Bridging the Gap

The UNC MD-PhD program recognizes the importance of tying together the MD and the PhD portions of a students training. To that end, we have developed a variety of opportunities for our students to “Bridge the Gap” between clinic and the lab.

Clinical and Translational Research Fundamentals:

Using the format of a weekly noon seminar, this newly developed course will include basic science PhD students and MD-PhD students during the PhD portion of their training. The course, offered by the Department of Epidemiology, will introduce clinical research and biostatistical methods including measurement, observational and experimental study design, bias and confounding, principles of statistical testing, statistical tests for categorical and continuous data, basic regression methods, principles of sample size and power, the process of drug development, and post-marketing surveillance. This course will also serve as an introduction to professional development by including such topics as teamwork, translational research careers, and examples of career trajectories.

Clinical Relevance of Doctoral Dissertation:

The majority of our MD-PhD students conduct their research in abasic science laboratory. To encourage their translational thinking, we will require that their dissertation proposal and thesis include a description of the clinical relevance of their research. We do not envision that this will change the content of most dissertations. Rather, we envision that this requirement will change the way our students think about their research projects - ensuring that the route to clinical relevance will always be at the forefront of their thinking. This required chapter in the thesis will include a description of the science underlying their proposed work, the clinical disease(s) or syndromes of relevance, and the steps of future research that must be completed before their work will have an impact on the care of patients or prevention of disease.

Campus-wide Doctoral Seminar in Clinical Research:

The year-long Clinical Research Doctoral Seminar will be a new initiative for doctoral students, the goal of which is to integrate basic science students with their more clinically oriented counterparts. This seminar will employ case examples to provide students with an understanding of the entire process of clinical investigation. An example of one such case study is the drug discovery process, including the basic physiology of the receptors and systems affected by the drugs, continuing with preclinical studies, Phase I and Phase II trials, larger Phase III trials, post-marketing surveillance, and when appropriate, changes in use of the agent after initial marketing. Seminar participants will work in small, interdisciplinary groups whose members traverse the entire research spectrum (bench, clinical, population). Each group will examine the case in depth, focusing on the process, the validity of results, and the influence of non-scientific pressures (e.g., the market). After thorough analysis of each case study within the small group, seminar participants will present their observations to the larger audience. Students will be asked to identify areas where the process could have been expedited or, in some cases, slowed to provide the best outcome. Over the course of the academic year, each group will examine 2 - 3 such case examples. As a final exercise, each of the groups will then select a specific research question relevant to human health and propose a series of research studies to move this question from bench to bedside to population. MD-PhD students will participate in this seminar during graduate school.

Interdisciplinary Journal Club:

Once per month, junior and senior faculty from different ends of the translational research continuum will choose 2-3 recent articles on a specific topic (e.g., obesity, depression) selected from across the research spectrum. They will then lead a discussion about the articles and, importantly, discuss how interdisciplinary teams could have accelerated the research. Through this process, predoctoral trainees will develop an appreciation of diverse research designs; gain an understanding of conceptual models, scientific literature, research questions, and methodologies relevant to other disciplines; and appreciate the contributions of interdisciplinary relationships and skills to clinical and translational research. MD-PhD students in the fourth year of medical school will attend this monthly journal club.

Clinical Research Rotation:

During their fourth year of medical school, all MD-PhD students will complete this rotation. The first week will consist of 15 hours of didactic training, divided between a review of clinical epidemiology, biostatistics and other quantitative topics. In addition, it will include lectures on the adoption, application and evaluation of state-of-the-art technologies in clinical settings. All of our senior medical students will take this didactic training as a group. The remaining time will be spent conducting the actual project under the supervision of the clinician scientist (or “clinical”) mentor. When possible, students will join an existing project to gain exposure to the practical aspects of performing clinical research and interacting with human subjects. Another option is to use the time to design a new study and prepare the necessary regulatory submissions. A third option is to analyze how diseases are diagnosed and treated in the particular research area and what gaps warrant future research. The MD-PhD program leadership will work closely with the mentors to make sure the student’s project is feasible and fulfills the rotation objectives.