100 REASONS 100 REASONS NE HUNDRED STUDENTS

each year make Yale the most stimulating place in the world to study medicine. Each chooses Yale for a hundred di≠erent reasons; this book is about Oa few of them. Our class size of 100 allows us to nurture each student’s own interests, ambitions, and vision of how the art and science of medicine can contribute to the world. What’s your reason for choosing Yale? “MEDICINE 1AT YALE. IS ABOUT

MORETHAN NUMBERS.”

“The numbers tell us what an outstanding school we have: number of grants, number of applicants, number of awards, number of medical breakthroughs. But what makes us extraordinary is that we never lose sight of the whole person behind the numbers—whether that person is the patient, the doctor, or the student.”

Robert J. Alpern, M.D. Dean and Ensign Professor of Medicine

4 5

The2. Yale SYSTEM

Since it was More than 80 years ago, the Yale School on these tests are known only instituted in the of Medicine embarked on a new approach to the individual student, and 1920s, the Yale System has to education, based on the premise that there are no grade point aver- fostered a collegial educational “the medical student is a mature individual,” ages or class ranking. The rare environment that as a 1928 Curriculum Committee put it. student who fails to achieve produces leaders in medicine. Highly motivated and self-directed, students mastery has many options for were to take an active role in acquiring not assistance in getting up to speed. just a set of facts but habits of inquiry and a > Class attendance at lectures is not recorded, capacity for critical thinking that would last and students are expected to make responsible a lifetime. This approach was so distinctive decisions about the best use of their time. that it became known as “the Yale System.” > Students are encouraged to explore their own The Yale System has endured through interests in medicine and advance at their myriad changes in biomedical knowledge, own pace within the Yale curriculum. About M.D. the nature of clinical practice, and technol- half complete the program in four years, ogy, but it retains its reliance on student and half take an optional, tuition-free fifth initiative, its emphasis on scientific investi- year to pursue additional clinical electives, gation, its respect for individuality, and thesis-related research, or international medical its encouragement of cooperation rather experiences. Several students each year pursue than competition. dual-degree programs with other Yale schools and departments. What does all this mean in practice? M.D. The Yale System embodies the school’s > Every student must complete a thesis commitment to educating leaders who will that represents a substantial body of original advance the science and practice of medi- research. The thesis project teaches students to cine. Such leadership requires the ability wield the tools of scientific investigation and to think critically and creatively, to work places students in close, collegial contact with collaboratively with others, and to take faculty from day one. responsibility for lifelong learning. Judging > In the first two years, students track their own by both the satisfaction of our current progress through optional self-assessment tests students and the extraordinary success of midway through each course and mandatory our graduates, the system works. final examinations called qualifiers. The grades 6 7 GET TO4. KNOW YOUR NEW CLASSMATES IN THE GREAT OUTDOORS... LEssons6. from PATIENTS

At Yale, “bedside manner” is not an add-on to physician training but an integral part of the concept of patients as The Medical Outdoor Orientation Trip is a whole people. From the very beginning, a Yale medical four-day hike on the education reminds students not to lose sight of the whole Appalachian Trail patient. In one first-year exercise, students are asked to just before first-year registration. interview a family member about a medical event and then to think about the psychosocial factors that came into play. At the end of the surgical clerkship, students must interview Anatomy students with lectures, study groups, consult course patients after surgery to gain a complete understanding and a wealth of web-based materials online of the experience. Classes build in discus- during a dissection. Before working in resources. Outcome meas- Yale uses a surgical 5. sions not just with medical experts but clinical settings, case model to ...OR IN students practice their history-taking ures show that students are teach anatomy. with nurses, social workers, and chaplains. SERVICE TO skills in a course 3. retaining more information This distinctively Yale approach to medical that employs YOUR NEW ANATOMY under the new model. training makes our graduates better, more actors to play the HOMETOWN role of patient. Rizzolo and his colleagues have pub- observant, more e≠ective doctors. CLASS lished on this unique approach and field

inquiries from other medical schools that would like to explore it. The sum of Yale has turned anatomy on its head. medical knowledge increases rapidly, but Traditional anatomy courses begin with the time students spend in medical school comprehensive lectures, overly detailed dis- is a constant. More e∞cient ways to learn sections and long nights memorizing terms. are essential. The case-based approach A four-day orientation to It all seems rather abstract until students does not only teach basic anatomy more the City of New Haven, see patients. So why not start with the patients? e≠ectively; students are simultaneously community service, and That’s what course director Lawrence J. practicing clinical reasoning skills, gaining fellow first-years, S.A.Y. P D. (Service at Yale) New Rizzolo, h. , associate professor of anatomy experience reading images, and negotiat- Haven sends crews and experimental surgery, asked himself. ing the complexities of working in teams. of volunteers to a variety He redesigned the course and made Yale the Experience with the cadavers is also an early of organizations, from Habitat for Humanity first medical school to teach anatomy using and important opportunity for students to Student Sight Savers, a surgical case model. Students begin the to address the issues of death and dying a glaucoma screening course by performing actual operations on that they’ll confront throughout their project at Yale-New their cadavers under the guidance of faculty careers. The course culminates in a Service Haven Hospital. surgeons. For example, they learn about the of Gratitude for the cadaver donors, heart’s structure by performing heart trans- who, through a final act of generosity, plants. Hands-on learning is supplemented became great teachers themselves. 8 9 7. SIZEMATTERS

“With only 100 students in a class, every student is an individual. There’s not just one model of success. Students are encouraged to be themselves, and to find out who they want to be in the future.”

Nancy Angoff, M.D., M.P.H. Associate Dean for Student Affairs

Students have the opportunity both to listen and discuss their ideas during lectures and small group discussions, such as this class in global health.

10 11 Visiting students from Yale talk with the of global health presents lectures on families of patients, subjects ranging from maternal mortal- left, and explore the area surrounding ity to the political uses of psychiatry. The Makarere University course is codirected by students and meets in Kampala. biweekly over dinner. Another elective, THE Introduction to Research Methods in Global Health, focuses on field-based 8. research in low-resource countries. This WORLD workshop is particularly relevant for students who are planning to apply for Downs Fellowships (see #9), which fund When you study medicine at Yale, New summer research projects abroad. Haven is a gateway to the world. You don’t First summer. walk through that gateway alone. The O∞ce First-year students may of International Medical Student Education apply for Downs Fellowships to conduct in 13 organs or systems. Included is discus- they’ve learned at Yale in di≠erent settings. oversees an integrated global health cur- research abroad during the following sion of illnesses that you would not find They’ll be seeing patients with di≠erent riculum that runs throughout your time in summer. Many of the projects become in New Haven. Students may also choose presentations of illness. They’ll develop an medical school. Like the rest of your Yale the basis for the thesis. clinically oriented elective courses in tropical awareness of the social and political factors in medical education, the study of global health A Russian physician medicine, pediatrics, and mental health. health and disease. They learn a basic cultural Second year. working with Yale issues is deliberately planned to keep the focus Throughout residents and competency.” Most students receive financial medical students Third year. on both patients and doctors as whole people. your second year at Yale, looks over an X-ray During their clinical clerkships, support for travel and living expenses associ- you participate in a course while on rounds at you will encounter patients whose paths to ated with international clinical electives. First year. Mulago Hospital in A year-long elective on the called The Modules, study- Kampala, Uganda, New Haven began in many varied parts of social, political, and economic determinants ing mechanisms of disease in 2007. the world. The New Haven area is a diverse enough community that students can gain exposure to a panoply of global health issues without leaving the city. 9. DOWNS Fourth and fifth years.Clinical electives in Argentina, China, England, Peru, South FELLOWSHIPS Africa, Thailand, Uganda, and Zambia take students out of their comfort zone and put Each year, the Wilbur who serve as mentors them into “one of the most intense and Downs International during their time abroad. thought-provoking experiences I have had Health Student Travel Downs Fellows present in years,” as one student put it. The inter- Fellowship supports 15 their research findings to 20 Yale students who and experiences at national clinical electives are no vacation: undertake a summer of a fall symposium and attending physicians from Yale run many of health-related research poster session. Many the programs in resource-poor and highly primarily in low- and fellows further develop middle-income countries. their studies into a stressed situations. The Internal Medicine Downs Fellows carry out thesis or dissertation. rotation at Mulago Hospital in Uganda, for research in the context Recent research example, confronts students with the sickest of their host countries’ subjects have included circumcision and HIV patients—about half of whom are infected culture, health problems, HIV and resources, with the prevention in Peru, lead with —in a country with an annual per intellectual support and exposure among children capita income of $280. Robert Rohrbaugh, practical assistance in Uganda, patient educa- M.D. of Yale faculty members. tion about HIV in Vietnam, , who heads the O∞ce of International Students also have and emergency contra- Medical Student Education, lists some benefits host-country sponsors ception in South Africa. for students: “They’ll be able to practice what 12 13

10. HAVEN FREE CLINIC

Students volunteer- In the spring of 2004, ing at HAVEN Yale students in medicine, provide care free of charge to residents public health, nursing, and of New Haven who lack health the Physician Associate insurance. Program conceived of a free clinic to serve the neediest people of their city. By November 2005, the students had found space and financial backing, enlisted volunteer attending physicians from the Yale faculty, arranged for referrals to Yale-New Haven Hospital, established links to social and educational services, scheduled bilingual student translators (mostly in Spanish, the language spoken by 85 percent of the clinic’s HAVEN The annual student- patients), and opened the doors of , If you’d like your medical school experience have included a week in a run auction raises New Haven’s first stationary free clinic for the to include lessons in sushi making, belly London flat and a vintage some $30,000 for HAVEN service organiza- uninsured. Today, —which stands for dancing, or “being a Southern gentleman,” Epiphone guitar. tions serving the homeless and Health, Advocacy, Volunteerism, Education, mark your calendar for the Hunger and The auction itself is the others in need. Neighborhood—is open every Saturday Homelessness Auction. Yale health profes- highlight of a year-round morning year round and helps hundreds sions students organize a massive annual process where students raise awareness of patients in the course of the year. Some 11. auction to benefit local programs that serve about the social and economic needs of students do their Primary Care Clerkship hungry or homeless people. “Massive” is New Haven’s diverse population. A student HAVEN HUNGER by volunteering at ; many more work AND the operative word for the enterprise that committee reviews grant applications there on an occasional basis. Because appoint- nets as much as $30,000 for New Haven from local non-profits to decide exactly how ments normally last at least an hour—not HOMELESSNESS organizations annually. Lessons are a the auction proceeds will be put to work the usual 10 or 15 minutes allotted in standard common auction item, as are homemade helping New Haveners. And while hunger practice settings—students as well as patients culinary treats. Popular faculty take high and homelessness remain di∞cult problems have an exceptional experience not often AUCTION bidders out to dinner and an evening to solve, organizers hope they’re challenges available in today’s medical practices. of theater. More conventional o≠erings that, one day, will be going, going, gone. 14 15 Medical students it has clear implications for therapeutic engagement, with the goal take classes with 12. interventions, and it has clear applications of extending Yale findings students in the Physician Associate FROM in the New Haven community. to improve the health of Program, Public Clinical research is a crucial part of the the region we are a part of. Health, Nursing, YCCI and the Graduate translational process, and Yale has created ’s e≠orts range from School. BENCH a comprehensive infrastructure to support working with Yale Cancer TO the movement of scientific discoveries Center on the creation of a statewide cancer “from bench to bedside.” Clinical trials— network to collaborations with community- that is, research with humans—are “By building bridges between BEDSIDE complicated by the inescapable fact that you cannot control people the way you departments and highways control laboratory specimens. The Yale M.D. to core services, by breaking Professor Linda Mayes, , at the Child Center for Clinical Investigation brings Study Center has been studying the together the tools and sta≠ needed to down barriers to collaboration, problems of mothers with substance abuse support clinical trials across the medical YCCI expands the possibilities disorders in forming emotional attachments campus: expertise in areas from regulatory to infants and toddlers. When she wanted issues to biostatistical analysis, nursing for team approaches to the to study the neural circuitry of parental and laboratory services, inpatient and out- important health problems attachment in these cases, she began patient facilities, and community outreach facing our nation.” the project under the auspices of the Yale specialists, to name a few. YCCI Center for Clinical Investigation. Her takes its charge a step further, Robert Sherwin, M.D., Director of YCCI project meets all the aims of the center: “from bedside to community.” Central it is innovative and important, it takes an to the center’s mission is an emphasis based partners, to advocacy on health 13.HEALTH interdisciplinary approach to a disease, on community-based research and policy issues. So far, the focus has been on five main areas: cancer, obesity, diabetes, Linda Mayes, heart health, and sexual health. left, works YCCI TEAMS with children Crucial to both stages of ’s mission in research is training new generations of researchers in correlating During the Vietnam War, students, and many of brain function the theory and techniques of clinical, trans- men who had served as those will come from the and stress. lational, and community-based research. corpsmen returned home PA Program, Department The Robert Wood Johnson Clinical Scholars with considerable skills. of Epidemiology and But there was no profes- Public Health, or School Program—Yale’s is one of only four in sional path to put those of Nursing. You’ll the U.S.—trains physicians to think beyond skills to use. Yale was find yourself in clinic healing the individual patient to healing one of the pioneers of alongside Yale students the health care system itself. Research the physician associate studying to be physician M.D. profession, admitting its associates, midwives fellowships are also available to and first class of PA students or nurse practitioners. M.D. P D. / h. students to support a year-long in 1971. The program You may do research YCCI intensive training core in the . trained them in trauma with someone pursuing YCCI care, though today that a public health degree. “ is the infrastructure of Yale’s role is much broader. Health professions culture of collegiality and creative interac- Maximizing the students also interact M.D. tion,” says Robert Sherwin, , director strengths of each health in social groups and in YCCI profession and preparing service projects, such as of . “By building bridges between students to practice in the HAVEN Free Clinic. departments and highways to core services, a team is a critical part You won’t just leave Yale by breaking down barriers to collaboration, of a Yale medical educa- with ideas or theories YCCI tion. Some of the best about interdisciplinary expands the possibilities for team teachers you’ll encounter practice; you’ll leave with approaches to the important health prob- will surely be fellow experience. lems facing our nation.” 16 17 BREAKTHROUGHS15. 14.Translational . Just a few of Yale’s medical firsts:

Research 1896 Arthur Wright publishes first X-ray in the U.S. “To make translation work, you 1942 First successful clinical use of penicillin in the U.S. need a way to connect physi- 1942 First use of chemotherapy cians and basic scientists, and as a cancer treatment

that is best done by people 1949 First artificial heart pump with both interests who are prototype (now at the willing to work in the middle.” Smithsonian) Jordan Pober, M.D., Ph.D. Director of the Human and Translational 1957 Continuous electronic fetal heart Immunology Program monitoring invented

1960 First newborn intensive care unit

How long does it take for a great idea in the 1975 Lyme disease lab—or a major finding that makes it to identified at Yale the cover of Nature—to make a di≠erence 1978 First insulin pump for diabetes in the lives of patients? That depends on the speed of translation. 1980 First transgenic m.d. P D. Research in the mouse Jordan Pober, , h. , professor matches dozens of Yale medical students Vascular Biology with a focus on Alzheimer’s of immunobiology, dermatology, and with faculty mentors for thesis research. and Therapeutics disease, Parkinson’s disease, vbt program looks 1997 Discovery of a mechanism of pathology, often points out that, while cur- One of the original goals of the closely at the and other neurodegenera- protein folding, a step toward rent cell biology or genetics texts bear little program was to improve outcomes for mechanisms tive conditions. understanding neuro­degenerative present in the and other diseases resemblance to their mid-1980s predecessors, organ-transplant patients by building on cells lining blood Pober now heads the vessels. many sections of medical textbooks are basic research. But in the eyes of Pober, program in Human and 1997 Discovery of the mechanism HTI much the same as students found them two translation is a two-way street: intimate Translational Immunology ( ), which has of innate immunity decades ago. knowledge of the biology of disease gained researchers working on human immunology 2008 Discovery of the first reliable method Pober was acutely aware of this knowl- in the clinic must guide the future direc- connected with clinical researchers in a vari- for early detection of autism edge gap early on, and in 2000 he founded tion of basic biomedical research if the ety of medical departments. By removing 1990s/ Discovery of the  the Interdepartmental Program in Vascular insights from laboratory experiments are roadblocks to clinical research, Pober, his vbt HTI 2000s genes responsible Biology and Transplantation ( ), one to be speedily applied to clinical medicine. colleagues, and their students hope to for responsible for vbt of the nation’s first research programs The example set by , now headed by see Yale discoveries turned into treatments high blood pressure, osteoporosis, dyslexia, macular explicitly focused on translational research. Professor of Pharmacology William C. for a wide range of diseases, from diabetes vbt P D. degeneration, Tourette syndrome, Ten years on, (now Vascular Biology Sessa, h. , has inspired the creation of and cancer to heart disease and stroke. and Crohn’s disease and Therapeutics) is a vibrant program that similar ventures in other fields. They are certain to change the course of

includes 35 faculty members, drawn equally In 2006 the medical school launched science and medical care. Who knows? You From top: An X-ray made by Yale physicist Arthur Wright in from basic science and clinical departments. the Program in Cellular Neuroscience, might even help rewrite the next edition 1896; Sewell artificial heart prototype; the Lyme disease vector, CNNR Ixodes scapularis (or deer tick); mouse; DNA sequence. It’s a rich area of science at Yale, and one that Neurodegeneration, and Repair ( ), of that textbook. 18 19 SECOND17. YEAR SHOW

THE NEXT18. BIG THING IN ANTI­BIOTICS Yale-New Haven With almost 1,000 Hospital is beds and 3,200 physicians, Connecticut’s largest, with a Thomas Steitz Yale-New Haven serves Level 1 trauma In 2009, Thomas A. Steitz, received the 16. center and close P D 2009 Nobel Prize more than 54,000 inpatients h. ., won the Nobel Prize Yale-New Haven to 1,000 beds. in Physiology and over half a million in Chemistry for untangling or Medicine from His Majesty King outpatients each year. The hospital includes a mystery. His models of Carl XVI Gustaf HOSPITAL Yale-New Haven Children’s Hospital, the ribosome—the organelle of Sweden. Yale-New Haven Psychiatric Hospital, and responsible for manufac- Smilow Cancer Hospital. The National turing proteins—look like many skeins of Students come to Yale and stars are second-year Institutes of Health have recognized to study with some students. The show is a brightly colored yarn, hopelessly knotted these facilities for the excellence of of the greatest names chance for them to have and intertwined. The Sterling Professor the Cancer Prevention Research Unit, in medicine. But on fun and blow off some of Molecular Biophysics and Biochemistry two magical nights in steam together before Cancer Information Service Center, February, they are clearly studying for the boards set out to map the ribosome, an enterprise Comprehensive Cancer Service, Digestive emulating Stephen and going their separate that involved plotting every twist and turn. Disease Research Center, Child Health Colbert and Weird Al ways to clinical clerkships. “It seemed a little like climbing Mount Yankovic. The Second The show’s tradition Research Center, Clinical Research Center, Year Show is a collection stretches back at least Everest. We knew it was doable in prin- and Claude D. Pepper Older Americans of song parodies and to 1949 with “The Four ciple, but we did not know if we would Independence Center. comedy skits in which Years for What Follies.” ever get there,” he reflected. He led an other medical school Dean Vernon W. Lippard In part because of the emphasis classes—and more often threatened to cancel interdisciplinary team to that summit and The name says a lot: it’s both an internation- on translational research in the School of faculty—get spoofed. it in the 1950s after produced the first map of the ribosome’s ally renowned university teaching hospital Medicine, the school’s relationship with The humor is entirely an especially PG-13 large subunit in 2000. Understanding its affectionate, if not entirely production. Students had and a front-line city hospital. That means Yale-New Haven Hospital is a particularly tasteful. Professors attend reportedly “passed the structure has already led to the develop- on rounds you will encounter patients from collaborative one when it comes to build- the show and sometimes bedpan” to solicit money ment of a new class of antibiotics, currently all economic strata, and you can’t lose sight ing clinical programs. Physicians and even pay for the privilege at the show. Today, in clinical trials, that targets bacterial of playing themselves on ticket sales go to support of the tremendous societal forces a≠ecting scientists work closely and respectfully, and stage. But the organizers New Haven charities. protein synthesis. The new drugs may health or the great variety of professional medical students on rotations are encour- prove e≠ective as a new weapon in the roles you take on with di≠erent patients. aged to participate in deliberations. battle to conquer drug-resistant infections. 20 21 AIDS Care Program Shortly after the Centers for Disease Control first identified AIDS in 1981, Yale-New Haven Hospital set up the AIDS Care Program, one of the first in the nation. The program has become a model for the provision of CLINICAL19. integrated outreach, testing, care, and clinical trials. Today its span reaches from neighborhoods in New Haven to St. Petersburg, Russia.

Advanced cardiac care Yale is a leader when it comes CARE to assessing the best approaches to AT YALE cardiac treatment, and its interven- tional cardiology service has one of the best “door-to-balloon” times in the country. Medical students learn state-of-the-art care in the catheter- A quarter of a million o∞ce visits each year. ization lab, which conducts 3,100 Another 129,000 adult and pediatric emer- procedures a year, and on the gency visits. Over 50,000 inpatient stays. electrophysiology service, which offers radiofrequency ablation, focal Yale physicians o≠er advanced care in more atria and pulmonary vein ablation, than 160 clinical specialties and subspecial- trans-septal catheterization, and ties, drawing patients from around the defibrillator implantation. world. Yale medical students have broad Yale Craniofacial Center opportunities to learn the art of medicine Cleft lips and palates are the most from outstanding doctors working in the common disfiguring craniofacial anomalies—problems in the growth finest of facilities and, even more important, of the bones of the head. Yale’s working in multidisciplinary teams to Craniofacial Center, led by John provide the most seamless, comprehensive Persing, M.D., is internationally recognized for its advanced, multi- care possible. disciplinary approach to craniofacial At the head of this operation is David deformities, from the most common M.D. Paige Smith Professor David J. Le≠ell, , to the rarest. CEO who serves both as of the Yale Medical Outpatient Group and deputy dean for clinical a≠airs. Medical students parathyroid surgery get hands-on Carmalt Professor of Surgery He manages to fulfill these functions while clinical experience— Robert Udelsman, M.D., M.B.A., maintaining a busy skin cancer practice— such as the rapid cooling procedure thinks about every surgery he using the sophisticated Mohs surgery for cardiac patients, performs on at least five different technique—and a research agenda as well. above—as they levels at once. How can he make rotate through this procedure faster and surer? What makes Dr. Le≠ell such a convincing services including medicine, pediat- What can students learn from this advocate for clinical excellence is his own rics, and surgery. procedure? How can the hospital commitment to giving priority to the be more efficient? How can we better manage all aspects of the needs of his patients. He is working hard patient’s dealings with the hospital, to see that vision of medicine instilled from parking to scheduling? in all aspects of physician training at Yale. How does this procedure advance our scientific understanding? Underlying every one of those ques- tions is his sensitivity to the entire experience of the patient, and the future patients of the doctors he trains.

22 23 21. 20. RECOG­NITION Yale University faculty are among the world’s most ADVISORS accomplished biomedical scientists and physicians.*

In a program as individualized as Yale’s, students need 1 in NIH research advisors to make sure they get exactly what they want YSM and need from their medical education. ’s mentoring funding per faculty member program works in many dimensions: 2 > Each student works with an academic advisor over the four or Nobel Prizes five years of medical school, meeting one-on-one and in groups to discuss their program of study. The advisor writes the student’s 17 dean’s letter for residency applications in the final year. Howard Hughes Medical Institute Investigators The Yale Center > Advisee groups get together regularly, providing an opportunity treated, based on a compre- for Genome for students at different stages of their education to interact more hensive genetic scan. Analysis is located on West Campus. closely and to mentor their peers. 60 That giant step for medi­­ Members of the cine was made possible by the Yale Center Students work National Academy > The program complements other mentoring closely with faculty for Genome Analysis, uniquely equipped members in plan- of Sciences activities, in particular the guidance provided ning their student with 12 Illumina sequencing machines. research projects 22. by thesis advisors for student research (#44) and The machines dramatically accelerate the and in charting 39 HIGH-END by clinical tutors, who work with students in their overall Members of the process of gene sequencing and yield results program of study. groups of four during the first two years (#36). Institute of Medicine INSTRUMENTATION that will be a≠ordable enough to be used clinically in the not-too-distant future. The 352 center is indispensible to researchers study- Active patents for At Yale, you work with the best technology— ing the genetic basis of disease. Projects Yale inventions in the lab and the clinic. Richard Lifton, focusing on multiple sclerosis, autism, and M.D., P D. h. , recently took advantage of that addiction all rely upon it. 45 fact with lifesaving results. A 5-month-old Core research facilities like the Center Yale-founded biotech companies in greater boy couldn’t gain weight and was danger- for Genome Analysis provide faculty and New Haven ously dehydrated. His medical team in students throughout Yale with the sophis- Turkey asked Lifton, who is chair and ticated technology and expert consultation Sterling Professor of Genetics, to search the they need to advance science. $557.9 DNA infant’s for a marker that would help million them diagnose the illness. Half a world Other cores include: Total medical away, Lifton’s group determined that the Proteomics school research Cell, Molecular, MR, and PET Imaging funding from... baby had congenital chloride diarrhea, which is manageable with diet and medica- Cell Sorting/Flow Cytometry DNA High-Throughput Cell Biology tion. The case, using next-generation 2,033 Small Molecule Screening grants and contracts sequencing to quickly and completely map Biostatistics & Informatics *data as of 6/30/10 the infant’s “exome,” marked the first time that a patient has been diagnosed, and 24 25 23.EMERGENCY MEDICINE

m.d. Professor Gail D’Onofrio, , chair of the Department of Emergency Medicine and chief of the Emergency Department at Yale- New Haven Hospital, chose her field for the excitement and satisfaction of saving lives in crisis situations. Yet today she focuses as much on preventing emergencies as respond- ing to them. In the Yale tradition, she greets every condition—individual or social—with a question: So many of the injuries we see are the result of alcohol and drug abuse; will the brief interventions we have time for in the emergency department make a di≠erence? Are women receiving the education they need to avoid heart attacks? Can we change the lives we save into healthier ones? Questions lead to exploration and, often, new solutions. Each year, with the resources of a Level 1 trauma center supporting them, Yale’s Emergency Medicine faculty handles 100,000 adult emergency visits, from patients who may have anything from a life-threatening injury to undiagnosed cancer. The specialty of emergency medicine draws on knowledge and skills not only across the full spectrum of medical problems but also in public health areas such as disaster preparedness, epidem- ics, and screening for substance abuse. As the point of access to the health care system for millions of people, emer- The Emergency Department at gency departments confront Yale-New Haven and help manage a host Hospital handles 100,000 adult of social issues. Emergency visits a year and is the point of entry medicine may be the ulti- to the health care mate example of thinking system for many globally and acting locally. patients. 26 27 as autism, Tourette syndrome, mental retar- dation, and obsessive-compulsive disorder. 25.THE A molecular neurobiology lab is studying CADAVER memory at the level of proteins. A develop- BALL 24.THE mental neurobiology lab is examining the relationship of genetics and environment in the development of the brain. These and other projects are under way around MENTAL the corner from the National Center for Children Exposed to Violence, which HEALTH continues its pathbreaking collaboration with the New Haven police. Others include OF CHILDREN the Community and School-Based Services Department, the Intensive In-Home Child and Adolescent Psychiatric Service, and the A century ago, Yale established the Child Early Childhood Programs Department, Study Center to better understand children’s which is testing a program of intervention development and devise therapies for with teenage mothers called Practitioners at the the disorders that arise, all based on careful “Minding the Baby.” At age Yale Child Study clinical observations of children. That 100, the Child Study Center Center conduct research on autism, mission has not changed. Many of the tools exemplifies the collegial, anxiety disorders, and child develop- 26. the center has available today, however, interdisciplinary, transla- ment, following in were unimaginable when the center started. tional, community-minded the footsteps of Arnold Gesell, who STEM CELL Currently, the center’s neurogeneticists are approach of the Yale School founded the center a century ago. PROGRAM searching the genetic basis of such disorders of Medicine.

Embryonic stem When the federal government limited its cells in the support for human embryonic stem cell intestine of a mouse. research, Connecticut set up a fund to make sure that investigations here continued and awarded The Cadaver Ball, which marks the end of the more than $13 million to Yale. So when President Obama anatomy course, is an expanded federal funding in the spring of 2009, the Yale annual highlight not just Stem Cell Center was in full operation: new core facilities for first-year students YSCC) but for faculty and had been set up ( for stem cell culture, imaging, cell students from other sorting and analysis, and genomics; 12 labs at Yale were parts of the university. involved in stem cell research; and about 40 faculty mem- YSCC bers throughout the university were a∞liated with the . P D. Director Haifan Lin, h. —whose work was listed by Science as one of the top 10 breakthroughs of 2006—says, “Few other places have been focusing on really understand- ing the inner workings of stem cells. We think we can and believe that by doing that we will generate more impact and speed the development of cures. Stem cell research is still in its infancy. Our center is a new baby that has been born, but now we need to feed it and let it grow up. One thing we know is that this baby is full of potential.” 28 29

27.A CLOSER BOND “What’s so great about the school is that it’s based on relationships—between you and your classmates, you and the faculty, you and the patients. You grow and develop as a person because of those relationships. Yale has been an adventure for me, not just a means to an end.” Jason Frangos, Class of 2009

First-year students in the “Molecules to Systems” course study biologic structure and func- tion with faculty, some of whom helped establish the field of modern cell biology.

30 31 or public medical schools, because of a 28. generous, need-based financial aid program. The program aims to make it possible for 30. FINANCIAL any accepted student to attend the school without hardship; 80 percent of our students receive financial aid. No financial MATCH DAY contribution is expected from the income of parents making less than $100,000 a year and there is a prorated extension for income up to $140,000 annually. Our total AID “unit loan”—the amount that a student must borrow before becoming eligible for Medical education is not cheap, and scholarship funds—is among the lowest of medical student debt is a growing national any medical school, and numerous grants problem. That said, graduates of the Yale enable all students to take advantage of a School of Medicine end up with less debt, rich array of elective opportunities without on average, than graduates of other private taking on additional debt. 29. SCHOOL OF PUBLIC HEALTH

Yale medical Top 15 hospitals University of California, Match Day is always a students have an the Class of 2010 San Francisco 7 Founded in 1915, Yale’s School of Public joyful moment at Yale. Our extraordinary are attending for track record after Hospital of the University internship/residency: Health is one of the oldest nationally accred- students have a strong graduation, placing of Pennsylvania 5 M.P.H. Public health in the nation’s Harvard Affiliated ited public health schools in the country. Program, providing students conduct record of residency place- top residency Memorial Sloan-Kettering Hospitals 35 It’s also a department within the medical rigorous public health mosquito research ments in the wide variety programs. Cancer Center 5 in the Caribbean, as Brigham and part of an ongoing school. The school has an extensive faculty training to individuals with a of venues they seek out. Women’s Hospital 16 Stanford University research project Programs 4 with diverse interests, divided among five doctoral-level degree in a field directed by Professor Medical school at Yale prepares them for Massachusetts academic divisions—Biostatistics, Chronic related to public health and Durland Fish. the nation’s most competitive residency General Hospital 9 New York Presbyterian Beth Israel Medical Hospital, Columbia 4 Disease Epidemiology, Environmental to medical students who have programs, as reflected in the list at right. Center 5 Hospital of St. Raphael 4 Health Sciences, Epidemiology of completed their third year. Students generally Yale graduates continue on to succeed in Harvard Longwood Microbial Diseases, and Health Policy and spend an intensive summer term and two a diverse array of careers, including all the Training Program 3 Johns Hopkins Hospital 3 Massachusetts Administration—and programs in Health regular, full-time academic terms in the pro- clinical subspecialties, health care policy,  Eye & Ear Infirmary 1 University of Southern California 3 Management and Social and Behavioral gram, which aims to train leaders in the many biotechnology, international medicine, Children’s Hospital Sciences. It also o≠ers a Masters of Public fields of public health. The school’s longtime and leadership in academic medicine. of Boston 1 Percent of class attending these hospitals 78% Health concentration in Global Health. leadership in public health policy and in Approximately 25 percent of the school’s Yale-New Haven Recently, the School of Public Health global health initiatives makes it a special asset alumni hold faculty positions. Hospital 15 began to o≠er the Advanced Professional to students in the School of Medicine. 32 33 31. JOINT DEGREES 32. MD/MHS In addition to the M.D./ PROGRAM Ph.D. program (See #39), joint degree programs in collaboration with Yale’s other outstanding In medical school, Matthew graduate and professional M.D. M.H.S. schools are attractive Vestal, ’10, ’10, options for many students. learned that one form of

The possibilities epilepsy may be preventable. include: The world learned it, too. Vestal was part of a team M.D./J.D. Prospective Vivek Murthy at students must apply whose research showed that a Doctors for America press separately to the Yale rats with a predisposition conference during School of Medicine and to absence epilepsy never developed severe seizures if given the health care Yale Law School for reform debate. the six-year M.D./J.D. anticonvulsant medications early enough. Even after the joint degree program. medications stopped, the rats’ seizures were greatly reduced. It was the first time any form of epilepsy had been prevented. to campaign leaders, with not a physician M.D. M.D./M.B.A. See #33 Vestal graduated with an and a master’s degree in among them, debating competing national M.D./M.DIV. Students health science research. The five-year program features an health care reform plans. He also co- apply to the six-year joint intensive research experience. The final year is fully funded founded a social network for scientists, degree program with the Yale Divinity School for through fellowships arranged by the O∞ce of Student Research. Epernicus, to connect researchers and facili- a variety of reasons, from Vestal wanted to “bridge the divide” between labora- tate collaboration. Customized versions an interest in bioethics tory research and clinical care. Though children outgrow are used by Glaxo-Smith Kline and others. to an intention to conduct absence epilepsy, they are left with a high risk of teen preg- 33.MD+MBA Finally, he’s developing systems to increase international missions of healing. nancy, alcoholism, and other problems. Vestal led human e∞ciency and safety in clinical research. m.d./m.b.a. neuroimaging studies aimed at detecting risk early, when Most graduates, like m.d./m.b.a. M.D./M.H.S. See #32 preventive treatment is e≠ective. “He was the driving force; Vivek Murthy, ’03, gives Murthy, remain in clinical medicine, said m.d., M.D./M.P.H. Several it was his project,” says his faculty mentor, Hal Blumenfeld, his patients his best: some days, as an Program Director Howard Forman, M.D. P D m.b.a. students each year enroll , h. ., professor of neurology, neurobiology, and academic hospitalist at Boston’s Brigham The five-year curriculum of classes, in a five-year program M.D./M.H.S. that gives them a Master neurosurgery. The program o≠ers access to and Women’s Hospital; others, as a social internships, and international experience of Public Health degree resources and a wealth of faculty guidance, but students entrepreneur changing health care delivery. positions them to have a strong and imme- along with their M.D. design their own projects. “There is no other place that I Yale prepared him to marry both halves diate impact. The experience “catalyzes degree. The program is designed for students know of that has this kind of operation,” says Blumenfeld. of his life into a powerful whole. your career,” says Forman, a professor of interested in biostatistics, Planning a career in academic medicine, Vestal already “I was able to actually see opportunity diagnostic radiology and public health. epidemiology, and health has publications and the experience of writing a successful more clearly in the world around me,” Students have extended interactions care management, and other aspects of million-dollar grant with Blumenfeld. His Howard Hughes explained Murthy. “I saw opportunities for with health policy leaders, for example, public health. Research Training Fellowship provided support for him creating change, both in the hospital and White House Special Advisor Ezekiel m.d. to attend conferences, where he was often Matthew Vestal, in the world outside.” Emanuel, , and former Food and Drug who matched in m.d. a presenter. He says he was able to capitalize neurosurgery at He co-founded Doctors for America, Commissioner David Kessler, , also a Harvard’s Brigham on the opportunities he found here to get a and Women’s a non-profit that engages physicians and former dean of the School of Medicine. But Hospital, talks head start in academic medicine. The world of about his fifth-year medical students in shaping health care Murthy was most influenced by his class- medicine is full of urgent problems begging project with mentor policy. The idea came to him during the mates. “I derive a lot of motivation from solutions, and “Yale,” he says, “is your oyster.” Hal Blumenfeld. 2008 presidential election while listening meeting other problem solvers,” he said. 34 35 34.INTER­ DISCIPLINARY STUDIES

Even if you are not of Management, and the a joint degree student, Forestry School as well opportunities for inter- as the medical school disciplinary work abound to “improve practices both within the medical and policies related to school and across Yale. nutrition and obesity.” A small sample of Kelly Brownell Ph.D., the many possibilities: founder and director of the Rudd Center, was Advanced Clinical named one of the “100 Elective in Law and most influential people Psychiatry, in which in the world” by Time fourth-year medical magazine for his work students participate in the area. in “competency to stand trial” evaluations The Health Diplomacy Cardiologist at the New Haven Initiative at Yale is Forrester Lee is the Correctional Center. inspired by the vision that associate dean for health can and should multicultural affairs. His office provides School of Forestry have a more prominent educational support Environment and role in international rela- and serves as Health Initiative. tions and foreign policy. a touchstone for Medical students may This initiative engages student groups take courses at the medical and public health promoting diversity. School of Forestry and scholars alongside social Environmental Studies scientists, economists, SNMA in the environmental legal scholars, and Dr. Lee knows that members of minor- national ), Asian Americans in Yale health concentration. This activists, and draws from ity communities often bring particular Medicine, and the Latino Medical Student concentration encourages fields such as health concerns and face special challenges along Association. The university’s O∞ce of course work and research and human rights. LGBTQ that explore relationships with the universal demands of profes- Resources coordinates support for among environmental The Yale 35. sional training. Since 1988, the O∞ce of the campus’ lesbian, gay, bisexual, trans- quality, human health, and Interdisciplinary DIVERSITY Multicultural A≠airs has provided sup- gender, and queer community. public policy. Center for Bioethics attracts scholars from port for minority students and worked to These groups provide forums for Yale’s Rudd Center the fields of medicine, increase sensitivity to minority concerns discussion, an organizational structure for for Food Policy law, religion, and envi- M.D. and Obesity brings ronmental studies to look Forrester Lee, , a cardiologist and the in the medical school as a whole, recogniz- service to the school and the New Haven together faculty from at issues ranging from associate dean for multicultural a≠airs, ing that a diverse student body helps train community, and academic and social support Arts & Sciences, the Post-Traumatic Stress describes telling an African-American patient doctors for the pluralistic world in which programs for individual students. Other Law School, the School Disorder to animal rights. that he needed a new heart. “And he looked they will serve. Under Dr. Lee’s leadership, associations throughout Yale University– at me and said, ‘They don’t transplant black the o∞ce conducts recruitment, retention, including cultural centers, religious people,’ and I looked at him and I said, and outreach programs. It provides educa- organizations, and a wide variety of student ‘You’re kidding, do you really believe that?’ tional support and serves as a touchstone societies–o≠er students a wide network And he did. So it was a very, very joyous day for student groups such as the Yale Student of contacts and support. in my life to walk into his room and say: National Medical Association (twice in ‘We have a heart for you today. Believe it.’ ” recent years the Chapter of the Year of the 36 37 the wars in Afghanistan and Iraq return PTSD 37. home, many su≠ering from , Yale PTSD RESEARCH is expanding clinical care and research to AND EXPERTISE IN better serve them. Yale investigators at the Clinical Neuroscience Division of the VA PTSD National Center for , located at the NEURO- VA Connecticut Healthcare System campus in West Haven, Conn., have established a partnership with psychiatrists at Fort Drum SCIENCE in upstate New York to study how troops react to combat experiences. Meanwhile, clinicians at the VA’s West Haven campus Emily Dickinson said, “The brain is wider have expanded their sta≠ to care for an than the sky.” The truth of that saying influx of veterans needing treatment for PTSD is more than poetic. The brain is vast and anxiety and . PTSD largely uncharted territory. Yale is full of represents a complex inter- explorers. Yale’s strength in neurobiology, relationship between mind and brain, neuroimaging, genetics, and related fields experience and neurobiology. Under­ is helping researchers map that territory. standing the physiological changes that PTSD Better understanding of brain physiology underlie is leading psychiatrists to and function have resulted in new treat- new treatments. Yale researchers have 38. BreakTHROUGH ments for dyslexia and schizophrenia. It is already identified a gene that increases PTSD unraveling the complex factors that contrib- The Department susceptibility to and of Psychiatry, MOLECULAR ute to addiction and is pointing to strategies which pioneered are in the midst of clinical 36. studies of SCIENCE that can improve success in recovery. PTSD and other trials of medications they PATIENTS Today there is particular urgency to disorders, has hope will provide improved FROM expanded its increase understanding of post traumatic clinical services symptom relief. for returning M.D. The chaperonin stress disorder. Yale psychiatrists have done veterans at the For John Krystal, , A basic mystery of bio­- molecule GroEL DAY ONE work on the disorder since the early 70s, VA hospital in Robert McNeil Jr. Professor chemistry is this: How do and co-chaperonin West Haven. GroES help before it even had a name. As veterans from of Translational Research newly synthesized proteins proteins fold and chair of Psychiatry, this fold into their mature, properly. At YSM, you meet your says Bia. Students learn is an essential mission. “We functional shapes? Arthur first patient in your second communication skills, from M.D. week of school. “You won’t social-history-taking to are at a critical moment L. Horwich, , Sterling Professor of HHMI wait until you’ve heard a breaking difficult news. in the lives of the soldiers Genetics and Investigator, discovered year or two of lectures on They confront “standard- doctoring before you see ized patients”—actors who have made sacrifices a molecular machine called the “chaperonin” a patient,” says Margaret “who play the part of on behalf of every American that helps the process along within cells. Bia, M.D., director of patients—as well as real citizen,” he said. “We as Recently, his research on chaperonins has the Clinical Skills Training ones. “By the time they Program. Yale medical get to Step 2 of the U.S. a country have to decide led him to study human neurodegenera- students take a “Preclinical Medical Licensing Exam, whether we are going to tive disorders such as Lou Gehrig’s disease Clerkship,” in which they in which they examine return the favor by sup- (amyotrophic lateral sclerosis), in which meet weekly during their 10 standardized patients first two years, in groups in a day and formulate porting our soldiers and proteins misfold and aggregate. Dr. of four, with their clinical diagnoses and treatment respecting the sacrifices they Horwich uses experimental approaches tutor, who observes plans, our students are have made by making sure ranging from crystallography to transgenic them taking histories well prepared.” and performing physical they get the treatment they model systems in his e≠orts to “see Helping a young exams. “You can imagine patient at Yale- need and by making sure something that’s not been seen before.” how intense that mentor- New Haven we can improve the treat- ing relationship becomes,” Hospital (above) ments we are o≠ering them.” 38 39 39.MEDICAL SCIENTIST TRAINING PROGRAM

“People hear Yale and they think it’s going to be intimidating. They don’t realize how incredibly accessible the faculty is, and how easy it is to get matched with a lab.”

Cecily Williams, M.D./Ph.D. student

The National Institutes of Health supports M.D. P D. the training of / h. students at 40 institutions around the country, and the Yale System makes this an especially apt place to pursue such training. The Yale tradition of close interaction between clinicians and basic scientists and between faculty and M.D./P D. students means that h. students experience collaboration at its best. Yale’s flexibility allows students to tailor programs to their individual interests. And because M.D. the curriculum already integrates thesis research with clinical work, it is conducive to a joint degree program. Through the M.D./ Medical Scientist Training Program, P D. h. students receive financial support for tuition, living stipends, and health fees until completion of the program.

Christopher Bartley, a student in the M.D./Ph.D. Program, and neuroscientist Angélique Bordey.

40 41 At Yale School of Polycystic kidney arteries. Since coming to Yale in 2006 as an Medicine, investiga- disease associate professor of biomedical engineer- tors have identified The most common ing, she has had a chance to develop her genetic bases for: life-threatening genetic disorder, PKD can result work further in animal models, to create Hypertension from gene mutations vessels that can be stored for implantation Dr. Lifton’s genomic identified by C.N.H. Long into any patient at a later date. Her research analyses of extreme cases Professor Stefan Somlo, of disease in patient M.D., under an NIH grant has expanded to include the engineering populations around that made Yale a Center of lung tissue. the world, which have for Excellence in the BIOMEDICAL Biomedical Engineering at Yale, says become a model for gene study of the disease. 40. P D hunters, have revealed department Chair Mark Saltzman, h. ., ENGINEERING more than 15 genes that Dyslexia has two related goals: first, the use of are crucial in the regula- Associate Professor the tools and methods of engineering to tion of blood pressure and Jeffrey Gruen, M.D.’s dis- the body’s salt balance. covery of a gene involved better understand human physiology and in dyslexia may make it As a resident in disease; second, the development of new Crohn’s disease possible to screen for anesthesiology in technologies for diagnosis, treatment, and Associate Professor Judy individuals whose reading Cho, M.D., who made ability is impaired and to the mid-1990s, prevention of human disease. Saltzman the first identification of provide early educational Laura Niklason, himself has focused on new technologies genes involved in inflam- interventions. M.D P D ., h. ., had for time-release drug delivery, including a matory bowel disease (IBD), recently identified Intracranial an idea. In the method for delivering chemotherapeutic a gene mutation that can aneurysms operating room, drugs directly to brain tumors. Other protect against Crohn’s Large-scale studies led by she would wit- researchers are developing new methods of disease, one form of IBD. neurosurgeon-geneticist Murat Günel, M.D., and ness vascular and diagnostic imaging, vaccine and drug deliv- Tourette syndrome Dr. Lifton uncovered heart surgeons ery, and tissue engineering for applications In a finding named a top genetic regions in which 41. scientific breakthrough searching their from spinal cord repair to liver trans- DISEASE, variants confer a high risk by the journal Science, of these deadly malforma- patients for spare plantation. “We have cell biologists and Donald J. Cohen Associ- tions of brain vasculature. veins to use as grafts, often finding only immunologists and surgeons and patholo- GENES, ate Professor Matthew vessels of very poor quality. “I’d think, if we gists and bioengineers all working together State, M.D., Ph.D., and Heart disease/ Associate Professor could grow new arteries, then we wouldn’t in an ideal environment for interdisciplin- GENOMES metabolic syndrome Nenad Sestan, M.D., Ph.D., Cardiologist Arya Mani, identified the first genetic M.D. have to harvest them from patients and ary work,” he says. “I think Laura Niklason, , and colleagues mutation associated subject them to such an invasive procedure.” that’s a very rare happening above. Mark discovered that one Saltzman, below. with Tourette syndrome. amino-acid substitution At the time, researchers were just among universities.” Chair and Sterling in a single gene causes a starting to understand how to get blood Professor of Macular degeneration rare form of early heart vessel cells to form microscopic tubes in Genetics Richard P. In pioneering whole- disease and metabolic M.D. P D genome association syndrome, providing clues a petri dish. In addition to her residency, Lifton, , h. ., studies, Associate Profes- to the causes of more Niklason was working as a postdoc in calls the charting of sor Josephine Hoh, Ph.D., common forms of these MIT Robert Langer’s lab at . One day she the human genome and her colleagues have diseases. identified genes that raise walked into Langer’s o∞ce and announced, “one of the great the risk of age-related Revolutionaries like “‘I’m going to grow an artery in the labora- revolutions in the macular degeneration, these on the front lines of tory.’ He said, ‘That’s great, Laura. You do history of medicine,” and you can be part of the leading cause of molecular genetics make blindness in the devel- that.’” It took a while, but in the third year the advance teams working Yale an exhilarating Zebrafish embryos, oped world. place to enter the fray. of her project, Niklason began to make at Yale. The latest gene an important model system in genetics, progress. She seeded blood vessel cells onto sequencing tools are allow- are labeled polymer tubes and pumped a nutrient solu- ing scientists like Dr. Lifton with green fluores­ cent protein in tion through the tubes. By mimicking the to find rare genetic variants “Embryonic Dance,” an artistic rendering natural forces that blood generates when it that contribute to disease by microRNA flows through real vessels, she had found in ways that were impossible researcher Antonio a way to produce strong, supple artificial just a few years ago. Giraldez. 42 43 44. THE THESIS

M.D. The school’s Office Since 1839, the Yale School of Medicine has required of Student Research students to complete a thesis based on original research. provides guidance The thesis requirement grew out of the recognition that and financial support, the scientific process of investigation, attentive observation, including: interpretation of data, and critical evaluation of literature > Assistance in identify- are as fundamental for a doctor making a diagnosis as for ing research topics and an investigator advancing the frontier of medicine. Thesis finding mentors projects also have a hugely beneficial side e≠ect: by the time > An annual Student Research Day poster they apply for residencies, all students have worked very session and presentations, closely with at least one member of the faculty, who can followed by the Farr therefore report in convincing detail on the student’s abili- Lecture by world-class scientists ties. “What makes it work is the faculty-student pairs. It’s M.D. > Summer research a great synergy,” said John N. Forrest Jr., , director of stipends and short-term the O∞ce of Student Research. “The value of the thesis is student research stipends not the concept of trying for a scientific career, but to teach > One-year student that all physicians are scientists.” Students have written fellowships, which enable their theses on topics including “From Mueller to Miller: students to spend a fully THE43. GREAT funded fifth year doing Determining Standards for Decisions Regarding Critically laboratory, translational, Ill Newborns” to “Mitral Cell Dendritic Development in or clinical research.

PIZZA the Mouse Main Olfactory Bulb” and from “Thinking DEBATE Farr Lecturers Medical students Outside the Black Box: Current Policies get a chance to FDA’ Arnold Relman present and discuss and Problems with s Highest Drug Anthony S. Fauci their thesis work Sidney Altman at Student Research Safety Warning” to “The Role of Matrix It is a truth universally Sydney Brenner Day, which takes Metalloproteinases in Axon Guidance acknowledged that New place each May. Joseph L. Goldstein Haven has the best pizza and Neurite Outgrowth.” Francis S. Collins in the United States, Judah Folkman maybe the world. But Alfred G. Gilman Pepe’s or Sally’s? We’ll Robert J. Lefkowitz 42. just have to keep testing Richard P. Lifton NEW ENGLAND them both until that Paul Greengard question is resolved.* Edward J. Benz Jr. Story C. Landis Arthur Horwich “No one tells you how beautiful New Jeffrey Friedman Jack Elias Haven is, or the area around the city. In David Nathan 10 minutes you can go for a walk on the Stuart Orkin Lewis Landsberg Clockwise from top: beach in the summer, or pick Sleeping Giant State Park; Lighthouse * Hey, what about Modern apples in October, or cross- Point on Long Island Sound; the on State Street? country ski in the winter. New Haven Green, the center of the Spring is just plain gorgeous.” city’s nine squares.

44 45 45.A CLOSE-KNIT COMMUNITY

“We don’t think of patients as collections of body parts, and we don’t think of doctors that way either. For that reason, we encourage our students to reflect on all aspects of their training and practice, from power relationships—with patients, with colleagues, with superiors—to dealing with death and dying. And, of course, because we are such a small school, the faculty can know each student as a whole person. Students will grow to be better doctors if they do not lose their individuality.”

Margaret Bia, M.D. Professor of Medicine and Nephrology and Director of the Clinical Skills Training Program

Clinical instruction includes classes that equip students to communicate with patients and provide compas- sionate care at the end of life.

46 47 Conventional microscopy is limited in resolution by the di≠raction limit of light (about 200 nanometers), and small details NEXT-GENERATION46. are lost. Various new ‘nanoscopes’ beat the light barrier and o≠er high resolution, 3-D YALE48. PROGRAM ON views of living cells over time. Researchers OPTICAL can observe and manipulate basic biological processes on the organelle and molecular AGING IMAGING level. For example, one student is watching how the vesicles of a fat cell react to insulin. Yale is not only one of the few institutions The cutting edge doesn’t “If people are interested in cutting-edge tech- to have these technologies; it is improving 47. have to be high tech. Mary M.D. nology for looking at processes in living cells, them. Scientists like Toomre and Bewersdorf INTEREST Tinetti, , for example, Yale is the place to go,” says Derek Toomre, are working to make it faster and more use- GROUPS has been studying ways P D. h. , associate professor of cell biology. ful to researchers. to reduce the risk of falls He’s walking through the Sterling Hall of The late George Palade, a Nobel laure- among the elderly. Such P D. Students form new Medicine alongside Joerg Bewersdorf, h. , ate who founded the Department of Cell interest groups each year; routine health issues have another expert in “super-resolution” imag- Biology in the 1970s, pioneered electron this is the list in 2010 long been overlooked in ing who recently joined the faculty. They microscopy. The department’s history Bioethics medical research, but Tinetti, pass labs where extremely sophisticated combines excellence in imaging with a MacArthur fellow and Emergency Medicine microscopes are pampered in spaces that fundamental discoveries. Today’s research director of the Yale Program Environmental Health Mary Tinetti, absorb vibration and precisely control using Yale’s super-resolution capabilities M.D., director on Aging, designed a clinical study that temperature. All this space, equipment, has implications for neurological disorders, Family Medicine of Yale Program demonstrated how a set of ordinary inter- on Aging and talent at Yale is dedicated to a single cancer and type 2 diabetes. Seeing life Geriatrics ventions—increased hydration, exercises, purpose: Catching life in action—down in unprecedented detail may help answer Nathan Smith Club changing doses of medications—could significantly reduce to the level of single molecules. some of medicine’s biggest questions. (History of Medicine) the rate of falls and prevent future disability and functional Integrative Medicine decline. Published in the New England Journal of Medicine Students interested Internal Medicine and other journals, Tinetti’s work could improve millions in the cutting edge of cell imaging have Nutrition and Medicine of lives. Such close attention to the patient, questioning of the opportunity to assumptions, and creative thinking about how to improve do research with Ob/Gyn scientists who are Pediatrics life for a broad population—these have been the hallmarks pushing the limits of the Program on Aging for decades, and they are the of the field. The Physician Scientists device at left is under­lying lessons of a Yale medical education. a Leica STED Neurology super-resolution One clinical counterpart to the Program on Aging is microscope, one Surgery of only three in the Dorothy Adler Geriatric Assessment Center at Yale-New the United States Wilderness Medicine Haven Hospital. The Adler Center sta≠ of geriatricians, in 2010. Women’s Health geriatric psychiatrists, nurse case managers, patient care assistants, physical therapists, and neuropsychologists helps patients and their families develop comprehensive plans to preserve their quality of life, manage their clinical care, and link them with other resources in the community. Another model program is the hospital’s Acute Care for the Elderly Unit, which integrates the work of specialists from many fields to provide the complex care that elderly inpatients often require. Programs such as these have put Yale-New Haven Hospital among the top 10 hospitals in the country for geriatric medicine. 48 49 immune system. Today, as the David W. Wallace Professor of Immunobiology at 49. Yale, Medzhitov is exploring the possibility that Toll-like receptors trigger chronic inflammation that is at the root of diseases 50. IMMUNO- from coronary artery disease to Alzheimer’s. Throughout the department, faculty BIOLOGY are working on basic science with highly CULTURE practical application. For example, Sterling P D Professor Richard Flavell, h. ., was The Yale University Art awarded $17 million in the first round of Gallery, left, has the Gates Foundation’s Grand Challenges works by Monet, Degas, Cezanne, in Global Health grants, to generate a and van Gogh in its collection. mouse with a rudimentary human immune Below: A produc- system that could be used in testing tion of “Pop!,” an Andy Warhol- vaccines against diseases prevalent in the inspired musical and whodunit, at developing world. The project fits Dr. the Yale Rep. Flavell’s definition of a good research project: “It is curiosity-driven, pursuing such basic questions as ‘How does the body work?’ But we always study this using diseases that matter. And what we try to do is to force ourselves to ask the question, ‘Is this an important problem?’” The mouse In 1988, Chair Yale wrote the book on it: Richard Flavell will allow researchers to pretest weakened Janeway’s Immunobiology has founded the first live vaccines for safety and e≠ectiveness academic unit in outlived its original lead the U.S. devoted before human trials with an unprecedented to research in Museums & Galleries Theatre author, the renowned Yale immunology. He level of confidence. New Haven is a small city, but that only Beinecke Rare Book & Little Theater professor Charles Janeway, also plays a rau- Yale’s Department of Immunobiology— means that its world-class museums and Manuscript Library M.D. cous lead guitar Long Wharf Theatre , but still carries his in a “biorock one of the few freestanding immunobiology galleries, its great repertory theaters, and its Creative Arts Workshop name. Janeway was part band” called the departments in the world—is now look- active schedule of festivals are all a≠ordable Shubert Performing Cellmates. of the exceptional group ing at the molecular, cellular, and genetic and easily accessible. There is more music, Eli Whitney Museum Arts Center AIDS of immunobiologists that has made Yale mechanisms of flu, , Lyme disease, art, film, and drama in any given week than John Slade Ely House The University Theatre a leader in studies of the immune system, genital herpes, chlamydia, asthma, and you can possibly fit in your schedule. New Haven Museum and Yale Cabaret Historical Society from the molecular level to the therapeutic. autoimmune diseases, including inflamma- Yale Repertory Theatre Janeway himself pioneered exploration tory bowel disease, diabetes, systemic lupus Peabody Museum of (left) Natural History of the innate immune system (the power erythematosus, and multiple sclerosis. They Festivals behind the adaptive immune system). are also studying the role of immunology Yale Center for British Art Celebration of American Yale Collection of Musical In the 1990s—a dark time for the sci- in organ transplantation and graft versus Crafts, Nov.–Dec. Instruments ences in Russia—Dr. Janeway’s work found host disease and developing ways for the Cherry Blossom Festival, Yale University Art its way into the hands of Ruslan Medzhitov, immune system to attack tumors. With a April P D Gallery (above) h. ., then a graduate student at Moscow distinguished faculty, a long-standing part- International Festival of University. Janeway’s theories about the nership with the Howard Hughes Medical Arts and Ideas, June–July immune system put Medzhitov on a career Institute, advanced facilities in the medical Concerts on the Green, path that led eventually to Yale, where he school’s newest buildings, the department July and Janeway discovered the role of Toll-like o≠ers unmatched training in the basic New Haven Jazz Festival, receptors as the central players in the innate and translational science of immunology. August 50 51 51. ALUMNI

“This is an auda- cious undertaking,” NIH declared Director Francis M.D., P D Collins, h. ., back when he signed on as head of the Human Genome Project. Perhaps you can’t teach NIH Director Bringing medical care Francis Collins. audacity, but at Yale we certainly encour- where there was none age it. That’s one reason this relatively Kinari Webb, M.D., small medical school has such a long list of distinguished who graduated from the home to internationally known faculty, alumni. If you’re around on reunion weekend or browsing School of Medicine in using state of-the art equipment to conduct the pages of the alumni magazine, you’re likely to meet a 2002, is making Borneo research on everything from microbial a healthier place. Her head of state, a college president, a U.S. senator, or one clinic near Gunung diversity to cancer biology. Those are the of the many medical school deans, biotech innovators or Palung National Park research areas central to two of the new health system reformers who studied at the Yale School of provides the only health institutes planned for West Campus; others P D care available in one of 52. Medicine. (Collins got his h. . at Yale and was a post- West Campus will be focused on systems biology, chemi- Indonesia’s most remote doctoral fellow in Human Genetics at the medical school areas. Her patients can cal biology, and “biodesign” (a collaboration in the early 1980s.) Some say Yale physicians thrive in earn credits and dis- between cell biology and engineering). counts by working in the leadership roles because the Yale System prepared them to clinic’s organic gardens Everyone uses the same word to describe Sophisticated new core facilities give be independent and original thinkers. or opting out of illegal West Campus: “Transformative.” Yale faculty and student researchers the Others believe the school’s commitment to service logging. Webb spent Yale made the largest property acquisi- tools to conduct high-throughput gene 10 years preparing to RNA drives so many to have a broad and lasting influence. tion in its history in 2007, when it bought sequencing, chemical screening, and M.D. open Alam Sehat Lestari, Assistant U.S. Secretary for Health Howard K. Koh, ’77, Indonesian for health and the former Bayer research center, a 136-acre interference studies, and student research M.P.H., went to Washington to help his own patients. “I’ve everlasting nature, always complex six miles from Sterling Hall of opportunities abound at West Campus. It envisioning it as both seen too many patients su≠er preventable su≠ering and a clinic and conservation Medicine. The property came with more is an integral part of Yale, but it is also a die preventable deaths,” he said. “The only answer to that program. Last year, than 400,000 square feet of high-end labo- neighborhood with a vibe of its own, where challenge is promoting prevention through public health.” 74 people who had been ratory space, ready to welcome scientists. wild turkey share the lawns with humans. blind regained vision Whether leading a federal agency, inventing a bet- through cataract surgery Even planning to build such a facility from The campus features Yale’s newest child care ter way to deliver care, or treating patients on the front there, a new four-wheel scratch would have taken years. center, school outreach programs run by the lines of medicine, Yale alumni engage at the highest level. drive ambulance took a The major investment in acquiring Peabody Museum, and a nature trail. Many Passionate curiosity and a deep resolve to improve human woman to the nearest city West Campus wasn’t real estate, says Dean of the university’s library, art and natural in time for an emergency M.D. health are the hallmarks of every student who walks C-section, and 10 acres Robert Alpern, It is and will be “filling history holdings are stored at West Campus, through the doors of the Sterling Hall of Medicine. These of newly planted trees that space with remarkable investigators,” a which is also home to a major digitization at the forest’s edge were qualities bind classmates to each other and to the genera- reaching for the sky. process that will unfold over a number of project for the university’s collections. tions of students who came before them. years. West Campus is rapidly becoming 52 53 FACULTY-STUDENT53. INTERACTION? WE GET IT.

“No other school has more intense and sustained interaction between students and faculty. And because faculty work so closely with students, they don’t need to quiz students to find out what they know, and they don’t need grades to assess their progress. This in turn means that there’s great room for individuality; students stand out for their own special talents and abilities and interests, not how well they do on the same tests as everyone else.” “We see not students, James Jamieson, M.D., Ph.D. Director, M.D./Ph.D. program but future colleagues.”

Dennis D. Spencer, M.D. Cushing Professor and Chair of Neurosurgery “The faculty gets working Students connect with faculty with students.” during a seminar on palliative care, Nancy Angoff, M.D., M.P.H. top, at the White Coat Ceremony, Associate Dean for Student Affairs and at the Hunger and Homelessness Auction.

54 55 Boston 56. New Haven NEW New York THERAPIES

Philadelphia In the 1990s, Yale boasted of the number of drugs in the pipeline from university labs to major pharmaceutical companies. Today, a laboratory discovery is as likely to lead to the startup of a company designed around a particular line of research. Yale has put substantial resources into fostering startups, which it sees both as a way to bring useful products to market and a means of boost- ing the New Haven economy. Over 30 new The Medical A GREAT PLACE TO virtually every medical pub- Library, dedicated 55. companies have been incubated through lication in the world via its in 1941, was Yale’s O∞ce of Cooperative Research, the brainchild of document delivery services. neurosurgeon attracting well over $3 billion in investments. 54. Harvey Cushing. P D. The Medical And the Cushing/Whitney Joseph Schlessinger, h. , the William Library is just one part H. Pruso≠ Professor and chair of the Historical of the 13 million-volume Yale University LIVE Department of Pharmacology, is a prime Library System. Medical students make example of the biomedical entrepreneurs particular use of the Kline Science Library, “I’m from New York City, and who are leading Yale’s e≠orts in this area. LIBRARY but they can also explore unparalleled New Haven is close enough Renowned for his work on the signaling collections ranging from the law library to that I could go home a lot, pathways that communicate to a cell whether the Beinecke Rare Book and Manuscript or not to divide and grow, Schlessinger has “Of all the libraries in all the educational Library. None of these libraries is more and my family could come started three companies to institutions of our world, there is none Joseph than a short walk from the medical school. pursue the therapeutic appli- Schlessinger is quite like this one. ... That large, comfort- here. But I found everything the founder of The Medical Library is an important cations of his basic science three biotechnol- able, book-lined room ... is a sanctum component of a Yale medical education. I needed here. I got to do research. These companies ogy companies, containing the lore and the collected including Kolltan During orientation week, each student lots of community service—I have already produced two Pharmaceuticals reminiscences of the art of healing. It is a in 2008. is introduced to his or her “personal new cancer drugs. museum, a portrait gallery, a storehouse worked as a patient trans­lator, librarian”—a library sta≠ member who of the literature of medicine’s past, and will work closely with about 20 students. for example—and still finished a refuge from the hurly-burly of modern Throughout the student’s time in in four years. But I liked it scientific technology that surrounds it.” medical school, librarians will recommend so much I’m staying for my Sherwin Nuland, M.D. resources for thesis research and patient from Doctors: The Biography of Medicine, 1988 care questions, and provide instruction residency.” in the use of relevant technologies. This T Luz Jimenez, Class of 2009 he Medical Historical Library is the unique program augments more general showpiece of the comprehensive Harvey seminars on evidence-based practice Cushing/John Hay Whitney Medical and information management that are Library, through which students can access scheduled in all four years. 56 57 57. TRANS­

PLANTATION 58. 59. SURGERY COMMUNITY SERVICE FIFTH YEAR

Today 18 people will die in the United States Why would you want to spend an extra year in medical waiting for an organ transplant. That’s Yale medical students school? As you peer ahead down the formidable road into M.D. have a strong not a statistic Sukru Emre, , can live commitment to social the medical profession, a fifth year of medical school might Sukru Emre, responsibility, and with. The internationally known surgeon “These are complicated chief of organ seem like the last thing you would sign up for. But about was recruited in 2008 to build Yale’s small enterprises. I say that trans- transplantation. every year they take on half of Yale medical students do, and many of them earn a important projects, from m.d transplant program into a leading one. The plantation is not a discipline promoting access to master’s of health science research in addition to their . number of organ transplants performed here but a complex matrix of disciplines, includ- medicines in developing Some are pursuing in-depth research on their thesis countries to defending climbed dramatically, with an outstanding ing surgery, medicine, hepatology, infectious torture victims. These topic. Some are exploring clinical electives and subintern- success rate. The transplant initiative creates disease, pharmacology, pathology, nursing, are a few of the organiza- ships. All are demonstrating how much they love their new hope for patients at Yale and beyond, as and psychology,” says Emre. Yale recruited tions in which medical experience at the Yale School of Medicine. Emre and his colleagues advance the field so top clinicians and provided other resources students act locally: If you do choose to complete your medical education that more lives can be saved, even with the in a range of specialties to support its trans- over five years rather than four, Yale will not charge you Anatomy Teaching limited number of donated organs available. plant initiative. The section performs liver Program (above) tuition for the fifth year. In fact, 20 to 25 students each year “The liver regenerates, as the ancient and kidney transplants, often with mini- are awarded fifth-year research fellowships from organiza- Bio2 Fifth-year students Greeks already knew,” explains Emre. mally invasive techniques. Heart transplants tions including the Howard Hughes Medical Ben Erickson and Columbus House nih Chris Painter (right “Remember Prometheus, whose liver grew are performed by cardiac surgeons. Walk-In Clinic Institute, the , the Sarno≠ Foundation, and second from back each time it was eaten by an eagle? We An active transplant program creates the Doris Duke Charitable Foundation, and right) are pursuing Committee Overseeing the M.H.S. degree. can identify eight segments within the liver, exciting research possibilities. Through Volunteer Services Yale. A living stipend is included. each of which has its own blood supply, collaborations with immunobiology and Downtown Evening bile duct, and venous return. These can all other basic sciences where the university Soup Kitchen function independently. So what I do is cut has a strong base, the section is developing Educational Care the liver into two pieces. Most commonly, strategies to combat rejection and address Clinic at Clifford Beers Community Mental we share one liver between one adult and the long-term health issues faced by trans- Health Clinic one child. We have recently started sharing plant recipients. Funny Bones at Yale one liver between two adults.” Emre often talks about his desire to be This “split liver” technique makes it a “complete physician,” one who combines HAVEN Free Clinic possible for a living person to be a donor. deep and broad medical knowledge with Health Professional Recruitment “Both the donor’s liver and the recipient’s compassionate care. Patients are amazed at Education Program will grow back to normal size in about eight how quickly he returns e-mails and at the (HPREP) weeks, and when the recipient is a child, the time he’ll take to carefully explain options. HIV Intervention and liver grows along with the child,” says Emre. For him, the role of complete physician Prevention Corps Organ transplants are di∞cult in part includes advocacy for his patients. He seizes Neighborhood Health because they a≠ect so many of the body’s on opportunities to speak to community Project systems. By the same token, building a groups and the press about organ donation. Nutrition Detectives strong transplant program a≠ects depart- “Don’t take your organs to heaven,” he urges, Youth Science ments throughout the medical center. “because heaven knows we need them here.” Enrichment Program 58 59 Yale Cancer Center Director Thomas Lynch: “I think we need to aspire to cure cancers, not 62. just help people live a little longer.” GREAT DEBATES

longer,” Dr. Lynch says. “One of the reasons Debating controver- why we’re not curing cancer today is that Students argue a lot during their clerkship sial issues helps we need to better understand the biology in Obstetrics, Gynecology, and Reproductive students develop the rigor in their of cancer. At Yale, the scale is right for an Sciences. In a weekly “Controversial Topics” thinking they will need to make integrated cancer program between science session, they debate issues such as water birth good decisions and clinical medicine. You have laboratories and hormone replacement therapy. Each as physicians. Smilow where fundamental discoveries are being side presents studies supporting its position, 60. made—within a couple hundred feet of clin- followed by rebuttal and discussion. 61.PAYNE ics where patients are being treated—and Though many students give voice to their inner Perry WHITNEY CANCER people who are active in the pursuit of both Masons, the debates are not a test of oratory skill. “In the clinical excellence and scientific discovery.” end, we want the evidence to prevail,” explained Assistant M.D. HOSPITAL Smilow Cancer Hospital includes 112 GYM Professor Jessica Illuzzi, , who directs the clerkship. inpatient beds, outpatient treatment rooms, She devised the format because students often returned expanded operating rooms, infusion suites, from clinical placements curious, even puzzled, about why a A gym that looks like a Yale Cancer Center has long been recognized diagnostic imaging services, and a special- cathedral, a hockey rink physician made a given choice. The Department of Obstetrics, for its excellence in all facets of cancer ized women’s cancer center (including that looks like a whale Gynecology, and Reproductive Sciences is a national leader in research, prevention, and treatment. It is one the Yale-New Haven Breast Center and the (designed by Eero research and clinical care, so students would expect that their NIH Saarinen!)—Yale’s athletic of only 40 -designated Comprehensive Gynecological Oncology Center), as well as facilities are in a class professors could easily answer their questions. But Illuzzi saw Cancer Centers in the United States, and the a floor each for diagnostic and therapeutic by themselves. Medical that students would learn more by finding their own answers. new Smilow Cancer Hospital at Yale-New radiology. Crucially, the new facility allows students have easy “There are more controversial topics in our field than in access to the score of Haven expands Yale’s ability to integrate information from all departments, includ- squash courts, rowing and others,” said Illuzzi. Without research definitively supporting all aspects of cancer patient care—both ing scheduling and billing records as well sailing centers, classes one side, physicians must be rigorous in evaluating evidence. inpatient and outpatient—with the most as the medical records from the variety of in ballet or judo or yoga, Debating helps students do just that. even a golf course ranked advanced research facilities. specialists a patient might see, to be seam- by Golf magazine as one It’s not unusual for a debater to declare afterward: “I’m In fact, the ability to achieve new levels lessly integrated in one system. The new of the 100 most difficult arguing against the side I believe in!” That itself is a learning of integration brought Thomas Lynch ease of coordination enhances collaboration in the world. experience, added Illuzzi, as students must challenge their M.D. Jr., , back to his alma mater to head among clinicians and scientists in the best preconceptions. Debaters arrive prepared and passionate. Yale Cancer Center and Smilow Cancer Yale tradition. Even more important, better Illuzzi believes this enthusiastic response is linked to the Hospital. “I think we need to aspire to cure communication means a better experience inquiring, independent bent she sees in students who choose cancers, not just to help people live a bit for patients. Yale. “It’s in their nature already.” 60 61 What would medical 63. school be without a liter- AMERICAN 79. ary magazine, a swing MEDICAL STUDENT STUDENT society, and a symphony ASSOCIATION NATIONAL MEDICAL orchestra? Here’s a ASSOCIATION partial list of student

organizations. The 64. list will be different by ASIAN PACIFIC 80. the time you come to AMERICAN THE Yale, but the energy MEDICAL STUDENT ULTRASOUNDS level will be the same. ASSOCIATION ACAPELLA GROUP

65. 81. ATRIUM YALE HEALTHCARE LITERARY 68. 71. AND LIFE MAGAZINE YALE MED HIV SCIENCES CLUB PLAYERS INTERVENTION AND PREVENTION CORPS 66. 82. LATINO MEDICAL 69. YALE JOURNAL STUDENT GAY STRIAGHT OF BIOLOGY ASSOCIATION MEDICAL 72. AND MEDICINE ALLIANCE MEDICAL STUDENT COUNCIL 88.

67. Transatlantic COMMITTEE 70. Top: Yale Med FOR THE GLOBAL Players; bottom: 73. WELL-BEING OF HEALTH WORKING MEDICAL Yale Medical ALLIANCE Campus Traffic STUDENTS GROUP STUDENTS FOR Safety Group. CHOICE

A unique partnership between the Yale and Michael Simons, 83. left, and John YALE MED SOCCER University College London was inaugurated Martin head 74. the UCL-Yale NEIGHBORHOOD in the fall of 2009. Involving the a∞liated Collaborative in HEALTH PROJECT Biomedicine. 84. hospitals of the two institutions as well as YALE MEDICAL the schools themselves, the broad collabora- CAMPUS TRAFFIC 75. SAFETY GROUP tion spans basic biomedical research, medical education, NEPAL HEALTH and clinical care. Two distinguished cardiologists, Michael EQUITY INITIATIVE m.d. Simons, , professor of medicine and cell biology and chief of cardiovascular medicine at Yale, and John Martin, 85. m.d. ucl YALE MEDICAL , professor of cardiovascular medicine at , conceived 76. STUDENT PEER ADVOCATES PSYCHIATRIC the arrangement as a way to enhance the capabilities of their SOCIETY institutions, both leading medical research centers. In joint clinical programs, the institutions are exchanging expert 77. physicians to treat patients at both sites and share clinical PHYSICIANS FOR A 86. NATIONAL HEALTH YALE SWING information. Meanwhile, the universities have begun joint PROGRAM SOCIETY research projects in genetics and cardiovascular medicine,

with more on the horizon in areas including cancer biology, drug discovery, nephrology, and neuroscience. Yale and ucl P D. 78. 87. also hope to create a coordinated program for h. PHYSICIANS YOUTH SCIENCE FOR HUMAN AND ENRICHMENT students from the two schools. RIGHTS PROGRAM

62 63 89. NO CLASS RANK

“No class rank takes completely off the table how well you’re doing compared to the person sitting next to you. You don’t need to position yourself in a curve; you benefit from helping those around you. It’s in the best interests of my patients and the world that the person sitting next to me is the best possible doctor.” Aaron Feinstein, Class of 2011

The Yale System, with decreased emphasis on grades and class rankings, encourages collaboration and cooperation among students.

64 65 90. SCIENTIFIC Science Hill COMMUNITY 91. Peabody Museum. SCIENCE Challenge: Walk two blocks in any direction Yale’s astounding on Yale’s campus without passing a building natural history collection, a rich resource HILL where someone is doing great science. for scholars of evolutionary biology. Hillhouse The university is completing a $1 billion School of Engineering & Applied Geneticist and NIH program of investment in the sciences, Science. Director Francis Collins investment that can be seen in a parade A world-class biomedical engi- did his Ph.D. research of sleek modern buildings, equipped with neering program that uses technology in the Department of Chemistry. Frank Ruddle, everything on a researcher’s wish list. to advance medicine, with labs on both Ph.D., worked on the Yale is fortunate to house its graduate and sides of campus. creation of the first professional schools on one campus, so the transgenic mice in Kline School of Forestry and Biology Tower. Nobel medical school is truly integrated with the Environmental Sciences. laureate Sidney Altman, full spectrum of scientific resources avail- A graduate Ph.D., has his lab on able throughout the university. You may school exploring how the health of the Cross Kline’s fourth floor, just Campus across the quad from find yourself working with a professor who biosphere a≠ects human health. fellow Nobelist Thomas is an engineer, environmental scientist, or A. Steitz, Ph.D. The School of Management. computational biologist. At Yale, we know Partner Biomedical Engineering M.D./M.B.A. department occupies that no single discipline has cornered the in the Program and in many Old New Haven a glassy new building a market on innovation. So our faculty work research e≠orts focused on health care. Campus Green block away. “Science in interdisciplinary teams and encourage Faculty expertise includes health care Hill,” just across campus from the Yale School of you to do likewise. reform and modeling to estimate and pre- Medicine, expands the pare for the impact of various public health intellectual reach of The Yale scientific community includes: emergencies, including bioterrorism. the school, and medical students can take Combined Program in the Biological School of Nursing. courses and conduct A leader in chronic research there. M.D./Ph.D. and Biomedical Sciences. An interdisci- illness research and the birthplace of the candidates pursue P D. M.D. plinary program that o≠ers h. and / hospice movement in America. their graduate studies P D. via Yale’s Combined h. students access to all the bioscience Program in the Bio­ School of Public Health. resources at Yale. One of the logical and Biomedical oldest public health schools in the country, Sciences (BBS), which Faculty of Arts and Sciences. is specifically aimed at Home with a history of training leaders. facilitating access to Yale the university’s array of to nationally known science departments, School of West Campus. bioscience resources including Chemistry; Computer Science; Yale’s largest property Medicine/ without standard Ecology and Environmental Biology; acquisition ever, a complex where interdis- Yale Medical academic boundaries. Center Molecular Biophysics and Biochemistry ciplinary teams use the most sophisticated (6 miles) (which has a presence on the medical equipment available to advance science. campus as well); and Molecular, Cellular, It’s a 6 mile shuttle ride from Sterling Hall and Developmental Biology. of Medicine. 66 67 94.YALE MEDICAL SYMPHONY ORCHESTRA 92. THE CARTS

New Haven has its share of Zagat-rated restaurants. But at lunchtime, Cedar Street is where the sizzle is. About 40 vendors o≠er fresh fare from sidewalk carts. With that many options you don’t ask, “Do any of them have pad thai?” You ask, “Which In medical school dormi- Nursing, Public Health, one has the best pad thai?” If Thai isn’t tories across the country, and the medical com- your thing, there’s Indian, Middle Eastern, violins gather dust at the munity at large now form Ethiopian, Mexican, and other cuisines. The back of closets. Medical the orchestra. A Yale was a fraction of what it is today and the students who had been School of Music doctoral chefs are international and the food tends number of women on the faculty could be serious musicians student conducts the to be authentic, with the possible exception through college cannot group, which practices counted on one hand. Today, like many of the “New Haven Roll” at the sushi cart. find opportunities to weekly. The orchestra 93. medical schools, women make up half the play. Lynn Tanoue, M.D., performs regularly And, yes, there are places to get a green OFFICE FOR student body, but women still face special professor of pulmo- at a packed Harkness salad or a grilled chicken sandwich, too. nary and critical care Auditorium and has challenges at med school. We continue Dining “a la carts” is a popular way to medicine, thought it was plans to do community to provide neutral, confidential counsel- high time to dust off her concerts as well. As the grab lunch on the run without sacrificing WOMEN ing to women at YSM, to offer an annual own violin. She invited medical school prepares taste or blowing your budget. On a warm students and faculty for its Bicentennial, the lecture series, and to sponsor various day, students and faculty turn the lawn IN MEDICINE throughout the school to symphony program will forums to bring women in the school do likewise. When she include an original work outside Harkness into a picnic ground. together. And we have a program to sent out a mass e-mail commissioned for the As spring stretches into summer, you about starting up a medi- school’s 200th birthday. “Yale is unique in having an Office for match current women students with role might even get a free side of live music. cal school symphony “There clearly is a musi- Women in Medicine, dedicated to the models and mentors.” orchestra, the response cal soul to the medical

advancement of women in medicine and was overwhelming. center,” says Tanoue, Merle Waxman, M.A. About 50 musicians from “that was waiting to be the medical sciences. When we started Associate dean and director of the Office for the schools of Medicine, discovered. the office, the number of women admitted Women in Medicine

68 69 95. Yale “Any course at Yale is open to you. When I first got here and I was feeling completely saturated by the science I was learning, I audited a course on Renaissance poetry. It was great.”

“I am a Nigerian immigrant, and I was so happy when I found I could go speak Yoruba with a Yale professor—and he was so happy to speak with me.”

“Awesome people. Awesome access.” Yale medical students

Harkness Tower looms above Yale’s Old Campus, a few blocks from the School of Medicine.

70 71 M.D. “The passion that drives A. Shaywitz, professor of pediatrics us is the knowledge and and neurology. The Shaywitzes discovered “functional lesions” in the left occipito- experience of what the cost temporal and parietotemporal regions of is to individuals. This isn’t the brain, which correspond exactly with an academic abstraction; physical lesions in people who have lost the ability to read because of a stroke or it’s about real people who brain tumor. Overcoming these functional have to live with something deficits requires e≠ort and assistance that people don’t see.” beyond the normal. Sally Shaywitz sums up the impact of their findings, “The passion Sally Shaywitz, M.D. that drives my husband and me is really Ratner Professor of Learning Development the knowledge and experience of what the cost is to individuals. This isn’t an academic P D. headed by Ami Klin, h. , Harris Associate abstraction; it’s about real people who have Professor of Psychology and Psychiatry. Klin to live with something that people don’t and his colleagues have created investiga- see. That’s why it’s a wonderful thing that tive techniques that have led to current we now have the ability to see the brain understanding of autism as an impairment at work, to actually see what is happening at of the “social brain,” the structures and the most basic levels.” functions in the brain that allow people to form emotional and cognitive attachments to other people. The Yale Epilepsy Surgery Program, currently directed by Dennis Spencer, M.D. , Harvey and Kate Cushing Professor of Neurosurgery, comprises neurosur- Scans produced on, a brain in seizure? by fMRI show the geons, neurologists, neuropsychologists, How can you examine the brain of a patient neuroradiologists, neuropathologists, with epilepsy. 97. biological underpinnings epidemiologists, pediatricians, biomedical of schizophrenia? engineers, and specialist nurses. The team POWER Yale researchers are making progress has been able not only to improve surgery on all these questions, and one tool is but has developed novel imaging tools to DAY functional magnetic resonance imaging co-register many kinds of functional data Cutting-edge MRI 96. (f ), which allows you to watch the and use this data to direct the placement It’s not about getting Dean for Student Affairs brain in action. Yale has the most advanced of electrodes, as wells as special catheters power; it’s about Nancy Angoff, M.D., equipment available and a cadre of talented, to analyze chemical changes. questioning it. Just M.P.H., who directs MRI before they start on the Power Day. “We want skillful, and knowledgeable experts to Functional not only advances our wards, rising third-year them to recognize the develop new ways to use such technology. understanding of the brain; it can change medical students and misuse of power and to fMRI The Autism Program at Yale brings society’s judgments of individual character. advanced-practice nurs- be prepared to deal with ing students spend a day it. We want them to think together professionals from the fields of Take, for example, dyslexia. Generations in discussions of power about relations between Nothing requires more scientific ingenuity clinical psychology, neuropsychology and of children with dyslexia have been seen and control in health care members of the hospital than studying the workings of the neuroimaging, child psychiatry, speech- as lazy or stupid as they struggled to relationships. “We don’t staff, between care want them to assume that providers and patients— brain. How can you tell what a boy with language pathology, social work, genetics, learn how to read. No one can continue the patterns they find in especially when race or autism is seeing when the disorder is, psychopharmacology, and psychiatric to hold that view in light of the findings their clinical rotations are gender are added to the NIH M.D. foremost, an inability to communicate? nursing. Recognized by as an Autism of Sally Shaywitz, , Ratner Professor ‘the way it’s supposed mix. We want them to be How can you examine, much less operate Center of Excellence, the program is of Learning Development, and Bennett to be,’” says Associate ready to make changes.” 72 73 HUMANITIES98. IN MEDICINE

If poetry is what is lost in translation, the whole person is what is lost in numbers. One of the ways we get back to the whole THE99. COAST O F person is through the humanities. “In the last century, the science of medicine has been the focus of medical education,” M.D. says Thomas Du≠y, , Director of MAINE the Program for Humanities in Medicine at Yale. “We are trying to bring the art of medicine back into the balance.” “This course has the potential to encourage people who otherwise A few examples: might not think about a research career. Some students have never > A yearlong biweekly lecture series brings run a gel, ground up tissue, or a humanistic perspective to medicine. A looked at cells under a microscope recent series opened with “Akhenaton: The in a research mode before. The Androgynous Pharoah” and ended with a presentation by residents in the writer’s work- idea of hands-on work is often so shop conducted by physician-authors Richard illuminating that it leads people M.D M.D. Selzer, ., and Lorence Gutterman, to say, ‘This is what I want to do for Students hone the rest of my life.’” > An art elective has encouraged students to serendipity: interactions between the two that they would otherwise miss. their powers explore anatomy through drawing, painting, domains are expected to be productive and The e≠ectiveness of the program of observation John N. Forrest Jr., M.D. by looking at Director of the Office of Student Research and director and photography, capturing something that is inspirational. has been demonstrated—and paintings at the JAMA of the Mt. Desert Island Biological Laboratory. missed in the process of dissection and analysis. published in —and the Yale Center for > Workshop on Observational Skills. Over British Art. course has been adapted by other You might choose Yale for its location close > Atrium, the student literary and arts journal. a decade ago, Professor of Dermatology Irwin M.D. medical schools, business schools, and police to the bustle of Manhattan and Boston, but Braverman, , began using paintings to NYPD > The Yale Journal for Humanities in departments, including the and Yale will give you the opportunity to study train Yale medical students to pay close atten- Medicine, an online journal that publishes Scotland Yard, training their o∞cers to be molecular biology for a week in a quieter tion to detail. Today, a mandatory class for essays (“The Leaf Blower as Metaphor”); more astute observers. locale—the coast of Maine. The Intensive first-year students meets in small groups at the poetry (“Emotional Fugue in a Supermodel Pedagogical Experience in Laboratory Yale Center for British Art each spring. The World”); and book reviews and has a The Yale Medical Humanities and the Research Techniques is a weeklong elective class aims to “jump-start the special diagnostic companion blog (http://blog.yjhm.org). Arts Council ensures that projects such for up to 28 students held each June at the skills” that usually take physicians years to as these are sustained and expanded, Mt. Desert Island Biological Laboratory. > West Campus. In Yale’s West Campus, a develop, according to Dr. Braverman. Taking engaging people throughout the university It’s an immersion in strategies and methods portion of the space is devoted to the most students out of their familiar setting removes and beyond at the intersection of health, of laboratory research, but there’s time advanced medical research technologies and some of the assumptions that might limit culture, and society. for hiking, relaxing, and a lobsterfest in another portion to the arts. Call it planned perception and lets them notice particulars one of the most beautiful places in America. 74 75 100.THE OTHER 99 PEOPLE AND THEIR OWN 100 REASONS

“Yale med students are the most amazing group of people you’ll ever be with. I knew that when I did the Service at Yale orientation and found the second-years so incredibly organized, with such good leadership skills. And then throughout the medical school, students really set the tone—as a group they are so mature, responsive, committed to the community. The friends you make here are one of the best reasons to come.” Molly Weiner, Class of 2012

76 77 INDEX BY PAGE NUMBER

Advanced Clinical electives fMRI 72 Intracranial National Center Robert Wood Student Yale Center for Clinical Elective 13, 36 aneurysms 43 for Children Johnson organizations British Art 74 Genetics 19, 43 in Law and Exposed Clinical Scholars 59, 62–63 Clinical research 16 Joint degrees 34 Yale Center Psychiatry 36 Global health 12, 32 to Violence 28 Program 17 Student research for Clinical Clinical Skills Latino Medical Advisors 24 Grades 6 Neuroscience 38 Rudd Center 6, 24, 34, 45, 75 Investigation 16 Training Program Student for Food Policy AIDS Care 38 Great debates 61 Association 37, 62 New England 44 Summer research Yale Center and Obesity 36 Program 23 stipends 45 for Genome Combined HAVEN Free Level 1 Trauma New Haven Sarnoff Analysis 25 Alumni 52 Program in the Clinic 14, 17, 59 Center 27 44, 51, 57 Super-resolution Foundation 59 Biological and imaging 48 Yale Craniofacial Anatomy class 8 Health teams 17 LGBTQ New therapies 57 Biomedical SAY, Service Center 23 resources 37 Technology 25, 48 Art elective 74 Sciences 66 Heart disease/ No class rank 65 at Yale 9 Yale Epilepsy metabolic Lighthouse Thesis 6, 45 Artificial heart Community 46, 59, 66 Outpatient School of Surgery syndrome 43 Point 44 pump prototype 19 para­thyroid Engineering Theatre 51 Program 73 Core facilities High-end Macular surgery 23 & Applied Asian Americans 25, 48 Tissue Yale Medical instrumentation 25 degeneration 43 Science 66 in Yale Medicine 37 Patients 9, 16, 38 engineering 42 Group 22 Crohn’s disease 43 Howard Hughes Match Day 33 School of Antibiotics 21 Payne-Whitney Tourette Yale Medical Culture 51 Medical Institute Forestry and MD/JD 34 Gym 61 syndrome 43 Symphony Autism 19, 72 34, 50, 59 Environmental Diversity 36 Orchestra 69 MD/MBA 35 Peabody Sciences 36, 66 Transatlantic Biomedical Human and Downs Museum 66 alliance 63 Yale Program Engineering 42 Translational MD/MDiv 34 School of Fellowships 12, 13 on Aging 49 Immunology 19 Physician Management 66 Translational Breakthroughs 19 MD/MHS 34 Dyslexia 43, 73 Associate research 18 Yale System 6 Humanities in School of Cadaver Ball 29 MD/MPH 34 Program 14, 17 East Rock Park 44 Medicine 74 Nursing 14, 17, 66 Transplantation Yale-New The carts 68 MD/PhD 40 Pizza 44 surgery 58 Haven Hospital Emergency Hunger and School of 20, 27, 49 Cell sorting/ Medicine 27 Homelessness Medical Library 56 Polycystic Public Health Uganda 13 flow cytometry25 Auction 14 kidney disease 43 14, 17, 32, 66 Faculty of Arts Medical Outdoor VA Connecticut Cell, molecular, and Sciences 66 Hypertension 43 Orientation Trip 9 Post-traumatic Science Hill 67 Healthcare MR, and PET stress disorder 38 System 39 Faculty-student Immunobiology 50 Medical Scientific imaging 25 interaction 54 Scientist Training Power Day 73 community 66 Vascular Innate immunity Cellular Program 40 Biology and Farr Lecture 45 19, 50 Primary Care Second Year Neuroscience, Therapeutics 18, 42 Mentors 45, 68 Clerkship 14 Show 21 Neurodegenera- Fellowships 12, Interdisciplinary West Campus 53, 66 tion, and Repair, 18 13, 45 Center for Modules 12 Protein Service of Bioethics 36 folding 19, 39 Gratitude 8 Women in Chemotherapy 19 Festivals 51 Mount Desert medicine 68 Interdisciplinary Island Biological Proteomics 25 Smilow Cancer Child Study Fetal heart Studies 36 Laboratory 75 Hospital 20, 60 The World 12 Center 16, 28 monitoring 19 Recognition 24 Interest groups 49 Multi­cultural Stem Cell Yale 70 Class Size 10 Fifth year 6, 45, 59 Residencies 33 affairs 37 Center 29 International Yale Cancer Clinical care 22 Financial aid 32 Ribosome 21 Medical Student Museums & Student National Center 17 Education 13 galleries 51 Medical Association 37, 63 78 79 Contact Equal Opportunity Bicentennial Year Statement Office of Admissions The School of Medicine is 367 Cedar Street The Yale School of Medicine celebrating its Bicentennial in New Haven, CT 06510 is committed to contributing 2010–2011 with a series of Tel: 203.785.2643 to a health-care workforce lectures and special publications, Fax: 203.785.3234 that reflects the diversity of a documentary film, a community [email protected] the patients it serves. We fair, and a symposium exploring seek to enroll students from a the biomedical sciences. An Produced by range of ethnic and economic illustrated book about the school, backgrounds, including from “Medicine at Yale: The First Institutional Planning and communities that have been 200 Years,” will be available Communications historically underrepresented from Yale University Press in 300 George St, Ste. 773 in the medical profession. November 2010. New Haven, CT 06511 Tel: 203.785.5824 The medical school abides The Bicentennial provides an Fax: 203.785.4327 by Yale University’s Equal opportunity to reflect on the Opportunity Statement, which achievements of the past two Project editor: Michael Fitzsousa is as follows: centuries and the ways in which medicine has changed since Design: Michael Bierut and Yale University is committed 1810. Then, life expectancy Yve Ludwig, Pentagram to basing judgments concerning in New Haven was less than 40 the admission, education, and years, and medical knowledge Text: Catherine Iino, employment of individuals on was derived from concepts that Colleen Shaddox their qualifications and abilities have long since been discounted. and affirmatively seeks to attract During the school’s evolution, Photography (by reason): to its faculty, staff, and student a largely unscientific occupa- Associated Press, 37; Heidi body qualified persons of diverse tion handed down through Brown, 29; Julie Brown, 25, 39, backgrounds. apprenticeship has become one 51, 94; John Curtis, 3, 5, 8, 11, of the most education-intensive, 13, 16, 27, 30, 32, 44, 53, In accordance with this policy rigorously scientific, and highly 58, 62, 99, 100; Terry Dagradi, and as delineated by federal regulated professions. 1, 2, 6, 10, 12, 17, 35, 36, and Connecticut law, Yale does 40, 46, 48, 53, 88, 89, 98; not discriminate in admissions, As American medicine looks Courtesy of Division of Medicine educational programs, or ahead to improving health care, and Science, Smithsonian employment against any indi- unraveling the mysteries under­ Institution, 19; Derek Dudek/ vidual on account of sex, race, lying disease, and optimally www.visitNewHaven.com, 44; color, religion, age, disability, preparing the doctors of the Antonio Giraldez, 41; Arthur status as a special disabled coming decades, Yale will con- Horwich, 38; Haifan Lin, 26; veteran or veteran of the Vietnam tinue to meet the challenges of Robert Lisak, 7, 14, 16, 19, 20, era, or national or ethnic origin; a changing medical landscape. 22, 23, 24, 45, 54, 56, 57, nor does Yale discriminate on 59, 92, 93; Michael Marsland, the basis of sexual orientation. For information, see 42, 43, 52, 95; Alex Marzuka, medicine.yale.edu/ysm200 4; New Haven Register/Brad University policy is committed to Horrigan, 60; Nobel Foundation, affirmative action under law in 18; William Sacco, 32; Harold employment of women, minority Shapiro, 49; United Press group members, individuals with International, 33; Yale Repertory disabilities, special disabled Theatre, 50; Yale University veterans, and veterans of the Art Gallery, 50 Vietnam era.

Photo research: Charles Questions about these policies Gershman should be referred to:

Copy editing: Cheryl Violante Office of the Provost 118 Hall of Graduate Studies Printing: Finlay Printing Phone: 203-432-4440 or Office for Equal Opportunity Programs 104 William L. Harkness Hall Phone: 203-432-0849

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