Degree Programs

Students at the School of Medicine may be candidates for the degrees of Doctor of Medicine (M.D.), Master of Public Health (M.P.H.), or Doctor of Public Health (Dr.P.H.). The School of Medicine, jointly with the Graduate School, administers a combined program leading to the degrees of Doctor of Medicine (M.D.) and Doctor of Philosophy (Ph.D.). In addition, the School of Medicine administers a combined program leading to the Doctor of Medicine (M.D.) and Master of Public Health (M.P.H.) degrees. Special arrangements may be made with the appropriate associate deans to receive the combined Doctor of Medicine (M.D.) and Doctor of Jurisprudence (J.D.) degrees, the combined Doctor of Medicine (M.D.) and Master of Divinity (M.Div.) degrees, and the combined Doctor of Medicine (M.D.) and Master of Business Administration (M.B.A.) degrees. The School of Medicine also offers a program leading to a Physician Associate certificate combined with a Master in Medical Science.

Doctor of Medicine
The degree of Doctor of Medicine is conferred upon students who have satisfactorily completed the requirements stated below.

1. Pass all of the required basic science courses.
2. Pass all of the required clinical clerkships.
3. Pass the examinations of the United States Medical Licensing Examination (USMLE), Steps I and II.
4. Submit an approved dissertation by mid-March of the year of graduation.
5. Meet all of the requirements of the Progress Committee and Board of Permanent Officers concerning academic standing, moral and ethical character, emotional stability, and professional conduct.

Because of the heavy demands in terms of time and energy required for the study of medicine, the Yale School of Medicine discourages students from assuming extracurricular activities that may prove burdensome. Such extracurricular work and/or professional activity will not justify inadequate academic performance. Any student wishing to work or pursue a professional activity other than medicine that would consume a significant amount of time must have the permission of the associate dean for student affairs.

Admissions
The Yale University School of Medicine seeks to provide an education in the scholarly and humane aspects of medicine and to foster the development of leaders who will advance medical practice and knowledge. The Committee on Admissions in general seeks to admit students who seem best suited for the educational programs and aims of the School. In particular, the committee looks for intelligent, mature, and highly motivated students who show the greatest promise for becoming leaders and contributors in medicine. The Committee on Admissions also considers very carefully personal qualities necessary for the successful study and practice of medicine. These include integrity, common sense, personal stability, dedication to the ideal of service, and the ability to inspire and maintain confidence.

School of Medicine graduates must have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care. In addition to scholastic accomplishments and potential, applicants must have the physical capacities and personal characteristics to meet the full requirements of the School’s curriculum and to graduate as skilled and effective practitioners of medicine. The policy of the School of Medicine regarding nonacademic considerations in the admissions process is available upon request from the Office of Admissions.

The School also attempts to ensure adequate representation of women and all minority groups and a diversity of interests and backgrounds. All applications to the Yale University School of Medicine are given careful consideration without regard to sex, race, age, religion, national origin, sexual orientation, or financial status. In evaluating candidates, the committee takes into consideration many factors including academic record, MCAT scores, record of activities and accomplishments, recommendations from premedical committees and individual science teachers, and personal interviews.

It is recommended that students enter medical school after four years of study in a college of arts and sciences. Students holding advanced degrees in science or other fields are also considered. Foreign students must have completed at least one year of study in an American college prior to application. Students who have been refused admission on three prior occasions are ineligible to apply for admission to the first-year class.

The minimum requirements for admission to the first-year class are:

1. Attendance for three academic years, or the equivalent, at an accredited college of arts and sciences or institute of technology.

2. Satisfactory completion of the following courses including laboratory work:

General Biology or Zoology
General Chemistry
Organic Chemistry
General Physics

(Acceptable courses in these subjects usually extend over one year and are given six to eight term hours credit.) These courses should be completed in a U.S. college or university. Advanced courses may be substituted for introductory-level courses in each of these subjects.

The Committee on Admissions has no preference as to a major field for undergraduate study and leaves this decision to students, with the advice that they advance beyond the elementary level in the field of their choice rather than pursue an undirected program. A liberal education is the supporting structure for graduate study, and must encompass understanding of the humanities, arts, and society as well as the scientific foundations of technology and civilization. The student of medicine enters a profession closely allied to the natural sciences and must be prepared to cope with chemistry and biology at the graduate level. Students entering college with a strong background in the sciences, as demonstrated by advanced placement, are encouraged to substitute advanced science courses for the basic requirements listed above.

Application Process
The Yale University School of Medicine participates in the “common” application process of the American Medical College Application Service (AMCAS). Applicants must first submit their AMCAS application, on which they indicate that they wish to apply to the Yale School of Medicine. After submitting the AMCAS application, applicants must complete the Yale Supplemental Application, which must be submitted online (see below for details).

Inquiries regarding AMCAS should be addressed to the American Medical College Application Service, 2501 M Street NW, Lobby 26, Washington DC 20037-1300. AMCAS can also be reached by telephone at 202.828.0600 or by e-mail at amcas@aamc.org. Extensive information can also be obtained at the AMCAS Web site: www.aamc.org/.

Inquiries to the Yale School of Medicine regarding the degree of Doctor of Medicine should be addressed to the Office of Admissions, Yale University School of Medicine, Edward S. Harkness Hall, 367 Cedar Street, New Haven CT 06510. The e-mail address of the admissions office is medical.admissions@yale.edu. Information can also be obtained online at http://info.med.yale.edu/education/admissions/. Inquiries are welcome at any time.

AMCAS applications may not be submitted earlier than June 1 and must be submitted no later than October 15 of the year prior to the fall in which enrollment is sought. Yale Supplemental Applications must be submitted online no later than November 15. Applicants seeking admission under the Early Decision Plan must submit the AMCAS application by August 1 and the Yale Supplemental Application by August 31. The number of students admitted each year for studies leading to the M.D. degree is approximately 100.

A complete application consists of the following components:

1. AMCAS application and all required components of the application (see 2 and 5 below).

2. Complete official transcripts from all colleges attended. Transcripts should be sent from the colleges directly to AMCAS.

3. Yale Supplemental Application submitted online no later than November 15. The Supplemental Application may be found at http://info.med.yale.edu/education/admissions/.

4. An evaluation from the applicant’s Premedical Advisory Committee, or individual letters from three of the applicant’s teachers, two of whom should be in science fields. These evaluations must be sent directly to Yale.

5. Scores from the Medical College Admission Test (MCAT) must be submitted in conjunction with the AMCAS application. For information on the MCAT, applicants should communicate directly with the MCAT Program Office, PO Box 4056, Iowa City IA 52243. Information on the MCAT can also be obtained online at www.aamc.org/. Scores of tests taken earlier than 1999 will not be accepted.

6. A fee of $75 or an AMCAS fee waiver must accompany the Yale supplemental application. The fee is not refundable.

During the course of the admissions process, selected applicants will be invited for personal interviews with members of the Committee on Admissions at Yale. Regional interviews can be arranged when necessary.

Early Decision Plan
The Yale School of Medicine offers an Early Decision Plan (EDP). Under this plan, a student may make a single early application to the school of his or her first choice and is guaranteed a prompt decision by the school. AMCAS applications for the EDP program must be submitted by August 1. Yale Supplemental Applications must be submitted by August 31.

Admission to Advanced Standing
Because of a limited number of available positions, the Yale University School of Medicine does not routinely consider requests for transfer with advanced standing. The only exception to this policy is that the School will consider applications into the second-year or third-year class from students who are enrolled in LCME-accredited medical schools in the United States or Canada and who have a compelling personal need to be at Yale.

The following three circumstances constitute “compelling personal need” under this policy:

1. The applicant’s spouse holds, or has been accepted for, a position in the Yale-New Haven Medical Center community as a student, a member of the house staff at Yale-New Haven Hospital, a postdoctoral fellow, or a faculty member.

2. There is a serious illness in the immediate family of the applicant, requiring the ill person to be in New Haven for treatment and the applicant to be in New Haven as the primary supportive member of the family during the time of the illness.

3. The applicant is on leave from his/her medical school and is enrolled in a doctoral degree program at Yale University, and completion of medical studies at the Yale School of Medicine would enable the applicant to achieve important and unique educational objectives that are not available at the original medical school.

The distance of the applicant from New Haven will also be taken into consideration. Regardless of other factors, students attending medical school in New York City, Connecticut, or Rhode Island will not normally be eligible to apply for advanced standing.

Transfer into the second-year class is possible only from medical schools with a basic science curriculum compatible with that at Yale. Transfer into the third-year class is contingent upon passing Step I of the United States Medical Licensing Examination (USMLE), and an applicant who fails USMLE Step I will not be considered for admission under any circumstances. Transfer into either the second- or third-year class is also contingent upon successful completion of courses being taken at the current medical school and upon the availability of space at Yale.

Eligible applicants will be evaluated competitively by the School’s admissions committee, with decisions based on academic credentials, supporting material, interviews, and the urgency of the personal need to transfer. Overall qualifications are expected to be comparable to those of Yale students admitted through the regular admissions process.

All accepted applicants must matriculate in the year accepted. Applicants whose eligibility is established by marriage must be married at the time of matriculation, and the applicant’s spouse must be in residence in New Haven and holding a position in the Yale-New Haven Medical Center community. Transfer students must complete all required clinical clerkships (including the fourth-year Primary Care Clerkship and the Integrative Clinical Medicine Clerkship) and the thesis requirement at the Yale University School of Medicine. If a transfer student wishes to spend an extra (fifth) year at Yale, one-half of the tuition for that year will be waived.

Completed transfer applications consist of Yale School of Medicine application forms, letters of recommendation, MCAT scores, college transcripts, a transcript from the current medical school, and a letter from the dean of students (or comparable official) at the current medical school. Inquiries regarding transfer applications should be addressed to the Office of Admissions, Yale University School of Medicine, 367 Cedar Street, New Haven CT 06510 or medical.admissions@yale.edu. Transfer applications, including all supporting credentials, must be submitted by April 1 of the year the student wishes to enter Yale.

Educational Objective
The educational objective of the School of Medicine is to develop physicians who are highly competent and compassionate practitioners of the medical arts, schooled in the current state of knowledge of both medical biology and patient care. It is hoped that Yale-trained physicians will establish a lifelong process of learning the medical, behavioral, and social sciences by independent study. The aim is to produce physicians who will be among the leaders in their chosen field, whether it be in the basic medical sciences, academic clinical medicine, or medical practice in the community. Belief in the maturity and responsibility of students is emphasized by creating a flexible program through anonymous examinations and the elimination of grades in pre-clerkship courses and by encouraging independent study and research.

Educational Philosophy: The Yale System
The Yale System of Medical Education remains unique among medical schools. It has been an important part of life at the Yale School of Medicine since 1931. Although it has undergone minor modifications in the intervening years, its essential spirit has remained intact, and it is a major reason why many students choose to come to Yale for their medical education.

The fundamental element of the system is the concept that Yale medical students are mature individuals, strongly motivated to learn, requiring guidance and stimulation rather than compulsion or competition for relative standing in a group. The corollary of this concept is that students must assume more than usual responsibility for their education. Students should be considered adults in a graduate school and be permitted to enjoy as much freedom as is consistent with the fulfillment of requirements for the degree of Doctor of Medicine. Memorization of facts should be far less important than a well-rounded education in fundamental principles, training in methods of investigation, and the acquisition of the scientific habit of mind.

During the pre-clerkship years, attendance in basic science courses is not taken, lectures are held to a minimum, and much instruction occurs in small-group seminars or conferences. Students evaluate themselves through anonymous examinations. Their performance is assessed by the faculty through participation in seminars, by an anonymous qualifying examination at the end of each course, and by passing of the United States Medical Licensing Examinations.

In the first two years there are no grades, and there is no class ranking throughout medical school. While grades are not given and rank order not established, evaluation of students is an important part of the educational process. The faculty considers small-group teaching with interchange between faculty and students to be the most effective means of teaching and evaluation. Students should expect direct questioning at seminars and labs as an important adjunct to the evaluation process. The final decision of acceptable performance for a given course will remain with the chairperson of the department and/or the designated director of the course. Freed from the usual anxieties provoked by examinations, students tend to learn for their future rather than for tests. Competition for grades is eliminated and students are eager to help one another. Class spirit is remarkably high year after year. Upon completing a course, all students are strongly encouraged to submit an evaluation so that course directors can make changes based on student feedback, which is taken very seriously.

Finally, the Yale System requires each student to engage in a form of research activity, designed to foster development of a lifelong commitment to learning (see Required Thesis).

Curriculum Management

The Educational Policy and Curriculum Committee (EPCC)
The Board of Permanent Officers, composed of the tenured faculty of the School, had delegated during the 1960s the governance of educational matters to the Medical School Council. The tenured faculty has now accepted direct responsibility for the curriculum. Currently, a single body, the Educational Policy and Curriculum Committee, holds a broad mandate to change, integrate, or manage the curriculum, as appropriate to adapt to emerging needs.

The chair of the EPCC is the deputy dean for education, who oversees the activities of the EPCC, its subcommittees, and the Office of Education, and is responsible for implementation of new curricular policies that have been approved by the Board of Permanent Officers.

The EPCC consists of three chairs of departments, five faculty elected by their peers, eight students (two from each class year), and ex officio members: the associate dean for student affairs, the chair of the Medical School Council, the director of the M.D./Ph.D. Program, the director of the Office of Student Research, the associate dean for admissions, the associate dean for administration, and an elected representative of the Yale Medical School Alumni. The chair of the EPCC reports during each academic year before the Board of Permanent Officers and the Medical School Council. The chair also makes presentations throughout the year to the Friday meetings of the collegium of departmental chairs as well as meeting weekly with the associate dean for student affairs.

In addition to responsibility for the curriculum, the EPCC is further charged with addressing the status of teaching at the School of Medicine, the evaluation and rewarding of the teaching process, the advisory relationships between teachers and students, and the general philosophy of the educational system. The EPCC has the authority to arbitrate final proposals. The chair of the EPCC is an ex officio member of all subcommittees.

Management of Educational Mission
Reporting to the EPCC are three education subcommittees that oversee specific aspects of the educational mission: Curriculum Design, Teaching, and Assessment. Specific issues under the purview of each of these subcommittees are managed by various education working groups. Students from each medical school class are elected to serve on each of the twelve education working groups. They also automatically become members of the education subcommittees to which their working group reports. Several times a year the faculty leaders and elected students assemble to discuss issues of school-wide importance.

Curriculum Design Subcommittee
This subcommittee is charged with establishing the goals and curriculum of the educational program. Four education working groups report to this subcommittee: School-wide Objectives; Knowledge; Skills; and Attitudes.

Teaching Subcommittee
This subcommittee is charged with overseeing various aspects of the teaching mission. Three education working groups report to this subcommittee: Allocation of Resources; Technology; and Faculty Development.

Assessment Subcommittee
This subcommittee is charged with evaluating the quality and success of the educational program. Five education working groups report to this subcommittee: Assessment of Pre-clinical Curriculum; Assessment of Clinical Curriculum; Assessment of Electives; Assessment of Students (Pre-clinical); and Assessment of Students (Clinical).

The Thesis Committee
The Thesis Committee is charged with the oversight of the M.D. thesis requirement, the selection of thesis prizes, and policy concerning the thesis and all aspects of independent research performed by medical students. The chair of the Thesis Committee is also appointed by the chair of the EPCC.

Pre-Clinical Curriculum

The first two years of the curriculum at Yale School of Medicine focus on providing students with a foundation in the science and art of medical practice. In the first year, the science of normal human biology is explored in four major areas. The structure of the human body is taught in Principles of Human Anatomy and Development via dissections and in Diagnostic Imaging. The normal function of the human body is taught in Molecules to Systems, which includes material from former departmental courses in biochemistry, cell biology and histology, and physiology. The structure and function of the brain and nervous system are taught in the Neurobiology and Biological Basis of Behavior courses. Teaching of the art of medicine begins the first day of school, which is devoted to the discussion of the importance of understanding the patient’s culture in practicing medicine. The Pre-Clinical Clerkship, also called the Doctor-Patient Encounter course, introduces students to the principles and skills of medical interviewing and physical examination. In addition to didactic sessions, which now include sessions on “Understanding Your Patient: Psychosocial Aspects of Medical Practice,” this course provides weekly opportunities for students to see patients and to meet in small groups with a Clinical Tutor (throughout the first two years). Further understanding of the patient is achieved in Aspects of Child and Adolescent Development, which presents a developmental approach to human behavior. The Professional Responsibility course is an opportunity to discuss the attitudes and behaviors of caring and ethical physicians who practice in this complex era of managed care. Integrating the art and science in medical practice requires problem-solving skills, which are developed in the Principles of Clinical Reasoning course. A major focus of this effort is discussing how to assess the value of information in the medical literature by understanding and applying the basic principles of Biostatistics. Throughout the year, students can hear various talks on the History of Medicine, which add depth and texture to the curriculum as well as provide some insight into the time continuum within which the practice of medicine exists.

The first year ends with a focus on the mechanisms of disease: Pathology, Genetics, and Immunobiology. The second year emphasizes abnormal human biology. During the fall term the major courses are Microbiology, Pharmacology, and Epidemiology and Public Health. Late in the first term and continuing throughout the year, students participate in The Modules, a large interdisciplinary course. Content traditionally taught in the separate disciplines of pathology, pathophysiology, pharmacology, clinical examination, laboratory medicine, and diagnostic radiology is organized according to organs or systems. The individual modules are: Blood, Cardiovascular, Clinical Neuroscience, Clinical Sciences of Psychiatry, Endocrine System, Digestive, Respiratory, Musculo-skeletal, Oncology, Renal and Urinary Tract, Reproduction, and Skin. Teaching the art of medicine continues throughout the year in the Pre-Clinical Clerkship, or Doctor-Patient Encounter course, which emphasizes developing greater skills in history taking and physical examination. Students continue to meet in small groups with their Clinical Tutors. In the second year, students are given the opportunity to assess their acquired clinical skills in the Standardized Patient Program at the University of Connecticut School of Medicine.

Pre-Third Year Information

In order to proceed to the third year, a student must satisfy the following requisites:

1. Pass the mandatory qualifying examinations for all first- and second-year courses.

2. Pass the Doctor-Patient Encounter course.

3. Complete assessment exercises in second-year modules.

4. Have a minimum of five commentaries from different required basic science courses in his/her evaluation folder.

5. Comply with all immunization requirements.

In addition, students are strongly encouraged to evaluate all of the basic science required courses.

The Third Year

USMLE
All students are required to sit for Step I of the United States Medical Licensing Examination for the first time by the end of December of the third year. The United States Medical Licensing Examination (USMLE) Steps I, II, and III are computer-administered at Prometric Testing Centers. This system has given students considerable flexibility over choice of test time and place. Students should consult the USMLE Web site for more information (http://www.usmle.org/).

The Office of Student Affairs holds an informational session in February. Applications may be downloaded from the USMLE Web site, or you may apply for the USMLE online at the NBME (National Board of Medical Examiners) Interactive Website for Applicants and Examinees (https://external1.nbme.org/ciwc/java/candidate_menu). CD-ROMs containing test simulations are available throughout the year in the Office of Student Affairs. Students should return their completed applications for Step I and Step II to the Office of Student Affairs, which will certify and mail them directly to the NBME for processing. The application form must be accompanied by one passport photo and a check made out to the NBME for $420. The student must also indicate one of the three-month periods during which he or she wishes to sit for the exam. Within six weeks, the student will receive an identification card with a student identification number. The student can then call any Prometric test site in the world to schedule a specific test day.

All Yale medical students are required to pass Steps I and II in order to graduate. If a student fails Step I, he or she may reschedule it at any time before May of the third year. Three failures of Step I will require consultation with the Progress Committee, and only in extraordinary circumstances will the student receive permission to take it a fourth time. In the absence of that permission, the student will be terminated from the School of Medicine.

If Step I is failed more than once, the student may be asked to discontinue clinical rotations until he or she takes and passes the exam.

Clinical Clerkships
The third year is devoted almost entirely to clinical clerkships. The required clinical clerkships that must be taken in the third year are:

Internal Medicine 8 weeks
Ambulatory Medicine 4 weeks
Surgery A 4 weeks
Surgery B 4 weeks
Pediatrics 8 weeks
Obstetrics and Gynecology (Inpatient) 4 weeks
Psychiatry (Inpatient) 4 weeks

Clerkship scheduling will be arranged through the Office of Student Affairs. There is no required order for taking clerkships, and there is no advantage to any particular order. It is to your advantage to complete as many required clerkships as possible during the third year. In order to change your clerkship schedule after it is assigned to you, you must (1) fill out a clerkship/elective change form giving your reasons for the change and (2) meet with the registrar. Changes are not guaranteed, and no change except in the case of a legitimate emergency will be considered less than four weeks before the start of the scheduled clerkship. You may receive a lower priority for rescheduling these postponed clerkships in your fourth year than new third-year students. All changes must be approved by the associate dean for student affairs.

The Fourth Year
Required clerkships that may be taken in the fourth year are:

Surgery C 4 weeks
Clinical Neuroscience 4 weeks
Combined Outpatient Ob/Gyn and Psychiatry 4 weeks
Primary Care 4 weeks
Integrative Clinical Medicine 3 weeks

The Office of Student Affairs holds a meeting in the spring of the third year to discuss the fourth year. A majority of the meeting centers on the National Residency Matching Program, residency applications, and the Medical Student Performance Evaluation (MSPE), also known as the dean’s letter, but issues of scheduling subinternships, electives, and the thesis requirement are also addressed.

Graduating students are required to submit a thesis plan to the Office of Student Research prior to fall registration of the final year. Students must provide a tentative thesis title as well as identify their thesis adviser.

A required Primary Care Clerkship is generally completed during the fourth year. This four-week clerkship provides students with an opportunity to experience primary care in an outpatient or office setting. Many students also take a number of clinical electives, including a subinternship in some clinical discipline. The residency application process and completion of the thesis are also major activities of the fourth year.
In the spring, students attend one final required course, entitled Integrative Clinical Medicine: The Biological, Social, and Behavioral Bases of Clinical Medicine. This three-week course provides an opportunity for graduating students to come together one last time before leaving for internships and residencies, and serves to integrate basic and clinical science knowledge with the social and behavioral sciences. The course devotes one week to each of three clinical case studies, the complexity of which gradually unfolds as the week progresses. It employs small-group and large-group formats, and independent research with group decision making and consensus. It runs concurrently with a course led by the Emergency Medicine section, which focuses on preparatory skills for internship.

Course Schedules

First year
Aspects of Child and Adolescent Development in the Practice of Medicine
Biological Basis of Behavior
Pre-Clinical Clerkship, also called Doctor-Patient Encounter, including
  Understanding Your Patient: Psychosocial Aspects of Medical Practice
History of Medicine is incorporated into relevant courses during the first two years
Human Anatomy and Development including Diagnostic Imaging
Human Genetics
Immunobiology
Molecules, Cells, Tissues, and Systems (integrated course combining Cell Biology,
  Molecular Foundations of Medicine, Physiology)
Neurobiology
Pathology
Principles of Clinical Reasoning1
Professional Responsibility
Basic Life Support

Second Year
Pre-Clinical Clerkship, also called Doctor-Patient Encounter
Epidemiology and Public Health
The Modules*

Blood/Hematology
Cardiovascular System
Clinical Neurosciences (including Ophthalmology)
Clinical Science of Psychiatry
Digestive Diseases
Endocrine Systems
Lungs/Respiratory Diseases
Musculo-Skeletal System
Oncology
Renal/Urinary Tract (including Male Reproductive System)
Reproduction
Skin

Medical Microbiology
Pathology: Tutorials
Pharmacology: Basic Principles
Advanced Cardiac Life Support
Universal Precautions

* Including Clinical Examination, Diagnostic Radiology, Laboratory Medicine, Pathology, Pathophysiology,
and Pharmacology.

Third Year
Internal Medicine

Inpatient - 18 weeks
Ambulatory - 14 weeks

Surgery

Surgery A - 14 weeks
Surgery B - 14 weeks
Surgery C* - 14 weeks

Pediatrics

Inpatient - 14 weeks
Ambulatory - 14 weeks

Clinical Neuroscience* - 4 weeks
Obstetrics and Gynecology (Inpatient) - 4 weeks
Psychiatry (Inpatient) - 4 weeks
Combined Outpatient Ob/Gyn and Psychiatry* - 4 weeks

* Clerkship may be taken in fourth year.

Fourth Year
Primary Care 14 weeks
Integrative Clinical Medicine 13 weeks
Electives
Research
Thesis

Required Thesis
Yale is the only medical school with a long tradition requiring a dissertation based on original research. The M.D. thesis, a requirement since 1839, is an essential part of the curriculum, designed to develop critical judgment, habits of self-education, and application of the scientific method to medicine. The thesis requirement gives students the opportunity to work closely with faculty who are distinguished scientists, clinicians, and scholars. The investigation may have its origins in basic science or in clinical, laboratory, or environmental medicine. A hypothesis must be defined, experimental methods developed, and data gathered to prove or disprove the hypothesis. Stipends are provided for summer and all other short-term research periods (four deadlines throughout the year), and there are many one-year research fellowships available. Conduct of the research is continued during free periods in the third and fourth year and often over summer vacations. A significant percentage of students elect to take an additional year of medical school to pursue their research project in greater depth, but this is not a requirement. A doctoral dissertation in the biological sciences that has previously been accepted as a part of the requirements for the Ph.D. degree may be submitted in lieu of a School of Medicine dissertation at the discretion of the director of the Office of Student Research and the Thesis Committee. Information about the thesis and research opportunities may be obtained from the Office of Student Research, 203.785.6633.

Required National Examinations
For the past several decades it has been a requirement of Yale School of Medicine that all students pass the Step I and Step II examinations of the United States Medical Licensing Examination. No student will be allowed to postpone Step I beyond three years from matriculation except in extraordinary circumstances. Students are granted three attempts to pass.

Students take Step I of the USMLE by the end of December of the third year, but they are strongly encouraged to take it before starting their clinical clerkships in June. Students are given up to nine weeks after the end of classes to study for Step I. The purpose of Step I is to determine if an examinee understands and can apply important concepts of the basic biomedical sciences, with a special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. If a student fails Step I, he or she must take it again by the end of the academic year, but there is no requirement to stop clinical work unless the exam is failed twice in succession.

Step II is generally taken after completion of the third year; however, it must be taken by December 31 of the final year. Successful completion of Step II, like Step I, is a requirement for graduation. Students who fail Step II will have time to retake it before graduation.

Each student is required to show proof of sitting for Step II of the boards by December 31 of his/her fourth year, or that student’s dean’s letter will be held. In the case of a student who has shown evidence of intention to sit for the boards by that date, but who subsequently fails to do so, all residency programs to which that student applies may be notified that there is a danger the student may not pass the boards in time to graduate.

A student who has not passed the USMLE exam, or who has failed to complete any requirement for graduation, will be placed on “In Absentia to Submit” (IAS) status at the end of the academic year. Students in this status are not charged tuition and are not eligible for University services or loan deferments. There is no health insurance, disability insurance, or other amenity that would otherwise be offered to a full-time student in good standing. Student names are kept in the system so that when they register for the USMLE again, the School can act as the sponsoring agent. Students on IAS will be granted an additional five attempts to pass Step II within a three-year period from the first failure date. After the three-year period, if the student has not successfully passed Step II, he or she will be dismissed from the School of Medicine. It is the student’s responsibility to maintain yearly contact with the Office of Student Affairs and to find out about registration deadlines.

If a student cannot graduate because of failure in Step II, residency programs will be contacted by the associate dean and the student may or may not be able to begin the residency under the status of a “sub-intern.” This is totally up to the residency program director’s discretion.

It is a policy of the USMLE that once a student has obtained a passing total test grade, he or she may not repeat the examination in order to obtain a higher score. Students may take Step II any time after passing Step I.

Step III is taken after the M.D. degree has been received and the Step III requirements set by the medical licensing authority to which you are applying have been met.

The USMLE program states that medical licensing authorities require completion of USMLE Steps I, II, and III within a seven-year period. This seven-year period begins after passing the first step. However, in some cases, combined-degree students may remain a student longer than seven years. Such individuals must petition for an extension.

Combined Degree Programs

Combined M.D./Ph.D. Degree
A limited number of highly qualified students will be admitted into the M.D./Ph.D. Program each year. Students accepted into this program have an excellent academic record and a strong motivation toward a career in academic medicine and the biomedical sciences, and will have had previous research experiences of a high caliber.

The goal of the M.D./Ph.D. Program at Yale University School of Medicine is to train physician-scientists and provide them 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 expected that these individuals will develop into academic physicians capable of assuming faculty positions in either basic science or clinical departments of schools of medicine, and in these positions provide leadership in academic medicine and in research related to medicine and human welfare.

The joint-degree program is intended for students who wish to obtain a research degree in an established Ph.D. program. Departments participating in the program are Cell Biology; Cellular and Molecular Physiology; Chemistry; Epidemiology and Public Health; Experimental Pathology; Genetics; Immunobiology; Microbiology; Molecular Biophysics and Biochemistry; Molecular, Cellular, and Developmental Biology; Neurobiology; Neuroscience; and Pharmacology. Students interested in taking the joint degree in another department may do so, provided they can work out, in advance, a program that is approved by the department concerned, the director of the M.D./Ph.D. Program, the dean of the School of Medicine, and the dean of the Graduate School.

All applicants selected for admission will receive support for stipend, tuition, and health fees. Funding is provided largely by the Medical Scientist Training Program (MSTP), a grant provided from the National Institute of General Medical Sciences. In order to be considered for MSTP support, candidates must be U.S. citizens or permanent residents. Some funding is also available through fellowships from the School of Medicine. The average length of time students spend completing the requirements for the M.D./Ph.D. Program is seven and one-half years.

Requirements of the M.D./PH.D. Degree
Students may apply to the M.D./Ph.D. Program at the time of admission to the School of Medicine or no later than November 15 of their second year of study in either the M.D. or Ph.D. program, and must be admitted to the joint program no later than the end of the spring term of that year. Applications for admission are reviewed by a special committee composed of faculty members and deans from both schools.

Candidates for M.D./Ph.D. degrees will normally begin their thesis research after completing the first four terms of the School of Medicine curriculum, although alterations in the sequence of the curriculum are possible where appropriate for individuals. For example, students may complete a series of clinical rotations at the end of the second year of medical school which will enable them to participate in longitudinal clinical experiences during their Ph.D. years; students following this schedule are expected to affiliate with a graduate program by the beginning of the third year of the program. Since the choice of a particular Ph.D. program will best be made after some exposure to areas of graduate study at Yale, students take courses in the Graduate School during their first and second years. The summer between the first and second years is spent in lab rotation(s). However, students must request affiliation with a particular department in the Graduate School by the middle of their third year of study in the joint program. Any exceptions must be approved by the director of the program and the dean of the Graduate School.
A student admitted to the combined program must satisfy the Graduate School Honors requirement by the end of the second year of study and must complete all remaining predissertation requirements within four terms of affiliation with the Ph.D. department. These include course requirements, teaching requirements if applicable, a departmental qualifying examination, and the submission of an approved prospectus. At that point, the student is then admitted to candidacy. Students in the M.D./Ph.D. Program must be admitted to candidacy one full year before they expect to be awarded the Ph.D. degree. An average of three to four years is spent completing the Ph.D. requirements.

The remainder of the program encompasses clinical clerkships and electives. This advanced clinical work is best incorporated in the first six months of the student’s third year and the last year of the program, after the doctoral dissertation has been completed. Only under unusual circumstances will students be allowed to take more than six months of clerkships prior to the beginning of their Ph.D. work. Students are encouraged to take at least the eight-week Internal Medicine Clerkship and one other clerkship prior to beginning their research, which will enable them to participate in outpatient clinical activities during their dissertation work.

The Ph.D. dissertation will be accepted as the thesis requirement for the School of Medicine, providing the Ph.D. degree is received before or at the same time as the M.D. degree. If the M.D. degree is to be awarded before the Ph.D., an approved thesis must be submitted to the School of Medicine by May 1 in order to meet the School of Medicine thesis requirement for graduation. Students will be eligible for the M.D. and Ph.D. degrees providing the degree requirements for both the School of Medicine and the Graduate School have been fulfilled, usually at the end of seven years. If requirements have not been completed, additional time will be required.

Combined M.D./M.Div. Degree
Students who have been admitted to the Yale School of Medicine and are enrolled for the M.D. degree may apply to the Divinity School for admission to a combined program leading to the award of the degrees of Doctor of Medicine and Master of Divinity. Students who apply to the joint M.D./M.Div. program are expected to do so at the same time that they apply to the School of Medicine or by the end of their second year at the School of Medicine in order to qualify for the special tuition arrangement. (Please see “Financial Aid.”)

The joint program is tailored to the individual interests and needs of those students seeking professional education and training in a theological understanding of the self, society, and work; in bioethics; in international health and missions; in relating a ministry of healing to hospice or similar patient-care facilities; in a biblical understanding of person; or in academic work in teaching, counseling, and chaplaincy.
Six years are required for the combined M.D./M.Div. degree.

Combined M.D./J.D. Degree
The Yale School of Medicine has a formal relationship with the Law School to allow students to seek degrees from both schools. This can be done in six years instead of seven, as would be the case if these disciplines were studied separately. Students pay three and one-half years’ tuition to the School of Medicine and two and one-half years’ tuition to the Law School. Students interested in this program must confer early with the associate deans at both schools to plan curriculum and determine whether they qualify for the special tuition arrangement.

Students who apply to the joint M.D./J.D. program are expected to do so at the same time that they apply to the School of Medicine or by the end of their second year at the School of Medicine in order to qualify for the special tuition arrangement. (Please see “Financial Aid.”) Students must be found acceptable by both admissions committees. It is suggested that the student state on each application that he or she is applying to both schools in order to pursue the joint-degree program.

Combined M.D./M.B.A. Degree
The purpose of the joint-degree program in medicine and management is to develop clinician-managers capable of pursuing careers that balance delivery of patient care with sound management in a changing health-care environment. The joint-degree program normally requires five years of study and simultaneous award of the degrees of Doctor of Medicine and Master of Business Administration at the conclusion of the five-year period. A joint-degree student pays three and one-half years’ tuition to the School of Medicine and one and one-half years’ tuition to the School of Management, in a pattern determined in advance by the two schools. Students interested in this program must discuss their intentions with the associate deans at both schools.

Epidemiology and Public Health
The Department of Epidemiology and Public Health (EPH) is also an accredited school of public health where students may earn the Master of Public Health (M.P.H.) degree and the Doctor of Philosophy (Ph.D.) degree through the Graduate School.

Master of Public Health Program
The M.P.H. program is a two-year, 60-credit course of study. For students with health-related doctoral degrees or those in joint programs with other Yale schools, the program is 45 credits.

The program consists of a required core curriculum, required curricula within divisions, and electives. The purpose of the core curriculum is to ensure that students master the skills and knowledge that are fundamental to the practice of public health. The divisions admitting master’s students are Biostatistics, Chronic Disease Epidemiology/Social and Behavioral Sciences, Environmental Health Science, Epidemiology of Microbial Diseases, Global Health, and Health Policy Administration/Health Policy Management.

The EPH core curriculum consists of a one-year sequence in statistical thinking and four other term courses, an internship, and a thesis. The core courses are designed to provide skills in statistical methodology and data analysis as well as to introduce students to the breadth of the public health profession. This program ensures a solid grounding in the basic and applied sciences, and also provides students with learning experiences in the field or the laboratory. The final requirement is the thesis.

Each of the divisions has its own required curriculum. Students are encouraged to take electives in divisions other than the one in which they are entered.

Four terms are usually spent in residence. Students holding health-related doctoral degrees may request a 45-credit program. This must be done at the time of admission.

Applications for the M.P.H. program are available from the Office of Admissions, Department of Epidemiology and Public Health, Yale University School of Medicine, PO Box 2o8o34, New Haven CT 06520-8034, or online at http://publichealth.yale.edu/. Completed applications should be submitted no later than March 1 of the calendar year for which admission is sought.

EPH requires the submission of official undergraduate and graduate transcripts, GRE scores, letters of recommendation, and a personal statement as part of the application for admission. The GMAT or MCAT may be substituted in lieu of the GRE.

Combined M.D./M.P.H. Degree
Students enrolled for the M.D. degree at the Yale School of Medicine may apply to the Department of Epidemiology and Public Health for admission to a combined program leading to the degrees of Doctor of Medicine and Master of Public Health. This program is designed for students with special interest in aspects of medicine dealing with biostatistics, epidemiology of acute or chronic disease, organization and management of health services, or aspects of preventive medicine and public health.

Normally the combined program requires five years of study. One thesis satisfies both degree requirements provided it is approved and carried out under the supervision of a faculty member of the Department of Epidemiology and Public Health and is in an appropriate subject area.

A medical student may carry out research and write a thesis under the supervision of Epidemiology and Public Health faculty without being a candidate for the combined degree.

Applications for this joint-degree program are available at the EPH Office of Admissions and should be filed by March 1 of the calendar year for which admission is sought. Medical students interested in the joint-degree program should learn about the requirements of the joint program during their first year in the School of Medicine. Detailed information may be obtained from the associate dean for student affairs in the Department of Epidemiology and Public Health, from the director of medical studies in EPH, or from the associate dean for student affairs at the School of Medicine.

Doctoral Program
The degree of Doctor of Philosophy (Ph.D.) is offered through the Graduate School of Arts and Sciences. Preliminary inquiries should be addressed to the Director of Graduate Studies, PO Box 208034, New Haven CT 06520-8034. Four or five academic years are usually needed to complete the Ph.D. degree. All doctoral candidates must pass comprehensive examinations and design and successfully execute a dissertation prospectus, approved by a dissertation advisory committee, before being admitted to candidacy. There are five divisions in EPH in which doctoral students may choose a specialty: Biostatistics, Chronic Disease Epidemiology, Environmental Health Sciences, Epidemiology of Microbial Diseases, and Health Policy and Administration.

Application should be made to the Graduate School of Arts and Sciences, Yale University. Applications should be filed by the first working day in January specifying interest in Epidemiology and Public Health. Admission is normally only in the fall. The GRE is required. The TOEFL is also required of foreign applicants whose native language is not English. Students may enter the program with a baccalaureate. Knowledge of a foreign language is not required for admission, although it may be needed in the course of study.

2002–2003 EPH Calendar

Fall Term 2002
Aug. 29	Thur.	Registration and orientation for incoming students begin, 9 a.m.
Aug. 30	Fri.	Orientation ends.
Sept. 3	Tues.	Registration for returning students begins, 8.30 a.m.
		Fall-term classes begin.
Sept. 11	Wed.	Course registration deadline (late fee: $25).
Oct. 18	Fri.	Final date for course withdrawal.
Nov. 27	Wed.	Thanksgiving recess begins, 6 p.m.
Dec. 2	Mon.	Thanksgiving recess ends, 8.3o a.m.
Dec. 9	Mon.	Reading period begins.
Dec. 13	Fri.	Reading period ends.
Dec. 16–20	Mon.–Fri.	Final examination week.
Dec. 20	Fri.	Fall term ends, 6 p.m.
Spring Term 2003
Jan. 13	Mon.	Registration begins, 8.30 a.m.
		Spring-term classes begin.
Jan. 20	Mon.	Martin Luther King Day; no classes.
Jan. 21	Tues.	Course registration deadline (late fee: $25).
Mar. 7	Fri.	Final date for course withdrawal.
		Spring recess begins, 6 p.m.
Mar. 24	Mon.	Spring recess ends, 8.3o a.m.
Apr. 28	Mon.	Reading period begins.
2-May	Fri.	Reading period ends.
May 5–9	Mon.–Fri.	Final examination week.
15-May	Thur.	Final due date for M.P.H. thesis.
26-May	Mon.	University Commencement.
2002–2003 EPH Grading Calendar
Jan. 6	Mon.	Grades for all students due in the registrar’s office.
15-May	Thur.	Grades for all graduating students due in the registrar’s office.
29-May	Thur.	Grades for all continuing students due in the registrar’s office.

The Yale Physician Associate Program
The concept of a physician assistant (or Physician Associate) was first developed in 1965. Today the Physician Associate is a widely accepted, highly valued member of the health-care team where this individual is distinguished from other advanced health-care practitioners by the extent to which he or she is given decision-making authority regarding patient care, diagnosis, and treatment. The twenty-five-month Yale program, established in 1971, is committed to educating students in the highest clinical skills of primary care. As of September 2002, the Yale Physician Associate Program has graduated 720 Physician Associates who are employed in a variety of settings throughout the nation. Responsible to their supervising physicians, these graduates are located in rural as well as urban areas, in emergency rooms, health maintenance organizations, clinics, and solo and group practices. They perform a variety of tasks, including history-taking and physical examination, diagnosis, formulation and follow-up of patient treatment, patient counseling and health education, medical procedures ranging from suturing of lacerations to lumbar puncture, and assisting in surgery.

Curriculum Structure and Goals of the Yale Physician Associate Program
The program is divided into a didactic phase of ten months and a clinical phase of fifteen months. The rigor of the studies precludes students working. As a result, applicants should be fully prepared to finance their education through other means. Tuition is $21,4oo per year; other expenses are similar to those estimated for medical students. A Master of Medical Science degree is awarded upon completion of the program.

The Didactic Phase. The first ten months are devoted to course work in basic and clinical sciences. Anatomy is taken with Yale medical students. Courses are listed below.

Anatomy (lecture and laboratory)
Clinical Laboratory Medicine (Hematology, Urinalysis, Chemistries)
Clinical Practicum
Clinical Psychiatry
Diagnostic Imaging
Electrocardiography
Emergency Medicine
History-Taking and Physical Examination
Human Sexuality
Introduction to Surgical Skills
Medical Ethics
Medicine and Surgery
Medicine and the Law
Microbiology
Nutrition
Pathology
Pharmacotherapeutics
Physician Associate Profession
Physiology
Quantitative Methods in Clinical Research
Substance Abuse

The Clinical Phase. During the clinical phase, each student completes thirteen four-week rotations and one eight-week rotation in a variety of medical services to acquire broad experience in primary and emergency care. Eight rotations are mandatory: Internal Medicine I, Internal Medicine II, General Surgery, Family/General Medicine (eight weeks), Psychiatry, Pediatrics, Obstetrics and Gynecology, and Emergency Medicine. The remaining five rotations are electives.

Although many rotations take place in the New Haven area, the experience of the student is broadened by exposure to rotations in other geographic settings. Consequently, students entering the program should expect to spend at least eight weeks in areas such as New York, Kentucky, Maine, or Massachusetts. Students should be prepared to provide their own transportation and housing for all elective rotations away from New Haven; housing is provided for out-of-state mandatory rotations.

In order to graduate from the program, a student must successfully complete all rotations as well as a research study proposal in clinical medicine.

Mandatory Rotations

Emergency Medicine
Family/General Practice
General Surgery
Internal Medicine I
Internal Medicine II
Obstetrics and Gynecology
Pediatrics
Psychiatry

Elective Rotations

Ambulatory Medicine
Anesthesiology
Cardiology
Cardiothoracic Surgery
Dermatology
Diagnostic Imaging
Endocrinology
Gastroenterology
Geriatrics
Hematology/Oncology
Hospice
Industrial and Occupational
Infectious Disease
Neonatology
Neurosurgery
Ophthalmology
Orthopaedic Neurosurgery
Orthopaedics
Otolaryngology
Pediatric Cardiology
Plastic Surgery
Rehabilitative Medicine
Rheumatology
Sports Medicine
Trauma

Admission to the Yale Physician Associate Program
The admissions process is highly selective and the competition each year is keen. Selection is based on three fundamental criteria: academic history, patient care experience, and interpersonal effectiveness.

Academic. Applicants must have baccalaureate degrees before entrance. In addition, the Admissions Committee closely examines applicant records for evidence that individuals are capable of successfully completing graduate-level science work. Premedical science majors are not necessary, but anatomy, physiology, microbiology, introductory chemistry, and psychology are prerequisites. The program considers Scholastic Aptitude Test (SAT) scores, Graduate Record Exam (GRE) scores, and other indicators of academic ability in light of applicants’ past records.

Experience. The Admissions Committee is concerned that applicants have some awareness of the intricacies of medical care delivery as it exists today and can realistically commit themselves to a profession that helps the sick and injured. The majority of the program’s students have had two or more years of direct patient contact experience in a variety of health-care roles such as orderly, nurses’ aide, military corpsman, nurse, surgical technician, or emergency medical technician. Experience need not be in a hospital setting.

Interpersonal. The program values ability to work skillfully, thoughtfully, responsibly, and constructively with people. Compassionate health care is a basic goal of physician assistant education. The Admissions Committee screens applicants to determine their career commitment, awareness of the physician assistant role, and willingness to work with the supervision of a physician.

In addition to scholastic potential and interpersonal skills, applicants must have the physical capacities and personal characteristics necessary to meet the full requirements of the program’s curriculum and to graduate as skilled and effective physician assistants. Policy on nonacademic considerations in the admissions process is available upon request from the Physician Associate Program office or on the program’s Web site.

The application deadline for the class entering in 2003 is December 1, 2002. Program catalogues may be obtained by writing to the Director of Admissions, Yale Physician Associate Program, 47 College Street, Suite 220, New Haven CT 06510-3209, by telephoning 203.785.4252, or by accessing the program’s Web site at http://www.med.yale.edu/phyassoc/. The Yale program participates in CASPA (centralized application service). Applications can be accessed at http://www.caspaonline.org/.

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