Graduate School of Arts and Sciences Bulletin of Yale University
 
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Investigative Medicine

Department of Medicine
808 Laboratory of Clinical Investigation, 785.6842
Ph.D.

Director of Graduate Studies
Keith Joiner (Internal Medicine) (LCI 808, invmed@info.med.yale.edu)

Deputy Director
Sharon Inouye (Internal Medicine)

Associate Director
Theodore Holford (Epidemiology & Public Health)

Faculty
A broad range of faculty from clinical and basic science departments participate in this program.

Fields of Study
The purpose of this program is to create a special training pathway for highly select physicians in clinical departments who are interested in careers in biomedical research. This program is designed to develop a broad knowledge base, analytical skill, creative thinking, and the hands-on experience demanded of clinical researchers devoted to disease-oriented and patient-oriented investigation. It will provide the candidate with individualized experience encompassing formal course work and practical experience, under the supervision and mentorship of a senior faculty member, along with a well-defined evaluative process to assure doctoral-level experience.

Students enter the program with a broad range of experience and interest. Some are most interested in exploring the molecular basis for a disease from the laboratory standpoint; others are oriented toward research that explores the biochemical, physiologic, and genetic basis for clinical disease in the setting of a Clinical Research Center; and another group are most interested in research that critically evaluates diagnostic and therapeutic interventions for clinical disease using modern concepts in quantitative methods and clinical study design.

Special Admissions Requirements
The Investigative Medicine program is designed for students with an M.D. degree who have completed two or more years of postgraduate clinical training. Individuals with an M.D. degree and a shorter duration of postgraduate clinical training will also be eligible if, in the opinion of the admissions committee, the applicants have demonstrated broad knowledge of the clinical basis of disease.

Application to the program may be made concurrently with application for subspecialty training in a clinical department at Yale. To be eligible for the Investigative Medicine program, the candidate must first be accepted into a subspecialty program (including General Medicine), at which point the candidate may apply to the Investigative Medicine program. Students will typically be involved in clinical training in their subspecialty for the first twelve to twenty-four months after arrival, and thus will enter the Investigative Medicine program after having completed two to five years of postgraduate clinical training. Prospective students already in a subspecialty clinical program at Yale may also apply to the Investigative Medicine program anytime during the first two years of that training (approximate, depending on subspecialty).

Successful candidates will need evidence of high academic achievement in undergraduate and medical-school courses and completion of residency training. Test scores from the USMLE, and (if available) the American Board of Internal Medicine, Pediatrics, Neurology, or other relevant subspecialty disciplines will be requested.

Special Requirements for the Ph.D. Degree
The overall requirements for the doctorate program are seven courses. These consist of three required one-term core courses: Principles of Clinical Research, Principles of Translational Research, and Practical and Ethical Issues in Clinical Investigation; a required year-long seminar course: either Seminars in Clinical Investigation or Seminars in Molecular Medicine; one of two intensive practical courses: Modern Strategies in Cell and Molecular Biology or Quantitative Clinical Epidemiology; and other electives. Course work will extend over three sequential terms. The first term will commence in July of each year. Students must enroll in a minimum of two courses each term, for three terms. Course work requirements may be completed by the end of a full year (twelve months) of study, or additional courses may be taken depending on individual needs. At the end of the first year, students submit their thesis prospectus and undertake a qualifying exam in which the broad general area of their research will be presented to a qualifying committee. In order to be admitted to candidacy, students must complete the course requirement, achieving the grade of Honors in one full-year course, or in two full-semester courses, submit an approved prospectus, and pass the qualifying examination. The remaining degree requirements include completion of a dissertation project, the writing of the dissertation, and its oral defense.

Courses
IMED 610a, Modern Strategies in Cell and Molecular Biology. Elisabetta Ullu.
Intensive lecture and laboratory course, given in July of each year. This course lasts two weeks and provides an overview of current concepts and laboratory methodologies used in modern molecular and cellular biology. Lectures begin the day and are followed by laboratory work. Emphasis is on performing experiments and on problem solving. Consent of instructor required. Two weeks, early July.

IMED 620a, Principles of Translational Research. Keith Joiner and staff.
Core course focusing on the general principles of translating recent scientific advances to the diagnosis and management of human disease. Lecturers emphasize how the knowledge base available in the biological sciences is being applied to human medicine, including topics in genomics, gene therapy, stem cell and organ transplantation, molecular therapeutics, immunotherapy, vaccine development, and metabolism. Lecturers and discussion leaders provide insights into the future promise and recognized limitations of these methodologies. Each session consists of a lecture followed by group discussion of a paper relevant to the topic. Students prepare a research paper in conjunction with one of the faculty. Consent of instructor required. Two weeks, late July-early August.

IMED 625a, Principles of Clinical Research. Sharon Inouye and staff.
Core course providing an overview of the objectives, research strategies, and methods of patient-oriented research. Topics include: competing objectives of clinical research; principles of observational studies; principles of clinical trials; principles of meta-analysis; interpretation of diagnostic tests; challenges in using statistics in clinical research; causal inference; decision analysis. Sessions include didactic presentations and discussion of readings distributed in advance. Students prepare a research paper in conjunction with one of the faculty. Consent of instructor required. Two weeks, mid-August.

IMED 630a, Practical and Ethical Issues in Clinical Investigation. Henry Binder and staff.
Core course addressing topics that are central to the conduct of clinical investigation, including biomedical ethics, medicolegal aspects of clinical investigation, and proper scientific conduct. Other topics include grant writing, scientific presentations, the NIH peer review process, informatics, technology transfer, and drug discovery and development.This course provides a framework for the clinical investigator to write, obtain funding for, conduct, and present a clinical study. Classes consist of a lecture followed by a group discussion. Consent of instructor required. Fall semester.

IMED 635b, Directed Reading in Investigative Medicine. Keith Joiner and staff.
A one-semester directed reading course of independent study for first-year students in the Investigative Medicine program. Topics are chosen by the student, and reading lists provided by faculty, for weekly meetings to discuss articles. Spring semester.

IMED 640a,b, Seminars in Molecular Medicine. Keith Joiner and staff.
Core course focusing on the details of basic investigation of the biochemistry, cell biology, genetics, immunology, and molecular biology of human disease from a sophisticated perspective. At each session, students review recent seminal articles on the basic laboratory investigation of a disease or disease process (which is well understood at the molecular level), which are selected by the faculty and discussed in advance with the student. The student presents a brief overview on the interface between the clinical and basic aspects of the disease or disease process, followed by discussion of the articles in a seminar format. Consent of instructor required. Fall and spring semesters.

IMED 650a,b, Seminars in Clinical Investigation. Sharon Inouye and staff.
Core course exploring the interface between clinical strategies and the methodologic issues that are central to investigating these topics. Seminal articles on the investigation of a particular topic are selected by the faculty and distributed to the students in advance. A student is assigned to review each article, and discusses the paper in advance with the faculty member(s) responsible for the session. The student presents a brief overview on the interface between the clinical aspects of the disease and the methodologic approach of the research, followed by discussion of the articles in a seminar format. Consent of instructor required. Fall and spring semesters.

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