It is a daunting commitment with a double degree of difficulty – an endeavor that combines two demanding academic degrees into USF’s elite MD/PhD program, an eight-year tour of duty that some have likened to the special ops of medical school.
“If medical school students are like the enlisted troops, then the MD/PhD students are the Navy SEALs,” said Robert Deschenes, PhD, chair of the USF Health Morsani College of Medicine’s Department of Molecular Medicine and interim director of the MD/PhD program.
Dr. Deschenes wanted to start the program at USF Health upon arriving here in 2009, after being involved in MD/PhD programs at his previous positions at the University of Iowa and the Medical College of Wisconsin. It launched in earnest six years ago with strong support from Charles J. Lockwood, MD, MHCM, executive vice president of USF Health and dean of the USF Health Morsani College of Medicine.
The MD/PhD program is designed to train the next generation of physician scientists – physicians who thinks like researchers and researchers who embed clinical relevance in their research.
Not surprisingly, the investment required to train this elite group of students is steep. In return for their commitment to the program, tuition is entirely covered and students receive a graduate student stipend, even when they’re in medical school.
That’s one reason USF Health is expanding the MD/PhD program so that it will qualify as a Medical Science Training Program (MSTP), funded by a training grant from the National Institutes of Health (NIH). “The NIH currently has about 50 medical science training programs,” Deschenes said. “We aspire to be one of them, though it will take a while. Our job is to find the people who have the passion, the commitment and the resilience to do it.”
The USF Health MD/PhD requires approximately 8 years to complete. Years 1-2 focus on MD classes, whereas Years 3-6 are dedicated to research, followed by Years 7-8 of clinical rotations. Throughout the program, MD/PhD experiences integrate medicine and research, so when students are in medical school, they’re thinking about research. And in the research lab, they’re thinking about clinics.”
One of those students is Natasha Ram, beginning her fifth year overall and third in the PhD phase. Her story of dedication and big dreams, reaching back to childhood and years in the International Baccalaureate program at Palm Harbor University High School, illustrate the enormity of the MD/PhD path – and the rewards it offers.
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Growing up in Palm Harbor, Ram has many memories of her scientist father coming home from work to tell the family about his research and creations in his research labs. “I was always surrounded by science because of my dad’s work,” she said. “He’d say, ‘Look what I made today!’ And from an early age I found science fascinating.”
Her father’s career ultimately led to a fortuitous research opportunity at USF while she was still in high school. He knew various researchers at the university, so she contacted them. That led to her getting hands-on lab experience during the summer of her junior year.
“It was a perfect fit – like high school biology class but 20,000 times cooler,” she said. “I knew I wanted to go into medicine and become a doctor. But after I finished that first lab experience, I knew I liked the integration of scientific research and medicine.”
That feeling solidified once she enrolled at USF as an undergraduate in 2016. Ram earned her bachelor’s degree in Cellular and Molecular Biology, while also finding time to serve as a USF Ambassador, participate in Women in Leadership and Philanthropy, volunteer at Moffitt Cancer Center, captain the Bollywood Fusion Dance team, and take on numerous other activities – earning the Outstanding Undergraduate Research Award in 2018 for good measure.
She began thinking about applying to the MD/PhD program as a sophomore.
“It seemed a little far-fetched, because I didn’t know anyone who had done that program, and USF’s program was so new at that point that I didn’t really have any contacts at USF to talk to,” she said. “But I had done a summer research program at Washington University in St. Louis, and they have one of the biggest MD/PhD programs in the country. The researcher I worked for was an MD/PhD and learning about his path had a big influence on me. By my junior year, I knew it’s what I wanted to do.”
Ram applied to several universities, but USF gave her the best offer and she eagerly set out to focus on neuroscience. “I had studied aging, neuroscience and Parkinson’s disease as an undergraduate, and I knew I wanted to continue working on neurodegeneration in graduate school,” she explained. “USF’s Neuroscience Institute was the best place for me to work on those areas. In addition, I would be close to my family. I also really liked the USF curriculum, because I’m very interested in public health and international medicine, and I wanted to be involved in community health.”
That interest had led her at the start of medical school to get involved in the leadership of Tampa Bay Street Medicine, specifically the Continuity Clinic, providing care to unsheltered and sheltered homeless communities in Tampa Bay – an initiative she remains involved with today. Most of her time, of course, is devoted to the ultra-intensive MD/PhD program.
“For me, the reward of being a physician scientist is so much greater,” she said. “For the eight years of the program it’s nice to be alleviated from financial burden since the program is fully funded and we receive a stipend through the entirety of the program, and I can focus all my efforts on my research and clinical work.”
After beginning her PhD, Ram started working on Alzheimer’s disease but then transitioned to working on a translational (bench-to-bedside) project with a neurosurgery team on chronic subdural hematomas, a chronic bleed above the brain commonly afflicting elderly patients. “Working in the PhD program showed me this beautiful intersection of working in a lab and also working in a clinic,” she said. “It gave me a great balance.”
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Ram has had an array of mentors along the way, but one who stands out is Lynette Menezes, PhD, associate vice president of USF Health International, among other roles.
“I’ve mentored Natasha in her work with Tampa Bay Street Medicine,” Dr. Menezes said. “And she meets with me on occasion and tells me how her PhD is going. Natasha is an absolutely amazing student. One thing that stands out about her is she’s very compassionate – and also brilliant.”
In May, Ram was put to one of the ultimate tests of the program, taking her PhD candidacy exam, which would allow her to become a PhD candidate. To pass, she had to write a 13-page NIH grant-style proposal and submit it to the committee. As part of the process, she had to conduct a one-hour public seminar for anyone who wanted to attend from her committee or from the graduate program. That was followed by a private Q&A session with her dissertation committee, akin to an oral exam where she was asked about many aspects of her presentation.
“I’m one of those students where I really like to be prepared for everything,” she said. “So I created a 150-page study guide over several weeks. You need to know anything and everything about your topic. So I knew every single experimental method backward and forward. And I watched hundreds of YouTube videos and read countless papers. I was totally prepared.”
When the day finally arrived, Ram admits that she felt nauseous all morning. But when she entered the room and began to speak, her jitters vanished. When she was done, she was asked to step outside for 10 minutes while the committee huddled.
“Then the door opened, and the committee chair was smiling and said, ‘Congratulations, you passed!’” More well-wishes followed from the group, with her friends throwing her a party upstairs with cake and balloons.
And then she got back to work.
-- Photos by Freddie Coleman, USF Health News
Related story: Medical student on track to be the first MD/PhD graduate of the USF Health Morsani College of Medicine