Rigorous MSTP Program Teaches Both Sides of Research/Clinical Equation

Rahul D’Mello started medical school in fall 2009 but won’t graduate until 2017. He hasn’t taken time off; in fact, he’s done just the opposite.

D’Mello, a student in the UC Medical Scientist Training Program (MSTP), is earning his MD and PhD all at once.

Like most other MSTP students, he spent years one and two on UC’s campus in medical school—completing half of the MD curriculum—before transitioning to graduate school. This summer marks the start of his third year in the immunobiology graduate program at Cincinnati Children’s Hospital Medical Center. In 2015, he’ll return to medical school to round out his medical education.

"It’s rigorous, but these students are really the ‘best of the best,’” says Gurjit Khurana Hershey, MD, PhD, director of the MSTP program at UC. "They are among the top of their class, almost uniformly.”

A Different Level

Formed in 1985, the MSTP admits students through a single process into UC’s College of Medicine for both medical and graduate training. Currently, 46 students are enrolled and 79 have graduated since the program’s inception.

UC’s MSTP is a 50/50 partnership between the university and Cincinnati Children’s—where a number of graduate programs are based—and is an important one for the UC College of Medicine, says Hershey.

"If you are one of the medical schools to offer this opportunity, it sets you apart,” she says. "It puts you on a different level,” adding that programs of its kind train people to understand how to connect and integrate research with medicine.

"Research is the engine that drives innovation. We need people to understand both sides of the equation—research and clinical medicine—to advance medicine and discover new therapeutics and technologies. Graduates of these programs are leaders who can impact change and improve health.”

A Cincinnati Children’s physician-scientist and MSTP graduate herself (completing the program at Washington University), Hershey knows well the experiences UC’s students will have. That’s why she’s worked very hard since becoming program director in early 2012 to expand the number and diversity of participating program faculty and to ensure that MSTP leadership is better aligned with the needs of MD, PhD students. In fact, five MSTP leaders (with director, associate director or committee chair titles) are physician-scientists.

"Students are getting mentorship from top senior physician-scientists,” says Hershey.

Huge Advantage

These changes haven’t gone unnoticed. The MSTP program was just re-funded by the National Institutes of Health (NIH) for the next 5 years. This is the third time since 2002 that the NIH has provided support for UC’s MSTP. And, says Hershey, Cincinnati’s application scored so well this round against peer institutions that it was recommended for expansion. 

Hershey says it’s the partnership between UC and Cincinnati Children’s that makes UC’s program so unique and impressive to the NIH.

"We are the only program with this kind of pediatric partnership,” she says. "And as we have begun to better understand that most diseases have their roots in childhood, this partnership makes sense and is recognized as a huge advantage.”

D’Mello certainly considers himself a beneficiary of this collaboration.

As a high school student in Cleveland, he was exposed to research through an internship and shadowing experience. He spent two summers conducting biomedical engineering research at Cleveland Clinic while completing his undergraduate degree in chemical engineering at Johns Hopkins University. It was there that D’Mello developed a strong interest in clinical medicine.

A family friend in Cleveland who had completed a fellowship at UC suggested he check out what Cincinnati had to offer.

D’Mello entered his first year of medical school in fall 2009 and quickly formed great relationships with his medical school class and the four other MD, PhD students among them. A chance to work in the lab of Marc Rothenberg, MD, PhD, a UC pediatric faculty member based at Cincinnati Children’s, was one he couldn’t pass up.

"Dr. Rothenberg completed the MSTP program at Harvard,” says D’Mello. "He is doing what I see an MD, PhD doing. Running a lab, seeing patients. He’s a great role model and leader in his field and at Children’s.”

D’Mello is currently working in Rothenberg’s lab to characterize the function of a molecule that may play a role in eosinophilic esophagitis, an allergic condition that causes inflammation in the esophagus, which leads to difficulty eating and swallowing.

Despite his many other obligations—he’s on the MSTP admissions committee, a College of Medicine faculty council student representative and member of Med Mentors—D’Mello is a self-proclaimed "lab rat,” and admits that he’s in the lab past midnight at least twice a week.

It’s all for a good cause, he’s decided. In Rothenberg’s lab, D’Mello is exposed to basic, translational and clinical research and has had the chance to interact with the patients and families who come through to see the research being conducted on their behalf.

"The interaction with patients and families is so motivating—they are going through so much,” says D’Mello. "I figure, ‘What’s running this one extra experiment and staying a bit late if you may find something?’”

Hershey agrees.

"When you become a doctor, you can help the patient you see—the one right in front of you,” she says. "When you are a physician-scientist, you can still do that, but you can also help patients around the world. This program allows students to ‘think big.’”

Staying Connected

Because UC has developed an integrated medical school curriculum, all medical students (MSTP students included) are getting a stronger mix of basic science and clinical training during years one and two. (MSTP students who began their academic careers before the College of Medicine curriculum changed in fall 2011 are being given the opportunity to complete year-one EMS training that wasn’t previously offered.)

MSTP students then break from medical school curriculum and enter a graduate program for anywhere from three to five years. They then return to complete the final two years of medical school, which are heavily focused on clinical experiences.

"We do all we can to ensure that our students remain connected to medical school while completing their PhD,” says Hershey.

For example, D’Mello and peers are now partnered with a senior physician-scientist who will serve as a mentor, assisting them in setting up formal clinical shadowing and physical examination time once a month for the remainder their graduate studies.

"By the time they enter their clinical years of the MD program, many have spent four years conducting research on a specific disease,” says Hershey. "They still have a lot to learn, but they can bring a lot to the table.”