholarly disciplines relevant to medicine. It is our expectation, met by the positions of our alumni, that graduates of the Program will develop into academic physicians who will assume faculty positions in either basic science or clinical departments of schools of medicine. This will enable them to fulfill the goals of their training: provide leadership in academic medicine and in research related to medicine and human welfare. We are proud of the fact that we have now graduated 206 individuals with the combined M.D. and Ph.D. Approximately 54% of our graduates pursue careers in clinical departments while 32% are in basic science departments. Our goal of preparing physician-scientists for academic/research careers has been successful in that ~90% of our graduates who have finished training are carrying out peer-reviewed research in academic settings. Graduates of our Program have always obtained their top picks of residencies, most often in programs that emphasize research and academic careers.

The Yale System of Medical Education and the M.D.-Ph.D. Program
The Yale University School of Medicine emphasizes the tradition that encourages its medical students to engage in significant research and prepare, defend and publish a thesis in order to graduate, a feature unique to our School. Medical students are selected and matriculated based on their experience and interest in research or some form of scholarly pursuit. This philosophy of the “Yale System”, which has been in existence since 1934, regards medical students as graduate students who plan their own individualized programs of study. Because of this rich tradition of individualized study and the thesis requirement, the atmosphere at the Medical School is highly compatible with the aspirations of the M.D.-Ph.D. Program which is a keystone of the “Yale System”.

Current Students
As of September 2009, we have 86 students enrolled in the Program at Yale University. M.D.-Ph.D. students are admitted in an “undifferentiated” status in order to enable them to make long-term decisions about graduate training only after they are equipped with a thorough knowledge of the opportunities at Yale. About 12 students each year enter our M.D.-Ph.D. Program and make up ~12% of the Medical School class. In order to be eligible for support by the M.D.-Ph.D. Program, applicants must be US citizens or Permanent Residents. All of the students who enter the Program have had previous research experiences of a high caliber.

Program Highlights
The strength of our Program is the flexibility of the Yale System of medical education and the breadth and depth of the graduate programs at Yale, unified under the Biological and Biomedical Sciences Program (BBS). These programs of medical and graduate education allow M.D.-Ph.D. students to customize their educational paths. The extensiveness of graduate training at Yale provides students with opportunities in biomedical tracks including Cell Biology & Molecular Physiology, Genetics and Development, Immunology, Microbiology, Molecular Biophysics & Biochemistry, Neuroscience, Pharmacologic Sciences and Molecular Medicine, Molecular, Cellular & Developmental Biology, Biomedical Engineering and Chemistry. We also accommodate students in non-traditional areas such as Epidemiology and Public Health, Psychology, Computer Sciences, and Sociology provided an appropriate program of study can be worked out with these departments and that funding support is guaranteed for M.D.-Ph.D. students. New programs in Translational Research (Genomics and Proteonomics, Clinical Immunology, etc.), and in Biomedical Engineering will provide new training opportunities for M.D.-Ph.D. students.

Another major strength of the Yale University M.D.-Ph.D. Program is the close working relationship between the clinical and basic science faculty. Significant numbers of clinical faculty, in departments such as Internal Medicine, Dermatology, Pediatrics, Neurology, Neurosurgery, Surgery, Ophthalmology, Obstetrics and Gynecology, Orthopedics, and Psychiatry, carry out basic research focused on clinically relevant problems. Many of these investigators hold joint appointments in basic science departments. They participate in teaching medical and graduate courses and act as research advisors and mentors for our M.D.-Ph.D. students. Because of this large group of clinicians carrying out investigative work, there is abundant cooperative, interdisciplinary research between these investigators and those in basic science departments.

Finally, we believe that our Program provides a unique opportunity for students to make the correlation between basic and clinical sciences during all phases of training which will ultimately enhance their ability to see early on the importance of connecting their research to practical medical problems. During the first two years of the Program, several of the courses that our M.D.-Ph.D. students will take as part of the Medical School curriculum are co-listed as Graduate School courses. Most students take these courses for credit and are thus able to obtain their two required Honors grades during the first years of medical school. More importantly, several of these courses are requirements or electives for graduate programs in which the students will enroll. We have begun several new courses designed specifically for M.D.-Ph.D. and science-oriented medical students that emphasize the direct connections between modern biomedical research and human pathophysiology. In addition, a unique aspect of our Program is that the majority of students complete six months of clinical clerkships in Internal Medicine and Psychiatry and Ob/Gyn following their second year of medical school and prior to beginning thesis work in a mentor’s laboratory. This prepares them for participation in the Primary Care Clinic at the Yale-New Haven Hospital, an Ambulatory Medicine Clinic at the West Haven VA Hospital, or Longitudinal Care Pediatric Clinics. These clinics, in which students participate during their thesis years, keep them connected with concepts of clinical medicine and pediatrics, enable them to obtain credit toward ambulatory and primary care requirements in Medicine and Pediatrics, and ease the transition back to the wards upon completion of the thesis work without compromising laboratory time.