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Curriculum and Community: The Making of a Medical Scientist

Nationally, more than a third of basic-science doctoral candidates do not finish their training. Pursuing basic-science research is extremely difficult, and I struggled to complete my dissertation.

My doctoral research focused on stem cells and their role in the spread of breast cancer. I thought my undergraduate and master’s degree training in mechanical and aerospace engineering would help ease my way into the field of molecular biology. Years of failed experiments, often-discouraging thesis advisory committee meetings, looming deadlines, and the near-constant question, “So, uhh, when do you think you’re gonna get out of here?” made it tough sometimes for me to maintain motivation and perspective.

Though I found the research more difficult than I had expected, and wanted to drop out of the Medical Scientist Training Program (MSTP) almost every day for several years, I was eventually able to channel my frustration into many productive endeavors. I will graduate with a combined M.D./Ph.D. degree tomorrow—after nine years of intense education and training.

It was not an easy journey.

While my classwork, research, and clinical training were invaluable, what made a critical difference was the countless positive experiences I had outside the classroom and the lab—things never printed in a syllabus. I call it Einstein’s “hidden curriculum,” which pushed me to learn more than how to take care of patients and conduct scientific inquiry. The environment at the medical school encourages curiosity, demands critical thinking, and allows for calculated risk-taking. While it wasn’t clear to me at first how to do so, I learned how to translate competencies gained from a rigorous training regimen into realms outside the clinic and the laboratory. That ability to take “soft” skills and apply them to “hard” problems is what drives the hidden curriculum.

Over time, I learned that many of the skills I had developed were even more valuable when applied outside the traditional settings of academic medicine, and helped me overcome many challenges that presented themselves over the years.

Developing Leadership Skills

Nine years at one institution is a really long time (especially for a student). On the plus side, they provided me with the opportunity to lead my colleagues, putting the skills of advocacy and collaboration to use in the world of academic medicine. This included working with other institutions to establish the first-ever New York City–wide M.D./Ph.D. student symposium. In 2015, I engaged with other student leaders to help mobilize the Einstein community to rally in support of the MSTP and Ph.D. programs, and became a subcommittee chair of Einstein’s Diversity and Inclusion Steering Committee. This work helped the institution finalize policy recommendations with the goal of making Einstein a leader in recruitment, mentoring, and retention of diverse talent. What I learned from these experiences became much more gratifying as time went on.

A Boost from the Community

These and numerous other activities involving community outreach gave me the energy to finish my M.D./Ph.D. degree. They provided much-needed time away from a tough project, and more important, allowed me to realize that what I learned during my training was useful for more than knowing that I had the appropriate controls for my experiments. What I learned in the lab was invaluable in helping me inspire the next generation of physicians and scientists by mentoring local high school and college students. It was a great way to step back and view the entire picture. I had a new perspective and remembered a key aspect of science: passing knowledge on to others.

Other experiences also eased my path toward graduation. As an executive board member of the Einstein Minority Scientists Association, I worked with fellow graduate students to help manage part of the Einstein Postbaccalaureate Research Education Program. I also helped organize numerous visits to schools in the Bronx and Harlem to expose students from underrepresented minorities (URM) to medicine and biomedical science.

Additionally, I volunteered as a mentor and a consultant for Einstein’s Summer Undergraduate Mentorship Program. It focuses on providing URM college students with clinical shadowing experience and helps students aspiring to careers in medicine, public health, and basic science by allowing them to research health disparities.

Though these activities took time away from my demanding research schedule, they taught me numerous lessons, including the value of getting away from the bench and exposing others to scientific and medical information.

The Power of Communications

The ongoing shift in our political climate has highlighted the importance of that lesson. Clinicians and scientists are well versed in speaking to one another, but we often do a terrible job communicating our findings to the general public.

This lack of communication between science and the people it serves has led to an environment where established scientific consensus is now being ignored, oftentimes out of fear, but surprisingly, in many cases, out of malice.

During my time at Einstein, it became clear that the medical and scientific communities could no longer idly watch as decades of progress were steadily reversed. It is not sufficient simply to shout from the ivory tower. I realized that we need to become more visible and more involved—to be heard—especially in communities we know well, both personally and professionally.

Training in the Bronx has taught me more than I could ever have imagined, providing a sharp contrast to my upbringing in western New York. Spending the vast majority of my time in the nation’s poorest urban county has given me an invaluable perspective on the inequities in our healthcare, education, and criminal-justice systems. Most important, it has provided keen insights into the social determinants that create disparities in these systems, and the policy and legislative decisions that maintain and exacerbate them. With encouragement from my cousin (a professor of sociology) and my then-girlfriend (now wife), I decided to begin educating others outside the Bronx about health problems in urban communities.

I spoke at high schools, colleges, and academic medical centers, and gave Grand Rounds at many institutions. In general, my presentations were very well received. However, what was encouraging from an educational standpoint was also surprising and disappointing from a societal one: most audience members were completely unaware of the scale of the problems we face and their origins.

How was it possible that so many physicians and scientists with years of experience at some of our nation’s premier academic medical institutions had so little knowledge of seemingly fundamental issues? I witnessed firsthand a glaring deficiency in our training as educators of the next generation of academics, and inadvertently found a calling that I had not anticipated: to wake people up and help change the biomedical education curriculum. I am not a public-health expert, but I quickly realized that I did not need a master’s degree in the field to convey the dire nature of these problems. As a physician-scientist and as a person of color, what mattered most to me was the message I presented, along with mountains of corroborating evidence.

I will soon say good-bye to Einstein and move on to the next phase of my training.  However, I am forever grateful for the colleagues, friends, teachers, and mentors I gained along the way. I am grateful for the high school and college students who taught me the importance of good mentoring. I am especially thankful to my patients, who allowed me to care for them and taught me so much about their lives. While I’m quite sure my Ph.D. thesis advisor would have appreciated me spending more time in the lab and focusing on my dissertation, I am grateful for his flexibility and patience, which allowed me to step away from the bench and have experiences that were among the most impactful moments in my training and education. I am also thankful for my family, who supported me every step of the way in this long journey. (Yes, Mom. I’m actually graduating this year.)

Finally, I’m thankful for all the training Einstein gave me: both the formal preparation, which has assured me that I will be an excellent physician-scientist, and the hidden curriculum, which has made me confident that I can be a great educator, mentor, and leader in our society.

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Dayle Hodge

Dayle Hodge

Dayle will graduate from the Medical Scientist Training Program at the Albert Einstein College of Medicine. In July, he begins a research-track residency program in Anesthesiology and Perioperative Medicine at Oregon Health & Science University.

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