Calvin Fang is a fifth year MD-PhD student at Yale School of Medicine. He completed a two-year postbaccalaureate fellowship at NICHD with Dr. Chris McBain from 2015–2017. As a postbac fellow, Calvin learned slice electrophysiology to study inhibitory hippocampal interneurons, with a focus on a subclass of interneurons that express Vesicular Glutamate Transporter Type 3 (VgluT3) and release the neurotransmitter glutamate.
We caught up with Calvin to learn about his career choices, advice, and experience so far in Yale’s MD-PhD program.
What led you down this career path—why an MD-PhD versus an MD or PhD program?
I began undergraduate studies at Cornell knowing (as much a freshman can know about anything) that I wanted to pursue medicine. During a research opportunity my freshman year, I realized I enjoyed science. I later learned about MD-PhD programs from an advisor who knew two investigators on campus with dual degrees—one person who got his MD, practiced, and then pursued the PhD, and another person who pursued them simultaneously through an MD-PhD program. This second person, Dr. Jesse Goldberg, associate professor in the Department of Neurobiology and Behavior, also happens to be a neuroscientist. I was able to speak to him about his experiences.
I decided to pursue both an MD and a PhD as I am interested in continuing a scientific career and practicing medicine. Although the MD can be sufficient for a clinician to establish a research program, my sentiment was that a PhD would provide more rigorous research training, and the dedicated time would help me learn a lot of concepts and skills for systems neuroscience that would not be covered through medical training.
Now that you’re several years in, what’s it like doing an MD-PhD program?
Like most other programs, Yale’s MD-PhD program lasts eight years, on average. This includes one and a half years of pre-clerkship training, followed by half a year of clerkships, then the PhD, the rest of clerkships, and finally advanced clinical electives and sub-internships. Yale also provides a lot of flexibility for the first one and a half years, so I was able to split my time between coursework and participating in research.
Pre-clerkship training involved lectures and workshops about physiology/pathophysiology, clinical skills training and practice, and other topics like ethics and statistics. For clerkships, I did neurology, psychiatry, internal medicine, and primary care (outpatient medicine). After I finish my PhD, I will complete surgery, emergency medicine, pediatrics, and ob-gyn clerkships. Clerkships mostly entail spending all day at the hospital or clinic, applying what you learned during pre-clerkship and understanding the different specialties.
After my first set of clerkships, I dedicated time to study and take the Step 1, which is the first of three US Medical Licensure Exams (USMLE) referred to as the “Boards,” before entering graduate school. I was fortunate that the department for my PhD program only required two courses—one I had already taken for medical school and another that I was able to take in the first year. The main PhD milestones I’ve completed are the qualifying exam, a thesis prospectus exam, and one teaching assistant requirement. Other than that, I have mostly focused on my research, while pursuing a few other extracurriculars.
It’s great you have been able to find time for extracurricular activities. What kind of extracurricular activities do you enjoy?
I enjoy volunteering. Given my interest in pediatrics, I joined the Court Appointed Special Advocates (CASA) chapter in Connecticut. This involves volunteer work with a child who is under the custody or supervision of the state due to concerns of neglect and abuse.
I have also participated in vaccine preparations and administrations, initially with the hospital’s mass vaccination sites and currently with Yale's Community Healthcare Van. This mobile medical clinic overcomes traditional medical care barriers by bridging the gap, literally, between patients and medical/social services.
I also enjoy participating in mentoring activities, including helping with workshops for a program at Yale called PATHS (Program to Advance Training in Health & Sciences). Finally, my various hobbies include paddling (I used to paddle with DC Dragon Boat as a postbac), playing the piano, tabletop gaming, reading, and, like many others, I've picked up cooking and baking during the pandemic.
Any advice for fellows who are just starting out with their MD-PhD program application process?
Having talked to faculty, at least at Yale, the most important thing for the initial screening before interviews is a history of quality research experience and a clear, realistic plan for a future training path that relates to those research experiences.
Have lots of people go over your statements. Talk to people about the story you want to tell for why you want to pursue an MD-PhD program. Not everyone who will interview you or screen your application will be from the same field, school, background, etc. as you are, so it’s important that your message can get across to anyone.
I believe the number of schools people apply to has been increasing over the last few years, but consider that with limited time and energy, the more applications you put out, the lower the quality might be for the secondaries and later the interviews.
When it comes to making a decision, ask yourself if you can see yourself being a part of that community over the next eight years or so. You might have a sense of labs and research you’re interested in, or the type of educational curriculum you want. But pay attention to whether the student body seems to be happy, how you feel about the possible living arrangements, etc. It’s easier to find success somewhere you feel like you belong and are supported.
What advice do you have for MD-PhD applicants who have been accepted into a program and will begin training soon?
Mentorship is, in my opinion, the most important thing by far for a successful training career. Obviously, finding a good fit with a principal investigator is important for research. But there is not going to be one mentor who will be able to address all your training needs. You want to build a collection of people who you can go to for advice and training.
There are many different flavors of mentorship. You want people who can teach you the actual skills you need, others who are great with networking and can help promote you, people who can guide you through the various institutional systems involved in medicine and science, etc.
Finally, mentoring is not a passive process; you cannot expect your mentors to know what you need. You must be introspective on what you may be lacking as a trainee and proactive about addressing such needs.
How did you find multiple mentors, and practically what does that look like?
In terms of finding mentors, it's mostly a matter of reaching out. I generally keep an eye out for people who do what I want to do, at any stage. This could involve searching up faculty at my current institution, talking to my colleagues, and more. And if someone says they can’t help me, I always follow up by asking if they know someone who could.
I think more often than not, people are happy to help. When I first started medical school, I emailed a number of physician-neuroscientists to help me get a sense of how best to start my path, and most were willing to find time. Being open about what you're looking for helps, such as managing work-life balance or how to write a successful grant. Once, during a local paddling event, I mentioned that I was trying to learn about what research and psychiatry could look like in residency, and it so happened a psych resident was there. She helped connect me to faculty leading an appropriate residency program. Also, mentorship doesn’t necessarily have to be one on one; I've received advice along with others who have had similar questions in a group setting.
Practically, it depends on what you need and what stage you are at. For myself, I had regular, scheduled meetings with a variety of people for things related to career development or preparing for medical school applications when I was an undergraduate student. Research generally involves meeting with the PI or a senior scientist, which has been true for me as an undergraduate, postbac, and as a current graduate student.
For some things, such as trying to figure out what my future could be, it has been more about hearing a variety of perspectives, as opposed to having continual feedback. I have learned a lot from informal conversations with various people, from more senior students, residents, postdocs, faculty, and people outside medicine and academia. Often, for me, mentoring is less a formal process and more a matter of informal advice and information gathering. I generally do prefer face-to-face meetings—or in this day and age video chats—as I can get more from an organic conversation. But the most important factor is having some form of contact.
What has surprised you the most about your MD-PhD program experience?
I’m someone who considers the brain to be the most interesting organ by far. It has been nice to have to learn in great detail about the other regions, especially since there is significant crosstalk between the nervous system and other systems, such as the immune system. There are a lot of interesting elements that go into health and disease.
What has been the most challenging aspect of your MD-PhD program?
Likely the same thing that’s been the most challenging for most people around the world across the last few years. Specifically, the pandemic occurred right when I was settling into my research and slowed things down quite a bit. Otherwise, I’m not quite a fan of standardized testing, so Step 1 was a chore.
Were there any workshops or programs at the NIH that helped you prepare for this next step in your education and training?
The NIH Office of Intramural Training and Education was helpful, with plenty of resources for the application process. And though I cannot recall anything specific now, there are plenty of helpful opportunities at the NIH for presenting your work and learning new skills.
What do you want to do after your MD-PhD training?
Honestly, I’m still figuring it out. I have always felt that a benefit of the long MD-PhD program is it gives plenty of time to try things and figure out what is best for me. I want to figure out whether to emphasize clinical practice or basic science research more. If I were to try to combine the two, I would likely pursue child psychiatry or neurology, with a research program focused on healthy and disordered neurodevelopment. However, I have plenty of other clinical interests, such as primary care, general pediatrics, and family medicine, and I’m interested in areas like policy and community engagement for addressing issues in health. For research, there’s so much to explore and understand about the brain that I can also see myself fully dedicating all my time to the lab as well.
Do you have any final tips or thoughts for fellows who are thinking about applying to MD-PhD programs?
MD-PhD programs require a great deal of time, so it is important to ask yourself if you think you have a strong enough motivation/drive/interest to see it through. That said, I don’t think it is important to feel like you know exactly what your future will look like. I have had colleagues change their research interests, and I’ve seen MD-PhD faculty working in fields that don’t necessarily relate directly to what they studied in school. The key is that programs are trying to build future physician-scientists and offer the required training, which can be used in many different ways. So, in case you think you don’t quite fit the image for a physician scientist, know that there isn’t really a single image of what a physician scientist has to be in the first place.
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