Marching with WiMSTP

By Christie Nguyen, MD2

Women in MSTP has been going full steam ahead since our official launch in the spring of 2015! As a group, we aim to advocate for and support the success of women in the Medical Scientist Training Program at ISMMS through mentorship and educational efforts. Read more

The First-Year Sinai MSTP’s Guide to NYC

By David Gonzalez and Tucker Matthews (MD1)

Tucker Matthews, University of Wisconsin-Madison:

New York is absolutely incredible for live music and Warsaw is a concert venue in Brooklyn that feels like a community center. I got to see this Brooklyn-based hippie-dance-punk band there, and it was incredible. Milano’s is just hands down my favorite bar in the city. It’s this super tiny hallway-shaped bar down on Houston, there are polaroids of patrons from the ‘90s on the wall, and it just has the greatest feel to it, in a way that you can only really get in NYC.

Christian Stevens, Harvey Mudd College:

New York is about balancing history with pragmatism. Of course I’d love to have a beer at the spot where Abraham Lincoln and America’s first spy, Nathan Hale, would meet in secret to discuss the evacuation of the British from Manhattan. But chances are, that bar is expensive and not real. But there are places, like St. Marks Place, where the history may not sound quite so grand but it feels more important. Ada Calhoun referred to St. Marks Place by saying: “the street is not for people who have chosen their lives … [it] is for the wanderer, the undecided, the lonely, and the promiscuous.” And finally, when you’re winding down your night, right before you head over to take the long and lonely 4, 5, 6 up to 96th street, you can stop by 2 Bros. There you’ll find the best $1 pizza in America, hands down.

Camille van Neste, Stanford University:

In the beginning of the year, New York hit international headlines for an unusual reason: the giant corpse flower at the Bronx Botanical garden was about to bloom. Shoulder to shoulder with an immense crowd, I observed botanical history. Even when the corpse flower is blooming, the botanical gardens and adjacent zoo provide a welcome, green respite from the smelly concrete jungle of Manhattan.

Varun Arvind, Rutgers University-New Brunswick:

One of the first weekends I went to Lombardi’s, a great slice of history and food. Equally fun was just walking around the city going into old bookstores and interesting places. NYC is great because you can just be walking around and serendipitously find a cool new store, restaurant, mural, place, or interesting people.

David Gonzalez, Brown University:

The public library on 42nd street next to Bryant Park is immense and a beautiful space to study in with some really impressive reading rooms that have just been renovated. On days when I don’t have mandatory class, I like to grab a coffee and head down there for the day to study. Its a great way to get away from the UES and explore a bit of NY while staying on top of your classes. During Structures a bunch of first years went to an improv show centered around Raiders of the Lost Ark. Audience members could propose a shift to a scene from a different movie three times during the show, and the actors had to find a way to incorporate it into the current storyline they were acting out, as well as incorporate lines written by audience members that were given to them on a piece of paper before the start of the show. Tickets for shows like this will run you a whopping $10 and are a great spontaneous thing to do in the evening.

Joel Kim, University of Rochester:

Central Park is literally a five minute walk from the student residence, Aron Hall. What is especially worth appreciation is the beautiful reservoir that is located very close by. As someone who enjoys jogging, it is a great way to destress and appreciate a nice view of nature in the midst of a crowded, bustling city.

Sahil Agrawal, Harvard University:

One lazy summer afternoon, I found myself enjoying oysters and craft cocktails on a historic sailboat anchored on the Hudson River — ‘Grand Banks.’ The gentle waves nudged the boat along and the setting sun cast a brilliant red-orange hue on the horizon, highlighting the skyline of the lower east side; in the distant, I could even make out the Statue of Liberty.

Louise Malle, University of Pennsylvania:

Dancing to disco music at a Chinese restaurant that doubles as a hipster nightclub in a desolate street in the Financial districtChina Chalet on Broadway and Morris Street. Spending a sunny afternoon in Chelsea looking at all the art we’ll never be able to afford and admiring NY street style.

Amara Plaza-Jennings, Princeton University:

I normally hate waiting in lines, but when videos started popping up of Dō, a place that makes (safe!) raw cookie dough that they serve like ice cream, I thought maybe it would be worth it. I waited in line with classmates for over an hour and it was freezing cold. I don’t know if I’ll be waiting in trendy food lines again anytime soon, but it was a very New York experience that I am glad I got to have.

Christie Nguyen, Stanford University:

Dominique Ansel Bakery, home to the cookie shot (also the cronut), a life-changing cup shaped cookie filled with tahitian vanilla milk. In classic new york style, it’s only sold at 3pm everyday and there’s usually a short line.

Fred Kwon, University of Pennsylvania:

The first time I visited New York, I wanted to appreciate the New York City landscape. I was recommended the cost efficient observatory deck at Rockefeller Center, from which you can see skyscrapers and appreciate how rectangular Central Park is. While I was in the area, I checked out the bizarre and fascinating Museum of Modern Arts (MoMA) and dropped by Nintendo NYC to take a photo with my favorite plumber brothers.

ISMMS Alumni Interview: Vivek Rudrapatna, MD PhD ’14

By Cindy Tian (MP2)

Vivek grew up in Basking Ridge, New Jersey and graduated from Harvard University in 2006 with a degree in Biophysics. After completing his MD/PhD from Mount Sinai in 2014, he went on to an Internal Medicine fast-track at Baylor College of Medicine in Houston. Currently, Vivek is in the first year of a UCSF Research Track (T32) Fellowship where he plans to pursue research interests in machine learning applications to gastroenterology/nutrition. He lives in San Francisco and in his spare time enjoys Carnatic (Indian Classical) violin music and traveling with his wife.

CINDY: How did you feel the MD/PhD path shaped your view of medicine and science?

VIVEK: Having a scientific background has definitely enriched my appreciation and understanding of medicine — in my mind the skillset required to plan experiments is the very same skillset required to reason through complex medical problems. It helps one to more critically appraise the literature, identify the important (and not-so-important) questions in the field, and think outside of the box in a way physicians aren’t always naturally good at. Of course a career in medicine helps one identify important questions and appreciate how research at all levels may contribute to the future of practice.

CINDY: How did you choose Internal Medicine?

VIVEK: I think IM is one of the most natural fits for a physician-scientist because it is a highly cognitive specialty that embraces most of the science that we do. Whether in genetics, MCB, immunology, microbiology, developmental biology, or cancer biology — our benchwork is definitely hitting the bedside (I’ve seen so many examples in just the last two years out of med school). Medicine is a highly versatile training pathway with so many fellowship offerings and is relatively short (2-3 years).

CINDY: Advice for students at different stages of training?

VIVEK: 1) No matter the stage of training you’re in, focus your efforts on getting the most out of the experience you can — those are the skills and insights you’ll carry with you forever.

2) Your residency options depends heavily on your medical school ranking, which depends heavily on your medical school performance (e.g. Step 1, MS3) and relatively little on your graduate school performance. Residencies want to pick doctors who will take good care of their patients — research prowess is icing on the cake but not a replacement for medical competence. However, when applying for fellowships (and/ or the last step of your career before eventually getting the job you want) your PhD will suddenly become more valuable in the eyes of academic programs seeking to find people with track records most likely to succeed at an academic career.

3) It’s long and it can be trying and difficult at times. Be adaptable and learn different things from different people (and try to learn from everyone). Stay humble. Don’t lose hope! All tough times will eventually pass. You are smart and you can do it!

Congratulations to our 2017 MSTP matching seniors!

 

Words to live by?

Megan: “For me, I am driven by two main philosophies: know more today about the world than I knew yesterday and lessen the suffering of others. You’d be surprised how far that gets you.” -Neil deGrasse Tyson

Mitra: The person on the operating room table is someone in your own family.

Biggest change/challenge you experienced over your MDPhD?

Noa: Constantly feeling like I wasn’t sure what was expected of me and how to compare myself to others around me (both in research and back in the clinical years). This was 99% in my head so be smarter than me and try to avoid making yourself miserable if you can!

Rachel: I definitely felt left behind – especially these past few years – as my classmates from the beginning of med school or college breezed through residency while I still had so much training to do. But it’s important to enjoy each step of the process and not just focus on the end.

What was the coolest thing you learned in your PhD?

David: That the general approaches I was using in the tiny, specialized segment of academia I was occupying were actually useful for studying almost anything in the realm of fact. The Practical Analysis of Your Personal Genome and Q.E.D. classes were really great (extra-curricular?) experiences too.

What did you come in thinking of specializing in and how did it evolve?

Tim: I started thinking I would be interested in internal medicine, which ended up continuing throughout the 8 years. I had done cardiology research prior to starting at Sinai, so was interested in cardiology but hadn’t fully committed to it yet. However, my PhD was cardiology (I learned to make artificial hearts in a dish!) and I fell in love with cardiovascular physiology, so my initial interests ended up carrying all the way through!

Harish: I initially wanted to do Peds, but as I spent time on the wards, I realized how limited my clinical experiences were, which was in stark comparison to how diverse my scientific experiences had been. I learned that I liked outpatient flow, working with cancer patients, and incorporating an anatomical approach to disease, which led me to radiation oncology. Plus, rad onc is a field with so many MD/PhDs who are receptive to doing good science.

Mixing Entrepreneurship and Medicine: A Coffee Chat with Ted Pak, MP3

By Andy McKenzie (MP3)

ANDY: You and your team at East Harlem Software developed the CareTeam App, which your website describes as “a web application that gives clinicians instant access at the bedside to contacts, guidelines, and protocols customized for their practice environment.” How did you come up with this idea?

Ted Pak, MP3

TED: The CareTeam App was actually born as the EHHapp, which started out as a static website that Ammar Siddiqui (MD class of 2016, current Columbia anesthesia intern) developed to coordinate referrals for EHHOP, the student-run free clinic at Mount Sinai. Since Ammar was working with a constantly rotating cast of first year med students to run access-to-care services every Saturday, it was a lot easier to get them up to speed and productively advising patients when they had a mobile website in their hands with high-yield information from previous members of the team. Therefore, he made the first version of the EHHapp to save valuable time, so everyone could better focus on patients’ needs. Of course, since info on referrals changes rapidly— services at Mount Sinai and nearby hospitals shift around all the time—the next challenge was to make the information editable by all team members. Otherwise, the website would go stale and lose its value within months. To do this, Kevin Hu and Mark Finkelstein (two current medical students at Sinai) and I figured out how to integrate the mobile-friendly front end of the website with a custom content management system that uses the Ruby and git software environments.

We used the Wikipedia model for the UI: every page has an Edit button. You login with a Mount Sinai email address and edit the pages in Markdown, a really simple formatting system that looks like plaintext email. When you save the changes, they can either go public right away if you’re an admin of the app, and if you’re not, they’re forwarded to one of the admins for approval. Because of the way git can track changes, admins can receive multiple edits for the same page and choose to merge them (or not) individually, so the pages always stay up to date with well-curated information.

Using this strategy allowed us to quickly scale the number of people that could contribute to the EHHapp. Within the first year of the launch of the editable app in September 2013, it grew to nearly 200 pages of content, with over 1,600 separate edits. Today, the app has logged 4,943 edits. It’s now an indispensable guide for all EHHOP members—kept alive entirely by user-contributed changes.

Eventually, the attendings that volunteer at EHHOP on Saturdays caught wind of our app (and some began using it too). They wanted to try it in their own practice environments, e.g., to support medicine house-staff on inpatient floors or at Internal Medicine Associates, the larger outpatient clinic that hosts EHHOP. When we heard this, and that these departments could be willing to pay for it, we knew we had a potential product. That’s when we decided to form a Delaware C corporation, convert the software into a software-as-a-service platform, and start providing it on a contract basis.

ANDY: What advice would you give to incoming MD/PhD students who are interested in starting a business?

TED: First, find a team, and then build your minimum viable product so you can get it in the hands of anybody, anywhere, that wants to use it. Start early—it’s a lot easier to carve out time for a potential business idea when you’re a first or second year compared to the grad phase, when your thesis advisor will expect you to continually grow your productivity rather than funnel time into non thesis-related projects. It also helps to have the idea half-baked before you find your thesis advisor, so you can bring it up with them and see how they react to that being a part of your life.

Secondly, if there is any chance developing the idea involved Mount Sinai resources—you should read the Intellectual Property policy early and carefully to see how that’s defined—you’ll want to disclose it to the institution. This is perhaps the most difficult part of getting off the ground, since if Mount Sinai decides that it contributed resources and therefore has ownership, you’ll have to license the IP from Mount Sinai. In our case, this required hiring a lawyer and spending months working through tricky legalese in contracts before we could close our first sale.

ANDY: Let’s dream big. What do you think would be most helpful to make biomedical entrepreneurship a more common career path for physician-scientists?

TED: If I could change anything? It would be remarkable if thesis research (for a PhD) could be more tightly coupled with training in starting and running a business. An incubator-type model might work. However, this isn’t to say there aren’t current opportunities for such training that already fit well into the PhD phase. For instance, at ISMMS, our students have done internships at Verily, IBM, and McKinsey.

ANDY: Thank you for the fascinating interview, Ted!

Director’s Note and Highlights from the Leadership

Authors: Associate Director Ben Chen, MD PhD; Associate Director Talia Swartz, MD PhD; and Director Margaret H. Baron, MD PhD

It is an exciting time for the Icahn School of Medicine MSTP. Many thanks to the new editors and the writing team for rejuvenating the MSTP Newsletter. We have numerous updates since our last issue.

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Director of the ISMMS MSTP, Margaret H. Baron, MD PhD

In October, 2015, we proudly welcomed Gayle Schneiderman as administrator of the MD/PhD program. She has been strongly committed to our students, multitasking very effectively, and making sure that everything runs smoothly.

Warm congratulations to our graduating class of 2016! We celebrated their achievements over champagne and cheese, shortly before Commencement. Our MD4 students did phenomenally well, matching in top programs all around the country. We are delighted to welcome them to our alumni network and hope that they will continue to serve as informal mentors to our students as they move on in their training. We also congratulate the large cadre of 13 newly defended PhD recipients this year and celebrate their impressive accomplishments in the laboratory.

A new MSTP-tailored core curriculum that was redesigned to integrate with the MD1 curriculum version 1.0 was successfully launched in fall 2015 and spring 2016 (BMS for MD/PhDs). We were able to offer a dedicated section of Responsible Conduct of Research (RCR) for MD/PhD students as well. All MD1 students took this course last fall, thereby freeing up some time when they begin to work in the lab in the PhD phase of the program. Our students also took the biostatistics course MPH0800 last fall. This course was considered more rigorous and relevant to the needs of MD/PhD students.

All graduate students, including MD/PhD students, can begin their thesis research much more rapidly as a result of the elimination of the General Knowledge Exam and the earlier timing of the Thesis Proposal Exam. The format of the Thesis Proposal is the same as that for an NIH F30/31 proposal and we strongly encourage all students to submit a proposal to the NIH as early as possible.

mstp_directors_2016

From Left: Associate Director Ben Chen, MD PhD; Associate Director Talia Swartz, MD PhD; and Director Margaret H. Baron, MD PhD.

We are excited to welcome our MD1 students, who arrived in July and have been engaged in summer rotations and an outstanding interactive course called Problem Solving in Biomedical Sciences. Just days after their arrival at Sinai, they were interacting on a professional level, teaching each other, analyzing and distilling information, and proposing novel and thoughtful new approaches to current scientific problems. They have made us very proud!

The 2016 Annual MSTP Retreat took place September 9-11 at the Bushkill Inn in the Pocono Mountains. It was a great opportunity for all of our students to bond. Our keynote speaker was Dr. Vincent Racaniello, Higgins Professor of Microbiology and Immunology at Columbia University, author of Principles of Virology, and celebrity host of the podcast TWIV (This Week in Virology). The breakout sessions were informative, the alumni participants inspiring, the student presentations fantastic, and the scientific discourse stimulating. Unique and grandiose awards were presented for the best posters, to Mark Bailey, Matt Chambers, Fiona Desland, Efrain Ribeiro, Ranjan Upadhyay, and Lum Zony. Many thanks to the Retreat Planning Committee for their hard work, new ideas, and enthusiasm and for organizing such a successful event.

Our MD/PhD Program Admissions season is about to begin, and we always appreciate the great efforts that the current students make to help us to continue to recruit the best students to our program. We appreciate the input of student representatives on the MSTP Admissions Committee and are pleased to announce that student interviewers will now be full voting members of the committee! The interview season always helps to showcase the accomplishments of our students and the unique qualities that make this MSTP great.

We warmly thank everyone who put in many hours of work for preparation and submission of our competitive renewal of the MSTP T32 Training Grant. The collection of data from our 94 students, ~180 participating faculty, MTA directors, alumni, and ISMMS leadership was no easy feat, but it allowed us to take stock of what a special program we have and how productive our students are. We learned, for instance, that our students publish an impressive average 5.6 papers before they graduate and that these are mostly in translational or clinically relevant areas of biomedical research. Over 80% of our graduates are in academic medicine, pharma, or biotechnology. The program is now approaching its 40th anniversary of NIH funding! We are so proud of the accomplishments of this MSTP and of our current and past students. This fall, we look forward to showcasing for the NIH site visitors the unique strengths of our program.

It’s a great time for our MSTP and we continue to marvel at the wonderful achievements of our students. Advances in science are coming faster than ever and there has never been a greater need for scientists who understand the major challenges of clinical medicine. We are proud to be involved in the training of future physician scientists who will transform the face of translational medicine.

Annual Fall MSTP Retreat in the Poconos: A Resounding Success

Authors: Michael Daniel (MP3) and Andrew McKenzie (MP3)

Every year the members of the ISMMS MSTP put down their books, pipettes, and stethoscopes for a weekend and head to a relaxing location outside of the city, in a tradition that is known as the MD/PhD Retreat. This year our retreat was at the Bushkill Inn & Conference Center in Bushkill, Pennsylvania, a bucolic setting for a brilliant event. Vincent Racaniello kicked off the festivities with a wonderful keynote talk. In this talk, he first entertained us with his fascinating data on his work on neurotropic viruses, and then he spoke to the importance of communicating our science to the public. After dinner and student poster presentations, many of the students joined together for a Trivia Night. The questions at this event spanned the gamut from Olympic athletes to contemporary pop music to 1950’s science fiction movies, and, as your humble narrators can attest, required the full activation of one’s dorsolateral prefrontal cortex.

retreat_2016

The Annual MSTP Retreat was held the weekend of September 9-11th, 2016. Per tradition, the entire MSTP student body, invited alumni, faculty, administration, and keynote speakers in attendance took a group photo on Saturday morning

Following a lively alumni panel with Dr Rita Shaknovich, Dr Steven Seigel, and Dr Jeffrey Parvin, students chose which breakout sessions to attend. These are designed to appeal to students at different stages of the program and allow some of the faculty members that attend the retreat to impart wisdom in lively, interactive meetings. This year the breakout sessions included a session on how to choose the right lab, how to develop a good research project, how to write an NIH F30 grant, and how to plan for a residency application. After this, everyone had a break, during which some people went on a hike to the beautiful Bushkill Falls, some played a spirited game of ultimate frisbee, and some just relaxed. Finally, one of the highlights of the retreat every year is the student presentations — and this year was no exception — where senior members of the MSTP have forty minutes to present their research. All in all, the retreat was once again a smashing success, with 95.9% of respondents saying that retreat was at least “Good,” and 10.2% percent saying that it was the “Best Ever.” Until next year!

A perspective from the 2016 Alzheimer’s Association International Conference (AAIC)

Author: Andrew McKenzie (MP3)

This July, I was fortunate to attend the Alzheimer’s Association International Conference (AAIC) in Toronto along with thousands of other attendees. The topics covered at this annual conference range from clinical practice guidelines to neuroimaging, postmortem neuropathology, animal and cellular models of disease, and results of clinical trials. Historically, the conference has focused on the clinical side of Alzheimer’s disease, including the first reports of results from several large clinical trials, and the clinical area retained the lion’s share of presentations this year; however, I was told by veteran attendees that the quantity and proportion of basic science lectures, especially genetics, have dramatically increased over the past several years. Another extremely hot topic at this year’s conference was tau imaging, the signal for which, as predicted from neuropathology data, was generally found to correlate better with memory loss than the imaging signal for amyloid.

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A View of Toronto’s Lake Ontario near the 2016 Alzheimer’s Association International Conference (AAIC)

In addition to attending a multitude of informational presentations, I was also given the opportunity to discuss my own work on the functional genetics of oligodendrocytes in Alzheimer’s disease at one of the AAIC symposiums. This was my first oral presentation at an international conference and I was quite nervous about it. I asked a mentor for advice and he assured me that I’d be fine — as long as I practiced my 20-minute talk at least ten times. The night before the presentation, I sat in my hotel room and timed myself as I read the slides over and over again until I fell asleep. The meat of the presentation aside, a key takeaway for me from this experience was how much effort it takes to make an oral scientific presentation look effortless.

I was also able to attend a number of career development events aimed at scientists and clinician-scientists in training. At one of these, we walked through a mock peer review process of an accepted manuscript originally submitted to a journal focusing on Alzheimer’s disease, and we were given pointers on how to make the manuscript submission process more efficient. At another training session, we learned from some of the leaders at the NIH about career development awards and pathways available to aspiring scientists interested in Alzheimer’s disease. One of the other trainees at this event asked whether the many such training programs that have recently been established would be cut due to lack of funding over the coming years. The speaker assured us that the two hardest things to do in government are to get something new started and to get something old stopped, so the training grants were highly likely to continue to be available.

In my anecdotal experience, the vast majority of MD/PhD students at the Icahn School of Medicine at Mt Sinai attend at least one national or international science conference a year. Doing so is obviously a great way to learn about new topics, make scientific contacts and rekindle old ones, and have fun traveling to a new location. What I didn’t expect to learn from attending AAIC is that going to a conference is also a tremendous motivator to work hard on my own lab work. Seeing so many bright clinicians and scientists interested in Alzheimer’s disease helped remind me that although my research can sometimes feel overly detail-oriented and esoteric, it makes a lot more sense contextualized within a broader research community that is exploring a wide variety of possibilities to develop better therapies to treat Alzheimer’s disease.

MD/PhD Involvement at EHHOP

Author: Sandhya Chandrasekaran (MP2)

The East Harlem Health Outreach Partnership (EHHOP), Mount Sinai’s student-run free clinic, has been serving uninsured patients in the East Harlem area for 12 years. Since its inception in 2004, EHHOP has steadily evolved from an urgent care model into the primary care home for over 200 patients. This growth has largely been due to the indispensable synergy of preceptor mentorship and student involvement. And as MD/PhDs committed to a dual-degree program, we are in the unique position to both contribute to and benefit from EHHOP in several fundamental ways over the duration of our training.

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The number of total senior clinicians (SCs, black) at EHHOP must remain close to 7 to comfortably accommodate the number of patients scheduled for Saturday clinic. While third- and fourth-year MD students generally volunteer very regularly (red), MSTPs in their PhD+ phase (blue) volunteer regularly as well, roughly compensating for major dips in the senior clinician pool due to medical student scheduling conflicts. In recent months, MSTPs have been increasing their volunteering commitments — hopefully, a trend that persists in the coming years!

On Saturday clinic days at EHHOP, a junior clinician (first or second year medical student) assists a senior clinician (third or fourth year medical student, or an MD PhD student in the PhD+ phase) who serves as the predominant medical interviewer. The history and physical examination information jointly gathered from the encounter by these students is then discussed with an attending preceptor to finalize an assessment and plan. For MD/PhDs in their PhD phase, this system not only offers a venue for regular note writing and oral presentation practice, but also provides ample opportunities for teaching students and developing mentorship qualities.

Clearly, EHHOP’s inherent structure relies heavily on senior clinician involvement to address patients’ medical concerns. However, given that many of these senior clinicians are third- and fourth- year medical students balancing demanding clerkships, shelf exams and residency interviews, certain weekends conceivably suffer from lower volunteer commitment. As the PhD years offer more flexibility with respect to specific work hours, MD/PhD students are prime substitutes. Indeed, MD/PhD involvement has reliably compensated for fluctuations in medical student involvement over the course of the last year to keep overall senior clinician numbers relatively stable year round, especially considering the size of our program in relation to the third- and fourth- year medical school classes.

Our additional years as practicing senior clinicians also afford us the opportunity to follow select patients longitudinally, consequently forging deep bonds and meaningful connections with some of the clinic’s sickest and medically complex patients. Jennifer Diaz, a sixth year in the program, has been following one of her patients for three years now, having honed her skills in hemodialysis and blood pressure management as a result. She attests, “I think patients have a lot to teach, and following them longitudinally gives us space to really learn from them. Each patient is unique. Given time, you learn to utilize clinical reasoning that incorporates your previous experience with the patient and the latest clinical research, rather than blindly applying textbook knowledge.” This chronic care dynamic builds upon the concept of ‘longitudinal clinical exposure’ or LCE introduced in the preclinical medical curriculum by granting MD/PhD students the responsibilities of overseeing patient care firsthand.

Understandably, years removed from regular clinical exposure renders MD/PhD students in their PhD phase both unconfident about their medical competence and anxious about their integration into third year rotations. To this end, Dr. Yasmin Meah and Robert Rifkin, a current seventh year in the program, meticulously designed and launched the EHHOP Clinical Service Enrichment Program (CSEP) for MD/PhDs in 2014, with the goal of providing concrete medical milestones and a structured platform for critical clinical practice discussions. Under the guidance of Benjamin Laitman and Noa Simchoni, the program has since morphed into tailored didactic sessions from physician experts; CSEP has received overwhelmingly positive reviews from students since it began.

Arguably, fueling EHHOP’s continued progress is its investment in research. MD/ PhDs have been instrumental in this effort by organizing and heading the EHHOP Quality Improvement Council (QIC). Now in its sixth year, the QIC caters to the budding research interests of preclinical students by equipping them with the tools to critically analyze and address key issues within EHHOP’s infrastructure in several successive ‘plan-dostudy-act’ (PDSA) cycles. Naturally, the QIC appeals to the research-oriented minds of MD/ PhD students, and has indeed benefitted from strong MD/PhD participation and leadership in coordinating QIC projects and initiatives.

With so many opportunities for involvement, it comes as no surprise that MD/PhDs have percolated several roles on the steering and executive leadership committees of EHHOP – overseeing research, finance, technology, education, and pharmacy. As such, it is clear that our steady presence in these capacities affords the clinic the necessary glue to hold together multiple isolated medical encounters in the context of a free clinic striving to better suit the needs of the patient population it strives to serve.