For Thomas Pisano, the motivation to become a doctor and scientist was personal. A skiing accident left his legs paralyzed, fueling his aspiration to become a physician and biomedical researcher who could both conduct scientific investigations and apply that knowledge to saving lives in the clinic.
"My goal is to take an idea, a concept that has been developed in the lab, and bring it to the point where it can improve the quality of life for patients," Pisano said. "For that I realized I needed two skill sets: the ability to understand basic science, and to work with patients to really understand their particular medical condition."
Pisano is one of 15 graduate students at Princeton who are training to be doctors through a joint program between Princeton University and Rutgers Robert Wood Johnson Medical School. The program unites laboratory-based research at Princeton — culminating in a doctor of philosophy (Ph.D.) degree — with the extensive education and clinical experiences required to earn a medical doctor (M.D.) degree from Rutgers.
At the end of the eight-year program, these M.D.-Ph.D. graduates will be ready to care for patients in a medical residency program as well as to explore the biology underlying their patient's medical conditions.
The joint university program, which has been in existence since 2005, brings benefits to both Rutgers and Princeton, which does not have a medical school.
"The partnership with Rutgers brings to Princeton an infusion of talented and committed students who are intensively focused on biomedical challenges," said Daniel Notterman, Princeton's faculty adviser for the program and a senior research scholar in the Department of Molecular Biology. Notterman, who is also a lecturer with the rank of professor in molecular biology, is himself a physician.
"This program offers unique opportunities for students attending a large state university like Rutgers," said James Millonig, director of the program at Rutgers and an associate professor at Rutgers Robert Wood Johnson Medical School Department of Neuroscience and Cell Biology. Millonig, who earned his doctorate at Princeton, continued, "Princeton offers the chance to work closely with faculty researchers on fundamental questions in biology."
Students in the program are attracted by Princeton's reputation for conducting groundbreaking research that explores the physical, chemical and biological underpinnings of life, according to Sam Wang, professor of molecular biology and the Princeton Neuroscience Institute, and Pisano's adviser.
"The M.D.-Ph.D. program is valuable for students because it brings their interest in medicine together with access to advanced research methods, as well as training in how to ask and solve cutting-edge scientific problems," Wang said.
Most Princeton students publish an average of three to four scientific papers during that period, according to Millonig. About half of the students receive prestigious fellowships through the National Institutes of Health.
Students in the program typically spend the first two years as medical students at Rutgers Robert Wood Johnson Medical School in New Brunswick, about 20 miles from Princeton University. The students then spend the next three to four years conducting laboratory research in biomedical laboratories at Princeton to earn the Ph.D., and then finish the last two years of medical school at Rutgers.
To help accepted students decide whether to do their Ph.D. at Princeton or Rutgers, the program allows students to work in laboratories at both universities during the summers before or after their first year, Millonig said. "They conduct short projects in one or more of the laboratories to find the right fit," he said.
Many of the classes that the M.D.-Ph.D. students take at Rutgers in the first two years of medical school also satisfy Princeton's coursework requirements for molecular biology graduate students, allowing the M.D.-Ph.D. students to spend more time on research.
A recent update to the program gives Princeton Ph.D. students the opportunity to accompany Notterman on visits to patients at the Robert Wood Johnson University Hospital. These "preceptorships" allow the Ph.D. students, who typically would spend their third and fourth years in the clinic, to interact with patients about once a month. In addition, some of the students volunteer their time at medical clinics.
A few of the current students are:
Alexander Goglia, a graduate student in molecular biology, is studying the molecular processes that allow cells to send and receive information. He is interested in how cells encode and then use information to make decisions about when to grow and divide, processes essential to both proper development and diseases like cancer. His adviser is Jared Toettcher, assistant professor of molecular biology.
"Medical school and graduate school are understandably quite different, as they each prepare us for two distinct aspects of our careers," Goglia said. "In the first two years of medical school, we do a lot of reading and learning as we prepare to apply this medical knowledge in the clinic. In the lab, the learning is much more self-directed and I’ve found that I have greatly benefited from that independence. I get to sit down and think deeply about something I really care about, discuss it with amazing advisers and colleagues, and then design experiments and carry a line of scientific investigation from beginning to end."
This training is what makes M.D-Ph.D. programs so valuable, Goglia said. "We learn to be independent thinkers and creative problem-solvers, which are skills that will be incredibly important in both the research and clinical aspects of our careers as physician-scientists."
Margaret MacGibeny earned her Ph.D. earlier this year and is now completing her clinical education at the Rutgers Robert Wood Johnson Medical School.
While at Princeton, MacGibeny studied viruses, such as rabies and herpes, which infect the nervous system, in the laboratory of Lynn Enquist, the Henry L. Hillman Professor in Molecular Biology and professor of molecular biology and the Princeton Neuroscience Institute.
MacGibeny said she chose the M.D.-Ph.D. program after meeting physicians who were also scientists at the National Institutes of Health in Maryland, where she had been a research fellow working in a laboratory. "I wanted to be involved in medical breakthroughs and ask why we use certain treatments, why we do certain things in medicine," she said. "With this program, we are learning how to ask questions, how to look at a patient and really understand what is happening at the biological level and how to decide on the appropriate treatments."
Ila Nimgaonkar is a graduate student in molecular biology who studies hepatitis viruses in the laboratory of Alexander Ploss, associate professor of molecular biology. She is developing improved animal models and therapeutics against hepatitis E virus, a globally prevalent virus that has severe effects in pregnant women and no cure.
"I was inspired to pursue the M.D.-Ph.D. while working on hepatitis C virus research at the National Institutes of Health,” Nimgaonkar said. “During that time, a drug with a 98 percent cure rate that was designed based on a mechanistic understanding of the virus became available for clinical use. I went to medical school the next year and worked in a free clinic, where I saw this basic science discovery lead to life-changing care for patients."
Nimgaonkar said she appreciated the fast-paced, translational nature of her work in the Ploss lab, as well as the supportive and collaborative environment at Princeton. "My adviser Alexander Ploss and M.D.-Ph.D. program directors Dan Notterman and Jim Millonig have gone out of their way to provide a unique training experience tailored to our needs, including providing clinical shadowing opportunities, organizing journal clubs to discuss developments in medicine, and exposing us to different career paths that fit our skills."
Thomas Pisano is a graduate student in molecular biology who works to understand the connections between regions of the brain. Alterations in these connections may play a role in conditions such as autism.
Pisano tracks the connections between brain cells using a virus that has been modified to carry a fluorescent green protein. After the virus spreads to nearby cells, researchers can follow the cell connections by the location of the green color. Pisano selected Wang as his mentor because of Wang's strengths as a scientist who can translate findings in ways that impact everyday lives. "I wanted to work with a mentor who would push me to develop both as a scientist and someone who could help translate this knowledge into applications," Pisano said. "At Princeton you have the opportunity to learn from leaders in the field, and that is really special."
Nilay Sethi was one of the early participants in the program, completing his Ph.D. at Princeton in 2010. He then finished his M.D. in 2012 and went on to a residency in internal medicine at the University of California-San Francisco. He is now a postdoctoral fellow in hematology and oncology at the Dana Farber Cancer Institute in Boston. He said that at Princeton he was able to "dive very deep into basic science concepts" including what causes cancer to spread, a topic he studied with adviser Yibin Kang, the Warner-Lambert/Parke-Davis Professor of Molecular Biology.
"Overall, my experiences at Princeton University were unparalleled," Sethi said. "I was trained extremely well in a rich scientific environment, preparing me for a future career in basic and translational research."
Princeton’s current M.D.-Ph.D. students and advisers
Lev Barinov - Thomas Gregor, associate professor of physics and the Lewis-Sigler Institute for Integrative Genomics
Eli Cadoff - Jean Schwarzbauer, the Eugene Higgins Professor of Molecular Biology
Ben Deverett - Sam Wang, professor of molecular biology and the Princeton Neuroscience Institute
Jon Ghergurovich - Joshua Rabinowitz, professor of chemistry and the Lewis-Sigler Institute for Integrative Genomics
Alexander Goglia - Jared Toettcher, assistant professor of molecular biology
Krupa Jani - Tom Muir, the Van Zandt Williams Jr. Class of 1965 Professor of Chemistry
Jacob Jaslove - Celeste Nelson, professor of chemical and biological engineering
Bahar Javdan - Mohamed Abou Donia, assistant professor of molecular biology
Camden MacDowell - Sam Wang, professor of molecular biology and the Princeton Neuroscience Institute
Allison Murawski - Mark Brynildsen, associate professor of chemical and biological engineering
Ila Nimgaonkar - Alexander Ploss, associate professor of molecular biology
Pul Park - Michael Berry, associate professor of molecular biology and the Princeton Neuroscience Institute
Thomas Pisano - Sam Wang, professor of molecular biology and the Princeton Neuroscience Institute
Emann Rabie - Celeste Nelson, professor of chemical and biological engineering
Yifan Zhang - Mohammad Seyedsayamdost, assistant professor of chemistry
In addition, two students will be joining over the summer:
Chloe Cavanaugh - Daniel Notterman, senior research scholar in the Department of Molecular Biology, and
Therese Kichuk - working with José Avalos, assistant professor of chemical and biological engineering and the Andlinger Center for Energy and the Environment.