REASONS

100

REASONS

100

each year make Yale the most stimulating place in the world to study medicine. Each chooses Yale for a hundred dierent reasons; this book is about a few of them. Our class size of 100 allows us to nurture each students own interests, ambitions, and vision of how the art and science of medicine can contribute to the world. Whats your reason for choosing Yale?

NE HUNDRED STUDENTS

1.

MEDICINE AT YALE IS ABOUT

MORE
THAN 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 numberswhether that person is the patient, the doctor, or the student.
Robert J. Alpern, M.D. Dean and Ensign Professor of Medicine

SYSTEM
More than 80 years ago, the Yale School of Medicine embarked on a new approach to education, based on the premise that the medical student is a mature individual, as a 1928 Curriculum Committee put it. Highly motivated and self-directed, students were to take an active role in acquiring not just a set of facts but habits of inquiry and a capacity for critical thinking that would last a lifetime. This approach was so distinctive that it became known as the Yale System. The Yale System has endured through myriad changes in biomedical knowledge, the nature of clinical practice, and technology, but it retains its reliance on student initiative, its emphasis on scientic investigation, its respect for individuality, and its encouragement of cooperation rather than competition.
What does all this mean in practice?

2. The Yale

> Class attendance at lectures is not recorded, and students are expected to make responsible decisions about the best use of their time.

on these tests are known only to the individual student, and there are no grade point averages or class ranking. The rare student who fails to achieve mastery has many options for assistance in getting up to speed.

Since it was instituted in the 1920s, the Yale System has fostered a collegial educational environment that produces leaders in medicine.

> Students are encouraged to explore their own interests in medicine and advance at their own pace within the Yale curriculum. About half complete the M.D. program in four years, and half take an optional, tuition-free fth year to pursue additional clinical electives, thesis-related research, or international medical experiences. Several students each year pursue dual-degree programs with other Yale schools and departments. The Yale System embodies the schools commitment to educating leaders who will advance the science and practice of medicine. Such leadership requires the ability to think critically and creatively, to work collaboratively with others, and to take responsibility for lifelong learning. Judging by both the satisfaction of our current students and the extraordinary success of our graduates, the system works.
7

> Every M.D. student must complete a thesis that represents a substantial body of original research. The thesis project teaches students to wield the tools of scientic investigation and places students in close, collegial contact with faculty from day one.

> In the rst two years, students track their own progress through optional self-assessment tests midway through each course and mandatory nal examinations called qualiers. The grades

GET TO KNOW YOUR NEW CLASSMATES IN THE GREAT OUTDOORS...

4.

PATIENTS
At Yale, bedside manner is not an add-on to physician training but an integral part of the concept of patients as whole people. From the very beginning, a Yale medical education reminds students not to lose sight of the whole patient. In one rst-year exercise, students are asked to 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 patients after surgery to gain a complete understanding of the experience. Classes build in discusBefore working in sions not just with medical experts but clinical settings, students practice with nurses, social workers, and chaplains. their history-taking This distinctively Yale approach to medical skills in a course that employs training makes our graduates better, more actors to play the role of patient. observant, more eective doctors.

LEssons From

6.

3. ANATOMY
CLASS
Yale has turned anatomy on its head. Traditional anatomy courses begin with comprehensive lectures, overly detailed dissections and long nights memorizing terms. It all seems rather abstract until students see patients. So why not start with the patients? Thats what course director Lawrence J. Rizzolo, Ph.D., associate professor of anatomy and experimental surgery, asked himself. He redesigned the course and made Yale the rst medical school to teach anatomy using a surgical case model. Students begin the course by performing actual operations on their cadavers under the guidance of faculty surgeons. For example, they learn about the hearts structure by performing heart transplants. Hands-on learning is supplemented
8

The Medical Outdoor Orientation Trip is a four-day hike on the Appalachian Trail just before rst-year registration.

with lectures, study groups, Anatomy students consult course and a wealth of web-based materials online during a dissection. resources. Outcome measYale uses a surgical ures show that students are case model to teach anatomy. retaining more information under the new model. Rizzolo and his colleagues have published on this unique approach and eld inquiries from other medical schools that would like to explore it. The sum of medical knowledge increases rapidly, but the time students spend in medical school is a constant. More ecient ways to learn are essential. The case-based approach does not only teach basic anatomy more eectively; students are simultaneously practicing clinical reasoning skills, gaining experience reading images, and negotiating the complexities of working in teams. Experience with the cadavers is also an early and important opportunity for students to address the issues of death and dying that theyll confront throughout their careers. The course culminates in a Service of Gratitude for the cadaver donors, who, through a nal act of generosity, became great teachers themselves.

...OR IN SERVICE TO YOUR NEW HOMETOWN

5.

A four-day orientation to the City of New Haven, community service, and fellow rst-years, S.A.Y. (Service at Yale) New Haven sends crews of volunteers to a variety of organizations, from Habitat for Humanity to Student Sight Savers, a glaucoma screening project at Yale-New Haven Hospital.

7 .
Nancy Angoff, M.D., M.P.H. Associate Dean for Student Affairs 10

SIZE
MATTERS

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

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

11

8. WORLD
THE
When you study medicine at Yale, New Haven is a gateway to the world. You dont walk through that gateway alone. The Oce of International Medical Student Education oversees an integrated global health curriculum that runs throughout your time in medical school. Like the rest of your Yale medical education, the study of global health issues is deliberately planned to keep the focus on both patients and doctors as whole people. social, political, and economic determinants
First year. A year-long elective on the

of global health presents lectures on subjects ranging from maternal mortality to the political uses of psychiatry. The course is codirected by students and meets biweekly over dinner. Another elective, Introduction to Research Methods in Global Health, focuses on eld-based research in low-resource countries. This workshop is particularly relevant for students who are planning to apply for Downs Fellowships (see #9), which fund summer research projects abroad.
First summer. First-year students may apply for Downs Fellowships to conduct research abroad during the following summer. Many of the projects become the basis for the thesis. Second year. Throughout

Visiting students from Yale talk with the families of patients, left, and explore the area surrounding Makarere University in Kampala.

your second year at Yale, you participate in a course called The Modules, studying mechanisms of disease

A Russian physician working with Yale residents and medical students looks over an X-ray while on rounds at Mulago Hospital in Kampala, Uganda, in 2007.

in 13 organs or systems. Included is discussion of illnesses that you would not nd in New Haven. Students may also choose clinically oriented elective courses in tropical medicine, pediatrics, and mental health. you will encounter patients whose paths to New Haven began in many varied parts of 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.
Fourth and fth years. Clinical electives Third year. During their clinical clerkships,

theyve learned at Yale in dierent settings. Theyll be seeing patients with dierent presentations of illness. Theyll develop an awareness of the social and political factors in health and disease. They learn a basic cultural competency. Most students receive nancial support for travel and living expenses associated with international clinical electives.

in Argentina, China, England, Peru, South Africa, Thailand, Uganda, and Zambia take students out of their comfort zone and put them into one of the most intense and thought-provoking experiences I have had in years, as one student put it. The international clinical electives are no vacation: attending physicians from Yale run many of the programs in resource-poor and highly stressed situations. The Internal Medicine rotation at Mulago Hospital in Uganda, for example, confronts students with the sickest patientsabout half of whom are infected with HIVin a country with an annual per capita income of $280. Robert Rohrbaugh, M.D., who heads the Oce of International Medical Student Education, lists some benets for students: Theyll be able to practice what
12

FELLOWSHIPS
Each year, the Wilbur Downs International Health Student Travel Fellowship supports 15 to 20 Yale students who undertake a summer of health-related research primarily in low- and middle-income countries. Downs Fellows carry out research in the context of their host countries culture, health problems, and resources, with the intellectual support and practical assistance of Yale faculty members. Students also have host-country sponsors who serve as mentors during their time abroad. Downs Fellows present their research ndings and experiences at a fall symposium and poster session. Many fellows further develop their studies into a thesis or dissertation. Recent research subjects have included circumcision and HIV prevention in Peru, lead exposure among children in Uganda, patient education about HIV in Vietnam, and emergency contraception in South Africa. 13

9. DOWNS

10. HAVEN FREE CLINIC

In the spring of 2004, Students volunteering at HAVEN Yale students in medicine, provide care free of charge to residents public health, nursing, and of New Haven the Physician Associate who lack health insurance. Program conceived of a free clinic to serve the neediest people of their city. By November 2005, the students had found space and nancial 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 clinics patients), and opened the doors of HAVEN, New Havens rst stationary free clinic for the uninsured. Today, HAVENwhich stands for Health, Advocacy, Volunteerism, Education, Neighborhoodis open every Saturday morning year round and helps hundreds of patients in the course of the year. Some students do their Primary Care Clerkship by volunteering at HAVEN; many more work there on an occasional basis. Because appointments normally last at least an hournot the usual 10 or 15 minutes allotted in standard practice settingsstudents as well as patients have an exceptional experience not often available in todays medical practices.
14

AND HOMELESSNESS

11. HUNGER

AUCTION

If youd like your medical school experience to include lessons in sushi making, belly dancing, or being a Southern gentleman, mark your calendar for the Hunger and Homelessness Auction. Yale health professions students organize a massive annual auction to benet local programs that serve hungry or homeless people. Massive is the operative word for the enterprise that nets as much as $30,000 for New Haven organizations annually. Lessons are a common auction item, as are homemade culinary treats. Popular faculty take high bidders out to dinner and an evening of theater. More conventional oerings

The annual studenthave included a week in a run auction raises London at and a vintage some $30,000 for service organizaEpiphone guitar. tions serving the The auction itself is the homeless and others in need. highlight of a year-round process where students raise awareness about the social and economic needs of New Havens diverse population. A student committee reviews grant applications from local non-prots to decide exactly how the auction proceeds will be put to work helping New Haveners. And while hunger and homelessness remain dicult problems to solve, organizers hope theyre challenges that, one day, will be going, going, gone.

15

it has clear implications for therapeutic interventions, and it has clear applications in the New Haven community. Clinical research is a crucial part of the translational process, and Yale has created a comprehensive infrastructure to support the movement of scientic discoveries from bench to bedside. Clinical trials that is, research with humansare complicated by the inescapable fact that you cannot control people the way you control laboratory specimens. The Yale Professor Linda Mayes, M.D., at the Child Center for Clinical Investigation brings Study Center has been studying the together the tools and sta needed to problems of mothers with substance abuse support clinical trials across the medical disorders in forming emotional attachments campus: expertise in areas from regulatory to infants and toddlers. When she wanted issues to biostatistical analysis, nursing to study the neural circuitry of parental and laboratory services, inpatient and outattachment in these cases, she began patient facilities, and community outreach the project under the auspices of the Yale specialists, to name a few. Center for Clinical Investigation. Her YCCI takes its charge a step further, project meets all the aims of the center: from bedside to community. Central it is innovative and important, it takes an to the centers mission is an emphasis interdisciplinary approach to a disease, on community-based research and

BENCH TO BEDSIDE

FROM

12.

Medical students engagement, with the goal take classes with of extending Yale ndings students in the Physician Associate to improve the health of Program, Public the region we are a part of. Health, Nursing, and the Graduate YCCIs eorts range from School. working with Yale Cancer Center on the creation of a statewide cancer network to collaborations with community-

By building bridges between departments and highways to core services, by breaking down barriers to collaboration, YCCI expands the possibilities for team approaches to the important health problems facing our nation.
Robert Sherwin, M.D., Director of YCCI

Linda Mayes, left, works with children in research correlating brain function and stress.

based partners, to advocacy on health policy issues. So far, the focus has been on ve main areas: cancer, obesity, diabetes, heart health, and sexual health. Crucial to both stages of YCCIs mission is training new generations of researchers in the theory and techniques of clinical, translational, and community-based research. The Robert Wood Johnson Clinical Scholars ProgramYales is one of only four in the U.S.trains physicians to think beyond healing the individual patient to healing the health care system itself. Research fellowships are also available to M.D. and M.D./Ph.D. students to support a year-long intensive training core in the YCCI. YCCI is the infrastructure of Yales culture of collegiality and creative interaction, says Robert Sherwin, M.D., director of YCCI. By building bridges between departments and highways to core services, by breaking down barriers to collaboration, YCCI expands the possibilities for team approaches to the important health problems facing our nation.

13.
HEALTH
During the Vietnam War, men who had served as corpsmen returned home with considerable skills. But there was no professional path to put those skills to use. Yale was one of the pioneers of the physician associate profession, admitting its rst class of PA students in 1971. The program trained them in trauma care, though today that role is much broader. Maximizing the strengths of each health profession and preparing students to practice in a team is a critical part of a Yale medical education. Some of the best teachers youll encounter will surely be fellow

TEAMS
students, and many of those will come from the PA Program, Department of Epidemiology and Public Health, or School of Nursing. Youll nd yourself in clinic alongside Yale students studying to be physician associates, midwives or nurse practitioners. You may do research with someone pursuing a public health degree. Health professions students also interact in social groups and in service projects, such as the HAVEN Free Clinic. You wont just leave Yale with ideas or theories about interdisciplinary practice; youll leave with experience. 17

16

14. .

Translational Research

BREAKTHROUGHS
Just a few of Yales medical rsts: 1896  Arthur Wright publishes rst X-ray in the U.S. 1942  First successful clinical use of penicillin in the U.S. 1942  First use of chemotherapy as a cancer treatment 1949  First articial heart pump prototype (now at the Smithsonian) Continuous electronic fetal heart monitoring invented

15.

To make translation work, you need a way to connect physicians and basic scientists, and that is best done by people with both interests who are willing to work in the middle.
Jordan Pober, M.D., Ph.D. Director of the Human and Translational Immunology Program

1957

How long does it take for a great idea in the labor a major nding that makes it to the cover of Natureto make a dierence in the lives of patients? That depends on the speed of translation. Jordan Pober, m.d., Ph.D., professor of immunobiology, dermatology, and pathology, often points out that, while current cell biology or genetics texts bear little resemblance to their mid-1980s predecessors, many sections of medical textbooks are much the same as students found them two decades ago. Pober was acutely aware of this knowledge gap early on, and in 2000 he founded the Interdepartmental Program in Vascular Biology and Transplantation (vbt), one of the nations rst research programs explicitly focused on translational research. Ten years on, vbt (now Vascular Biology and Therapeutics) is a vibrant program that includes 35 faculty members, drawn equally from basic science and clinical departments. Its a rich area of science at Yale, and one that
18

1960  First newborn intensive care unit 1975  Lyme disease identied at Yale 1978  First insulin pump for diabetes 1980  irst transgenic F mouse

matches dozens of Yale medical students with faculty mentors for thesis research. One of the original goals of the vbt program was to improve outcomes for organ-transplant patients by building on basic research. But in the eyes of Pober, translation is a two-way street: intimate knowledge of the biology of disease gained in the clinic must guide the future direction of basic biomedical research if the insights from laboratory experiments are to be speedily applied to clinical medicine. The example set by vbt, now headed by Professor of Pharmacology William C. Sessa, Ph.D., has inspired the creation of similar ventures in other elds. In 2006 the medical school launched the Program in Cellular Neuroscience, Neurodegeneration, and Repair (CNNR),

with a focus on Alzheimers disease, Parkinsons disease, and other neurodegenerative conditions. Pober now heads the program in Human and Translational Immunology (HTI), which has researchers working on human immunology connected with clinical researchers in a variety of medical departments. By removing roadblocks to clinical research, Pober, his HTI colleagues, and their students hope to see Yale discoveries turned into treatments for a wide range of diseases, from diabetes and cancer to heart disease and stroke. They are certain to change the course of science and medical care. Who knows? You might even help rewrite the next edition of that textbook.
Research in the Vascular Biology and Therapeutics program looks closely at the mechanisms present in the cells lining blood vessels.

1997  Discovery of a mechanism of protein folding, a step toward understanding neuro degenerative and other diseases 1997  Discovery of the mechanism of innate immunity 2008  Discovery of the rst reliable method for early detection of autism

1990s/ Discovery of the  2000s  genes responsible for responsible for high blood pressure, osteoporosis, dyslexia, macular degeneration, Tourette syndrome, and Crohns disease

From top: An X-ray made by Yale physicist Arthur Wright in 1896; Sewell articial heart prototype; the Lyme disease vector, Ixodes scapularis (or deer tick); mouse; DNA sequence.

19

SHOW

SECOND YEAR

17.

16. Yale-New Haven

HOSPITAL

The name says a lot: its both an internationally renowned university teaching hospital and a front-line city hospital. That means on rounds you will encounter patients from all economic strata, and you cant lose sight of the tremendous societal forces aecting health or the great variety of professional roles you take on with dierent patients.
20

Yale-New Haven With almost 1,000 Hospital is beds and 3,200 physicians, Connecticuts largest, with a Yale-New Haven serves Level 1 trauma more than 54,000 inpatients center and close to 1,000 beds. and over half a million outpatients each year. The hospital includes Yale-New Haven Childrens Hospital, Yale-New Haven Psychiatric Hospital, and Smilow Cancer Hospital. The National Institutes of Health have recognized these facilities for the excellence of the Cancer Prevention Research Unit, Cancer Information Service Center, Comprehensive Cancer Service, Digestive Disease Research Center, Child Health Research Center, Clinical Research Center, and Claude D. Pepper Older Americans Independence Center. In part because of the emphasis on translational research in the School of Medicine, the schools relationship with Yale-New Haven Hospital is a particularly collaborative one when it comes to building clinical programs. Physicians and scientists work closely and respectfully, and medical students on rotations are encouraged to participate in deliberations.

ANTI BIOTICS
Thomas Steitz In 2009, Thomas A. Steitz, received the Ph.D., won the Nobel Prize 2009 Nobel Prize in Chemistry for untangling in Physiology or Medicine from a mystery. His models of His Majesty King XVI Gustaf the ribosomethe organelle Carl of Sweden. responsible for manufacturing proteinslook like many skeins of brightly colored yarn, hopelessly knotted and intertwined. The Sterling Professor of Molecular Biophysics and Biochemistry set out to map the ribosome, an enterprise that involved plotting every twist and turn. It seemed a little like climbing Mount Everest. We knew it was doable in principle, but we did not know if we would ever get there, he reected. He led an interdisciplinary team to that summit and produced the rst map of the ribosomes large subunit in 2000. Understanding its structure has already led to the development of a new class of antibiotics, currently in clinical trials, that targets bacterial protein synthesis. The new drugs may prove eective as a new weapon in the battle to conquer drug-resistant infections.

THE NEXT BIG THING IN

18.

Students come to Yale to study with some of the greatest names in medicine. But on two magical nights in February, they are clearly emulating Stephen Colbert and Weird Al Yankovic. The Second Year Show is a collection of song parodies and comedy skits in which other medical school classesand more often facultyget spoofed. The humor is entirely affectionate, if not entirely tasteful. Professors attend the show and sometimes even pay for the privilege of playing themselves on stage. But the organizers

and stars are second-year students. The show is a chance for them to have fun and blow off some steam together before studying for the boards and going their separate ways to clinical clerkships. The shows tradition stretches back at least to 1949 with The Four Years for What Follies. Dean Vernon W. Lippard threatened to cancel it in the 1950s after an especially PG-13 production. Students had reportedly passed the bedpan to solicit money at the show. Today, ticket sales go to support New Haven charities.

21

CARE AT YALE
A quarter of a million oce visits each year. Another 129,000 adult and pediatric emergency visits. Over 50,000 inpatient stays. Yale physicians oer advanced care in more than 160 clinical specialties and subspecialties, drawing patients from around the world. Yale medical students have broad opportunities to learn the art of medicine from outstanding doctors working in the nest of facilities and, even more important, working in multidisciplinary teams to provide the most seamless, comprehensive care possible. At the head of this operation is David Paige Smith Professor David J. Leell, M.D., who serves both as CEO of the Yale Medical Group and deputy dean for clinical aairs. He manages to fulll these functions while maintaining a busy skin cancer practice using the sophisticated Mohs surgery techniqueand a research agenda as well. What makes Dr. Leell such a convincing advocate for clinical excellence is his own commitment to giving priority to the needs of his patients. He is working hard to see that vision of medicine instilled in all aspects of physician training at Yale.

CLINICAL

19.

AIDS Care Program Shortly after the Centers for Disease Control rst identied AIDS in 1981, Yale-New Haven Hospital set up the AIDS Care Program, one of the rst in the nation. The program has become a model for the provision of 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 to assessing the best approaches to cardiac treatment, and its interventional cardiology service has one of the best door-to-balloon times in the country. Medical students learn state-of-the-art care in the catheterization lab, which conducts 3,100 procedures a year, and on the electrophysiology service, which offers radiofrequency ablation, focal atria and pulmonary vein ablation, trans-septal catheterization, and debrillator implantation. Yale Craniofacial Center Cleft lips and palates are the most common disguring craniofacial anomaliesproblems in the growth of the bones of the head. Yales Craniofacial Center, led by John Persing, M.D., is internationally recognized for its advanced, multidisciplinary approach to craniofacial deformities, from the most common to the rarest.
Medical students get hands-on clinical experience such as the rapid cooling procedure for cardiac patients, aboveas they rotate through services including medicine, pediatrics, and surgery.

Outpatient parathyroid surgery Carmalt Professor of Surgery Robert Udelsman, M.D., M.B.A., thinks about every surgery he performs on at least ve different levels at once. How can he make this procedure faster and surer? What can students learn from this procedure? How can the hospital be more efcient? How can we better manage all aspects of the patients dealings with the hospital, from parking to scheduling? How does this procedure advance our scientic understanding? Underlying every one of those questions is his sensitivity to the entire experience of the patient, and the future patients of the doctors he trains. 23

22

ADVISORS
In a program as individualized as Yales, students need advisors to make sure they get exactly what they want and need from their medical education. YSMs mentoring program works in many dimensions: > Each student works with an academic advisor over the four or ve years of medical school, meeting one-on-one and in groups to discuss their program of study. The advisor writes the students deans letter for residency applications in the nal year. > Advisee groups get together regularly, providing an opportunity for students at different stages of their education to interact more closely and to mentor their peers. > The program complements other mentoring activities, in particular the guidance provided by thesis advisors for student research (#44) and by clinical tutors, who work with students in groups of four during the rst two years (#36).
Students work closely with faculty members in planning their student research projects and in charting their overall program of study.

20.

RECOG NITION
Yale University faculty are among the worlds most accomplished biomedical scientists and physicians.*

21.
1

in NIH research funding per faculty member

Nobel Prizes

Howard Hughes Medical Institute Investigators

17

Members of the National Academy of Sciences

60

Members of the Institute of Medicine

39

22.

HIGH-END

INSTRUMENTATION
At Yale, you work with the best technology in the lab and the clinic. Richard Lifton, M.D., Ph.D., recently took advantage of that fact with lifesaving results. A 5-month-old boy couldnt gain weight and was dangerously dehydrated. His medical team in Turkey asked Lifton, who is chair and Sterling Professor of Genetics, to search the infants DNA for a marker that would help them diagnose the illness. Half a world away, Liftons group determined that the baby had congenital chloride diarrhea, which is manageable with diet and medication. The case, using next-generation DNA sequencing to quickly and completely map the infants exome, marked the rst time that a patient has been diagnosed, and

Active patents for Yale inventions

352 45

Yale-founded biotech companies in greater New Haven

$557.9 million
Total medical school research funding from...

treated, based on a compre- The Yale Center for Genome hensive genetic scan. Analysis is located That giant step for medi on West Campus. cine was made possible by the Yale Center for Genome Analysis, uniquely equipped with 12 Illumina sequencing machines. The machines dramatically accelerate the process of gene sequencing and yield results that will be aordable enough to be used clinically in the not-too-distant future. The center is indispensible to researchers studying the genetic basis of disease. Projects focusing on multiple sclerosis, autism, and addiction all rely upon it. Core research facilities like the Center for Genome Analysis provide faculty and students throughout Yale with the sophisticated technology and expert consultation they need to advance science.
Other cores include: Proteomics Cell, Molecular, MR, and PET Imaging Cell Sorting/Flow Cytometry High-Throughput Cell Biology Small Molecule Screening Biostatistics & Informatics

grants and contracts

*data as of 6/30/10

2,033

24

25

23.

EMERGENCY MEDICINE

Professor Gail DOnofrio, m.d., chair of the Department of Emergency Medicine and chief of the Emergency Department at YaleNew Haven Hospital, chose her eld for the excitement and satisfaction of saving lives in crisis situations. Yet today she focuses as much on preventing emergencies as responding to them. In the Yale tradition, she greets every conditionindividual or socialwith 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 dierence? 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, Yales 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, epidemics, and screening for substance abuse. As the point of access to the health care system for millions of people, emerThe Emergency gency departments confront Department at Yale-New Haven and help manage a host Hospital handles 100,000 adult of social issues. Emergency visits a year and is medicine may be the ultithe point of entry to the health care mate example of thinking system for many patients. globally and acting locally.
26 27

24.
THE

as autism, Tourette syndrome, mental retardation, and obsessive-compulsive disorder. A molecular neurobiology lab is studying memory at the level of proteins. A developmental neurobiology lab is examining the relationship of genetics and environment in the development of the brain. These and other projects are under way around the corner from the National Center for Children Exposed to Violence, which continues its pathbreaking collaboration with the New Haven police. Others include 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 childrens 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 exemplies the collegial, anxiety disorders, and child developthe center has available today, however, interdisciplinary, translament, following in were unimaginable when the center started. tional, community-minded the footsteps of Arnold Gesell, who Currently, the centers neurogeneticists are approach of the Yale School founded the center a century ago. searching the genetic basis of such disorders of Medicine.

OF CHILDREN

MENTAL HEALTH

THE CADAVER BALL

25.

STEM CELL
PROGRAM
The Cadaver Ball, which marks the end of the anatomy course, is an annual highlight not just for rst-year students but for faculty and students from other parts of the university.

26.

When the federal government limited its Embryonic stem 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 more than $13 million to Yale. So when President Obama expanded federal funding in the spring of 2009, the Yale Stem Cell Center was in full operation: new core facilities had been set up (YSCC) for stem cell culture, imaging, cell sorting and analysis, and genomics; 12 labs at Yale were involved in stem cell research; and about 40 faculty members throughout the university were aliated with the YSCC. Director Haifan Lin, Ph.D.whose work was listed by Science as one of the top 10 breakthroughs of 2006says, Few other places have been focusing on really understanding 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.
29

28

27.
A CLOSER

BOND

Whats so great about the school is that its based on relationshipsbetween 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 function with faculty, some of whom helped establish the eld of modern cell biology.

30

31

28. FINANCIAL

Medical education is not cheap, and medical student debt is a growing national problem. That said, graduates of the Yale School of Medicine end up with less debt, on average, than graduates of other private

AID
29. SCHOOL OF
HEALTH

or public medical schools, because of a generous, need-based nancial aid program. The program aims to make it possible for any accepted student to attend the school without hardship; 80 percent of our students receive nancial aid. No nancial 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 unit loanthe amount that a student must borrow before becoming eligible for scholarship fundsis among the lowest of any medical school, and numerous grants enable all students to take advantage of a rich array of elective opportunities without taking on additional debt.

30.

MATCH DAY

PUBLIC
Founded in 1915, Yales School of Public Health is one of the oldest nationally accredited public health schools in the country. Its also a department within the medical school. The school has an extensive faculty with diverse interests, divided among ve academic divisionsBiostatistics, Chronic Disease Epidemiology, Environmental Health Sciences, Epidemiology of Microbial Diseases, and Health Policy and Administrationand programs in Health Management and Social and Behavioral Sciences. It also oers a Masters of Public Health concentration in Global Health. Recently, the School of Public Health began to oer the Advanced Professional
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M.P.H. Program, providing rigorous public health training to individuals with a doctoral-level degree in a eld related to public health and to medical students who have completed their third year. Students generally spend an intensive summer term and two regular, full-time academic terms in the program, which aims to train leaders in the many elds of public health. The schools longtime leadership in public health policy and in global health initiatives makes it a special asset to students in the School of Medicine.

Public health students conduct mosquito research in the Caribbean, as part of an ongoing research project directed by Professor Durland Fish.

Match Day is always a Yale medical students have an joyful moment at Yale. Our extraordinary track record after students have a strong graduation, placing record of residency placein the nations top residency ments in the wide variety programs. of venues they seek out. Medical school at Yale prepares them for the nations most competitive residency programs, as reected in the list at right. Yale graduates continue on to succeed in a diverse array of careers, including all the clinical subspecialties, health care policy, biotechnology, international medicine, and leadership in academic medicine. Approximately 25 percent of the schools alumni hold faculty positions.

Top 15 hospitals the Class of 2010 are attending for internship/residency: Harvard Afliated Hospitals 35
 righam and B Womens Hospital 16  assachusetts M General Hospital 9  eth Israel Medical B Center 5  arvard Longwood H Training Program 3  assachusetts M Eye & Ear Inrmary 1  hildrens Hospital C of Boston 1  Yale-New Haven

University  Hospital 

of California, San Francisco 7 of the University of Pennsylvania 5 Memorial Sloan-Kettering  Cancer Center 5 Stanford  New  University Programs 4 York Presbyterian Hospital, Columbia 4 Hospital  of St. Raphael 4 Johns Hopkins Hospital 3  University  of Southern California 3 Percent of class attending these hospitals 78%

Hospital 15

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JOINT DEGREES
In addition to the M.D./ Ph.D. program (See #39), joint degree programs in collaboration with Yales other outstanding graduate and professional schools are attractive options for many students. The possibilities include: M.D./J.D. Prospective students must apply separately to the Yale School of Medicine and Yale Law School for the six-year M.D./J.D. joint degree program. M.D./M.B.A. See #33 M.D./M.DIV. Students apply to the six-year joint degree program with the Yale Divinity School for a variety of reasons, from an interest in bioethics to an intention to conduct international missions of healing. M.D./M.H.S. See #32 M.D./M.P.H. Several students each year enroll in a ve-year program that gives them a Master of Public Health degree along with their M.D. degree. The program is designed for students interested in biostatistics, epidemiology, and health care management, and other aspects of public health.

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MD/MHS
PROGRAM
In medical school, Matthew Vestal, M.D. 10, M.H.S. 10, learned that one form of epilepsy may be preventable. The world learned it, too. Vestal was part of a team whose research showed that rats with a predisposition to absence epilepsy never developed severe seizures if given anticonvulsant medications early enough. Even after the medications stopped, the rats seizures were greatly reduced. It was the rst time any form of epilepsy had been prevented. Vestal graduated with an M.D. and a masters degree in health science research. The ve-year program features an intensive research experience. The nal year is fully funded through fellowships arranged by the Oce of Student Research. Vestal wanted to bridge the divide between laboratory research and clinical care. Though children outgrow absence epilepsy, they are left with a high risk of teen pregnancy, alcoholism, and other problems. Vestal led human neuroimaging studies aimed at detecting risk early, when preventive treatment is eective. He was the driving force; it was his project, says his faculty mentor, Hal Blumenfeld, M.D., Ph.D., professor of neurology, neurobiology, and neurosurgery. The M.D./M.H.S. program oers access to resources and a wealth of faculty guidance, but students design their own projects. There is no other place that I know of that has this kind of operation, says Blumenfeld. Planning a career in academic medicine, Vestal already has publications and the experience of writing a successful million-dollar grant with Blumenfeld. His Howard Hughes Research Training Fellowship provided support for him to attend conferences, where he was often Matthew Vestal, matched in a presenter. He says he was able to capitalize who neurosurgery at Harvards Brigham on the opportunities he found here to get a and Womens head start in academic medicine. The world of Hospital, talks about his fth-year medicine is full of urgent problems begging project with mentor solutions, and Yale, he says, is your oyster. Hal Blumenfeld.

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33.
MD+MBA
Vivek Murthy, m.d./m.b.a. 03, gives his patients his best: some days, as an academic hospitalist at Bostons Brigham and Womens Hospital; others, as a social entrepreneur changing health care delivery. Yale prepared him to marry both halves of his life into a powerful whole. I was able to actually see opportunity more clearly in the world around me, explained Murthy. I saw opportunities for creating change, both in the hospital and in the world outside. He co-founded Doctors for America, a non-prot that engages physicians and medical students in shaping health care policy. The idea came to him during the 2008 presidential election while listening

Vivek Murthy at a Doctors for America press conference during the health care reform debate.

to campaign leaders, with not a physician among them, debating competing national health care reform plans. He also cofounded a social network for scientists, Epernicus, to connect researchers and facilitate collaboration. Customized versions are used by Glaxo-Smith Kline and others. Finally, hes developing systems to increase eciency and safety in clinical research. Most m.d./m.b.a. graduates, like Murthy, remain in clinical medicine, said Program Director Howard Forman, m.d., m.b.a. The ve-year curriculum of classes, internships, and international experience positions them to have a strong and immediate impact. The experience catalyzes your career, says Forman, a professor of diagnostic radiology and public health. Students have extended interactions with health policy leaders, for example, White House Special Advisor Ezekiel Emanuel, m.d., and former Food and Drug Commissioner David Kessler, m.d., also a former dean of the School of Medicine. But Murthy was most inuenced by his classmates. I derive a lot of motivation from meeting other problem solvers, he said.
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Even if you are not a joint degree student, opportunities for interdisciplinary work abound both within the medical school and across Yale. A small sample of the many possibilities: Advanced Clinical Elective in Law and Psychiatry, in which fourth-year medical students participate in competency to stand trial evaluations at the New Haven Correctional Center. School of Forestry Environment and Health Initiative. Medical students may take courses at the School of Forestry and Environmental Studies in the environmental health concentration. This concentration encourages course work and research that explore relationships among environmental quality, human health, and public policy. Yales Rudd Center for Food Policy and Obesity brings together faculty from Arts & Sciences, the Law School, the School

INTER DISCIPLINARY STUDIES

of Management, and the Forestry School as well as the medical school to improve practices and policies related to nutrition and obesity. Kelly Brownell Ph.D., founder and director of the Rudd Center, was named one of the 100 most inuential people in the world by TiME magazine for his work in the area. The Health Diplomacy Initiative at Yale is inspired by the vision that health can and should have a more prominent role in international relations and foreign policy. This initiative engages medical and public health scholars alongside social scientists, economists, legal scholars, and activists, and draws from elds such as health and human rights. The Yale Interdisciplinary Center for Bioethics attracts scholars from the elds of medicine, law, religion, and environmental studies to look at issues ranging from Post-Traumatic Stress Disorder to animal rights.
Cardiologist Forrester Lee is the associate dean for multicultural affairs. His ofce provides educational support and serves as a touchstone for student groups promoting diversity.

DIVERSITY
Forrester Lee, M.D., a cardiologist and the associate dean for multicultural aairs, describes telling an African-American patient that he needed a new heart. And he looked at me and said, They dont transplant black people, and I looked at him and I said, Youre kidding, do you really believe that? And he did. So it was a very, very joyous day in my life to walk into his room and say: We have a heart for you today. Believe it.

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Dr. Lee knows that members of minority communities often bring particular concerns and face special challenges along with the universal demands of professional training. Since 1988, the Oce of Multicultural Aairs has provided support for minority students and worked to increase sensitivity to minority concerns in the medical school as a whole, recognizing that a diverse student body helps train doctors for the pluralistic world in which they will serve. Under Dr. Lees leadership, the oce conducts recruitment, retention, and outreach programs. It provides educational support and serves as a touchstone for student groups such as the Yale Student National Medical Association (twice in recent years the Chapter of the Year of the

national SNMA), Asian Americans in Yale Medicine, and the Latino Medical Student Association. The universitys Oce of LGBTQ Resources coordinates support for the campus lesbian, gay, bisexual, transgender, and queer community. These groups provide forums for discussion, an organizational structure for service to the school and the New Haven community, and academic and social support programs for individual students. Other associations throughout Yale University including cultural centers, religious organizations, and a wide variety of student societiesoer students a wide network of contacts and support.
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PTSD RESEARCH AND EXPERTISE IN

NEUROSCIENCE
Emily Dickinson said, The brain is wider than the sky. The truth of that saying is more than poetic. The brain is vast and largely uncharted territory. Yale is full of explorers. Yales strength in neurobiology, neuroimaging, genetics, and related elds is helping researchers map that territory. Better understanding of brain physiology and function have resulted in new treatments for dyslexia and schizophrenia. It is unraveling the complex factors that contribute to addiction and is pointing to strategies that can improve success in recovery. Today there is particular urgency to increase understanding of post traumatic stress disorder. Yale psychiatrists have done work on the disorder since the early 70s, before it even had a name. As veterans from

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At YSM, you meet your rst patient in your second week of school. You wont wait until youve heard a year or two of lectures on doctoring before you see a patient, says Margaret Bia, M.D., director of the Clinical Skills Training Program. Yale medical students take a Preclinical Clerkship, in which they meet weekly during their rst two years, in groups of four, with their clinical tutor, who observes them taking histories and performing physical exams. You can imagine how intense that mentoring relationship becomes, 38

PATIENTS FROM DAY ONE

says Bia. Students learn communication skills, from social-history-taking to breaking difcult news. They confront standardized patientsactors who play the part of patientsas well as real ones. By the time they get to Step 2 of the U.S. Medical Licensing Exam, in which they examine 10 standardized patients in a day and formulate diagnoses and treatment plans, our students are well prepared.
Helping a young patient at YaleNew Haven Hospital (above)

the wars in Afghanistan and Iraq return home, many suering from PTSD, Yale is expanding clinical care and research to better serve them. Yale investigators at the Clinical Neuroscience Division of the VA National Center for PTSD, located at the VA Connecticut Healthcare System campus in West Haven, Conn., have established a partnership with psychiatrists at Fort Drum in upstate New York to study how troops react to combat experiences. Meanwhile, clinicians at the VAs West Haven campus have expanded their sta to care for an inux of veterans needing treatment for anxiety and PTSD. PTSD represents a complex interrelationship between mind and brain, experience and neurobiology. Under standing the physiological changes that underlie PTSD is leading psychiatrists to new treatments. Yale researchers have already identied a gene that increases susceptibility to PTSD and The Department of Psychiatry, are in the midst of clinical which pioneered trials of medications they studies of PTSD and other hope will provide improved disorders, has expanded its symptom relief. clinical services For John Krystal, M.D., for returning veterans at the Robert McNeil Jr. Professor VA hospital in West Haven. of Translational Research and chair of Psychiatry, this is an essential mission. We are at a critical moment in the lives of the soldiers who have made sacrices on behalf of every American citizen, he said. We as a country have to decide whether we are going to return the favor by supporting our soldiers and respecting the sacrices they have made by making sure they get the treatment they need and by making sure we can improve the treatments we are oering them.

MOLECULAR
SCIENCE
A basic mystery of bio The chaperonin molecule GroEL chemistry is this: How do and co-chaperonin GroES help newly synthesized proteins proteins fold fold into their mature, properly. functional shapes? Arthur L. Horwich, M.D., Sterling Professor of Genetics and HHMI Investigator, discovered a molecular machine called the chaperonin that helps the process along within cells. Recently, his research on chaperonins has led him to study human neurodegenerative disorders such as Lou Gehrigs disease (amyotrophic lateral sclerosis), in which proteins misfold and aggregate. Dr. Horwich uses experimental approaches ranging from crystallography to transgenic model systems in his eorts to see something thats not been seen before.
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BreakTHROUGH

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

TRAINING PROGRAM

MEDICAL SCIENTIST

People hear Yale and they think its going to be intimidating. They dont realize how incredibly accessible the faculty is, and how easy it is to get matched with a lab.
The National Institutes of Health supports the training of M.D./Ph.D. 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 students means that M.D./Ph.D. students experience collaboration at its best. Yales exibility allows students to tailor programs to their individual interests. And because the M.D. curriculum already integrates thesis research with clinical work, it is conducive to a joint degree program. Through the Medical Scientist Training Program, M.D./ Ph.D. students receive nancial 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 Anglique Bordey.

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BIOMEDICAL ENGINEERING
As a resident in anesthesiology in the mid-1990s, Laura Niklason, M.D., Ph.D., had an idea. In the operating room, she would witness vascular and heart surgeons searching their patients for spare veins to use as grafts, often nding only vessels of very poor quality. Id think, if we could grow new arteries, then we wouldnt have to harvest them from patients and subject them to such an invasive procedure. At the time, researchers were just starting to understand how to get blood vessel cells to form microscopic tubes in a petri dish. In addition to her residency, Niklason was working as a postdoc in Robert Langers lab at MIT. One day she walked into Langers oce and announced, Im going to grow an artery in the laboratory. He said, Thats great, Laura. You do that. It took a while, but in the third year of her project, Niklason began to make progress. She seeded blood vessel cells onto polymer tubes and pumped a nutrient solution through the tubes. By mimicking the natural forces that blood generates when it ows through real vessels, she had found a way to produce strong, supple articial
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arteries. Since coming to Yale in 2006 as an associate professor of biomedical engineering, she has had a chance to develop her work further in animal models, to create vessels that can be stored for implantation into any patient at a later date. Her research has expanded to include the engineering of lung tissue. Biomedical Engineering at Yale, says department Chair Mark Saltzman, Ph.D., has two related goals: rst, the use of the tools and methods of engineering to better understand human physiology and disease; second, the development of new technologies for diagnosis, treatment, and prevention of human disease. Saltzman himself has focused on new technologies for time-release drug delivery, including a method for delivering chemotherapeutic drugs directly to brain tumors. Other researchers are developing new methods of diagnostic imaging, vaccine and drug delivery, and tissue engineering for applications from spinal cord repair to liver transplantation. We have cell biologists and immunologists and surgeons and pathologists and bioengineers all working together in an ideal environment for interdisciplinary work, he says. I think Niklason, thats a very rare happening Laura above. Mark Saltzman, below. among universities.

At Yale School of Medicine, investigators have identied genetic bases for: Hypertension Dr. Liftons genomic analyses of extreme cases of disease in patient populations around the world, which have become a model for gene hunters, have revealed more than 15 genes that are crucial in the regulation of blood pressure and the bodys salt balance. Crohns disease Associate Professor Judy Cho, M.D., who made the rst identication of genes involved in inammatory bowel disease (IBD), recently identied a gene mutation that can protect against Crohns disease, one form of IBD. Tourette syndrome In a nding named a top scientic breakthrough by the journal Science, Donald J. Cohen Associate Professor Matthew State, M.D., Ph.D., and Associate Professor Nenad Sestan, M.D., Ph.D., identied the rst genetic mutation associated with Tourette syndrome. Macular degeneration In pioneering wholegenome association studies, Associate Professor Josephine Hoh, Ph.D., and her colleagues have identied genes that raise the risk of age-related macular degeneration, the leading cause of blindness in the developed world.

Polycystic kidney disease The most common life-threatening genetic disorder, PKD can result from gene mutations identied by C.N.H. Long Professor Stefan Somlo, M.D., under an NIH grant that made Yale a Center for Excellence in the study of the disease. Dyslexia Associate Professor Jeffrey Gruen, M.D.s discovery of a gene involved in dyslexia may make it possible to screen for individuals whose reading ability is impaired and to provide early educational interventions. Intracranial aneurysms Large-scale studies led by neurosurgeon-geneticist Murat Gnel, M.D., and Dr. Lifton uncovered genetic regions in which variants confer a high risk of these deadly malformations of brain vasculature. Heart disease/ metabolic syndrome Cardiologist Arya Mani, M.D., and colleagues discovered that one amino-acid substitution in a single gene causes a rare form of early heart disease and metabolic syndrome, providing clues to the causes of more common forms of these diseases. Revolutionaries like these on the front lines of molecular genetics make Yale an exhilarating place to enter the fray.

DISEASE, GENES, GENOMES

Chair and Sterling Professor of Genetics Richard P. Lifton, M.D., Ph.D., calls the charting of the human genome one of the great revolutions in the history of medicine, and you can be part of the advance teams working Zebrash embryos, at Yale. The latest gene an important model sequencing tools are allowsystem in genetics, labeled ing scientists like Dr. Lifton are with green uores to nd rare genetic variants cent protein in Embryonic Dance, that contribute to disease an artistic rendering microRNA in ways that were impossible by researcher Antonio Giraldez. just a few years ago.

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44. THE THESIS

Since 1839, the Yale School of Medicine has required M.D. students to complete a thesis based on original research. The thesis requirement grew out of the recognition that the scientic process of investigation, attentive observation, interpretation of data, and critical evaluation of literature are as fundamental for a doctor making a diagnosis as for an investigator advancing the frontier of medicine. Thesis projects also have a hugely benecial side eect: by the time they apply for residencies, all students have worked very closely with at least one member of the faculty, who can therefore report in convincing detail on the students abilities. What makes it work is the faculty-student pairs. Its a great synergy, said John N. Forrest Jr., M.D., director of the Oce of Student Research. The value of the thesis is not the concept of trying for a scientic career, but to teach that all physicians are scientists. Students have written their theses on topics including From Mueller to Miller: Determining Standards for Decisions Regarding Critically Ill Newborns to Mitral Cell Dendritic Development in the Mouse Main Olfactory Bulb and from Thinking Outside the Black Box: Current Policies Medical students get a chance to and Problems with FDAs Highest Drug present and discuss Safety Warning to The Role of Matrix their thesis work at Student Research Metalloproteinases in Axon Guidance Day, which takes place each May. and Neurite Outgrowth.
The schools Ofce of Student Research provides guidance and nancial support, including: > Assistance in identifying research topics and nding mentors > An annual Student Research Day poster session and presentations, followed by the Farr Lecture by world-class scientists > Summer research stipends and short-term student research stipends > One-year student fellowships, which enable students to spend a fully funded fth year doing laboratory, translational, or clinical research. Farr Lecturers Arnold Relman Anthony S. Fauci Sidney Altman Sydney Brenner Joseph L. Goldstein Francis S. Collins Judah Folkman Alfred G. Gilman Robert J. Lefkowitz Richard P. Lifton Paul Greengard Edward J. Benz Jr. Story C. Landis Arthur Horwich Jeffrey Friedman Jack Elias David Nathan Stuart Orkin Lewis Landsberg

NEW ENGLAND
No one tells you how beautiful New Haven is, or the area around the city. In 10 minutes you can go for a walk on the from top: beach in the summer, or pick Clockwise Sleeping Giant State Park; Lighthouse apples in October, or crossPoint on Long Island Sound; the country ski in the winter. New Haven Green, the center of the Spring is just plain gorgeous. citys nine squares.
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PIZZA
DEBATE
It is a truth universally acknowledged that New Haven has the best pizza in the United States, maybe the world. But Pepes or Sallys? Well just have to keep testing them both until that question is resolved.*

THE GREAT

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* Hey, what about Modern on State Street?

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A CLOSE-KNIT

COMMUNITY

We dont think of patients as collections of body parts, and we dont think of doctors that way either. For that reason, we encourage our students to reect on all aspects of their training and practice, from power relationshipswith patients, with colleagues, with superiorsto 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 compassionate care at the end of life.

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 Conventional microscopy is limited in resolution by the diraction limit of light (about 200 nanometers), and small details are lost. Various new nanoscopes beat the NEXT-GENERATION light barrier and oer high resolution, 3-D views of living cells over time. Researchers can observe and manipulate basic biological processes on the organelle and molecular 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 If people are interested in cutting-edge tech- to have these technologies; it is improving nology for looking at processes in living cells, them. Scientists like Toomre and Bewersdorf Yale is the place to go, says Derek Toomre, are working to make it faster and more usePh.D., associate professor of cell biology. ful to researchers. Hes walking through the Sterling Hall of The late George Palade, a Nobel laureMedicine alongside Joerg Bewersdorf, Ph.D., ate who founded the Department of Cell another expert in super-resolution imagBiology in the 1970s, pioneered electron ing who recently joined the faculty. They microscopy. The departments history pass labs where extremely sophisticated combines excellence in imaging with microscopes are pampered in spaces that fundamental discoveries. Todays research absorb vibration and precisely control using Yales super-resolution capabilities temperature. All this space, equipment, has implications for neurological disorders, and talent at Yale is dedicated to a single cancer and type 2 diabetes. Seeing life purpose: Catching life in actiondown in unprecedented detail may help answer to the level of single molecules. some of medicines biggest questions.

OPTICAL IMAGING

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YALE PROGRAM ON

AGING
The cutting edge doesnt have to be high tech. Mary Tinetti, M.D., for example, has been studying ways to reduce the risk of falls among the elderly. Such routine health issues have long been overlooked in medical research, but Tinetti, a MacArthur fellow and director of the Yale Program on Aging, designed a clinical study that Mary Tinetti, M.D., director demonstrated how a set of ordinary interof Yale Program on Aging ventionsincreased hydration, exercises, changing doses of medicationscould signicantly reduce the rate of falls and prevent future disability and functional decline. Published in the New England Journal of Medicine and other journals, Tinettis work could improve millions of lives. Such close attention to the patient, questioning of assumptions, and creative thinking about how to improve life for a broad populationthese have been the hallmarks of the Program on Aging for decades, and they are the under lying lessons of a Yale medical education. One clinical counterpart to the Program on Aging is the Dorothy Adler Geriatric Assessment Center at Yale-New Haven Hospital. The Adler Center sta of geriatricians, 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 hospitals Acute Care for the Elderly Unit, which integrates the work of specialists from many elds 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.
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INTEREST
GROUPS
Students form new interest groups each year; this is the list in 2010 Bioethics Emergency Medicine Environmental Health Family Medicine Geriatrics Nathan Smith Club (History of Medicine) Integrative Medicine Internal Medicine Nutrition and Medicine Ob/Gyn Pediatrics Physician Scientists Neurology Surgery Wilderness Medicine Womens Health

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Students interested in the cutting edge of cell imaging have the opportunity to do research with scientists who are pushing the limits of the eld. The device at left is a Leica STED super-resolution microscope, one of only three in the United States in 2010.

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IMMUNOBIOLOGY

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Yale wrote the book on it: In 1988, Chair Richard Flavell Janeways Immunobiology has founded the rst academic unit in outlived its original lead the U.S. devoted author, the renowned Yale to research in immunology. He professor Charles Janeway, also plays a rauM.D., but still carries his cous lead guitar in a biorock name. Janeway was part band called the Cellmates. of the exceptional group of immunobiologists that has made Yale a leader in studies of the immune system, from the molecular level to the therapeutic. Janeway himself pioneered exploration of the innate immune system (the power behind the adaptive immune system). In the 1990sa dark time for the sciences in RussiaDr. Janeways work found its way into the hands of Ruslan Medzhitov, Ph.D., then a graduate student at Moscow University. Janeways theories about the immune system put Medzhitov on a career path that led eventually to Yale, where he and Janeway discovered the role of Toll-like receptors as the central players in the innate
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immune system. Today, as the David W. Wallace Professor of Immunobiology at Yale, Medzhitov is exploring the possibility that Toll-like receptors trigger chronic inammation that is at the root of diseases from coronary artery disease to Alzheimers. Throughout the department, faculty are working on basic science with highly practical application. For example, Sterling Professor Richard Flavell, Ph.D., was awarded $17 million in the rst round of the Gates Foundations Grand Challenges in Global Health grants, to generate a mouse with a rudimentary human immune system that could be used in testing vaccines against diseases prevalent in the developing world. The project ts Dr. Flavells denition 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 will allow researchers to pretest weakened live vaccines for safety and eectiveness before human trials with an unprecedented level of condence. Yales Department of Immunobiology one of the few freestanding immunobiology departments in the worldis now looking at the molecular, cellular, and genetic mechanisms of u, AIDS, Lyme disease, genital herpes, chlamydia, asthma, and autoimmune diseases, including inammatory bowel disease, diabetes, systemic lupus erythematosus, and multiple sclerosis. They are also studying the role of immunology in organ transplantation and graft versus host disease and developing ways for the immune system to attack tumors. With a distinguished faculty, a long-standing partnership with the Howard Hughes Medical Institute, advanced facilities in the medical schools newest buildings, the department oers unmatched training in the basic and translational science of immunology.

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CULTURE
The Yale University Art Gallery, left, has works by Monet, Degas, Cezanne, and van Gogh in its collection. Below: A production of Pop!, an Andy Warholinspired musical and whodunit, at the Yale Rep.

New Haven is a small city, but that only means that its world-class museums and galleries, its great repertory theaters, and its active schedule of festivals are all aordable and easily accessible. There is more music, art, lm, and drama in any given week than you can possibly t in your schedule.

Museums & Galleries Beinecke Rare Book & Manuscript Library Creative Arts Workshop Eli Whitney Museum John Slade Ely House New Haven Museum and Historical Society Peabody Museum of Natural History Yale Center for British Art Yale Collection of Musical Instruments Yale University Art Gallery (above)

Theatre Little Theater Long Wharf Theatre Shubert Performing Arts Center The University Theatre Yale Cabaret Yale Repertory Theatre (left) Festivals Celebration ofAmerican Crafts, Nov.Dec. Cherry Blossom Festival, April International Festival of Arts and Ideas, JuneJuly Concerts on the Green, July New Haven Jazz Festival, August 51

ALUMNI
This is an audacious undertaking, declared NIH Director Francis Collins, M.D., Ph.D., back when he signed on as head of the Human Genome Project. Perhaps you cant teach NIH Director audacity, but at Yale we certainly encourFrancis Collins. age it. Thats one reason this relatively small medical school has such a long list of distinguished alumni. If youre around on reunion weekend or browsing the pages of the alumni magazine, youre likely to meet a head of state, a college president, a U.S. senator, or one of the many medical school deans, biotech innovators or health system reformers who studied at the Yale School of Medicine. (Collins got his Ph.D. at Yale and was a postdoctoral fellow in Human Genetics at the medical school in the early 1980s.) Some say Yale physicians thrive in leadership roles because the Yale System prepared them to be independent and original thinkers. Others believe the schools commitment to service drives so many to have a broad and lasting inuence. Assistant U.S. Secretary for Health Howard K. Koh, M.D. 77, M.P.H., went to Washington to help his own patients. Ive seen too many patients suer preventable suering and die preventable deaths, he said. The only answer to that challenge is promoting prevention through public health. Whether leading a federal agency, inventing a better way to deliver care, or treating patients on the front lines of medicine, Yale alumni engage at the highest level. Passionate curiosity and a deep resolve to improve human health are the hallmarks of every student who walks through the doors of the Sterling Hall of Medicine. These qualities bind classmates to each other and to the generations of students who came before them.
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Bringing medical care where there was none Kinari Webb, M.D. , who graduated from the School of Medicine in 2002, is making Borneo a healthier place. Her clinic near Gunung Palung National Park provides the only health care available in one of Indonesias most remote areas. Her patients can earn credits and discounts by working in the clinics organic gardens or opting out of illegal logging. Webb spent 10 years preparing to open Alam Sehat Lestari, Indonesian for health and everlasting nature, always envisioning it as both a clinic and conservation program. Last year, 74 people who had been blind regained vision through cataract surgery there, a new four-wheel drive ambulance took a woman to the nearest city in time for an emergency C-section, and 10 acres of newly planted trees at the forests edge were reaching for the sky.

West Campus
Everyone uses the same word to describe West Campus: Transformative. Yale made the largest property acquisition in its history in 2007, when it bought the former Bayer research center, a 136-acre complex six miles from Sterling Hall of Medicine. The property came with more than 400,000 square feet of high-end laboratory space, ready to welcome scientists. Even planning to build such a facility from scratch would have taken years. The major investment in acquiring West Campus wasnt real estate, says Dean Robert Alpern, M.D. It is and will be lling that space with remarkable investigators, a process that will unfold over a number of years. West Campus is rapidly becoming

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home to internationally known faculty, using state of-the art equipment to conduct research on everything from microbial diversity to cancer biology. Those are the research areas central to two of the new institutes planned for West Campus; others will be focused on systems biology, chemical biology, and biodesign (a collaboration between cell biology and engineering). Sophisticated new core facilities give Yale faculty and student researchers the tools to conduct high-throughput gene sequencing, chemical screening, and RNA interference studies, and student research opportunities abound at West Campus. It is an integral part of Yale, but it is also a neighborhood with a vibe of its own, where wild turkey share the lawns with humans. The campus features Yales newest child care center, school outreach programs run by the Peabody Museum, and a nature trail. Many of the universitys library, art and natural history holdings are stored at West Campus, which is also home to a major digitization project for the universitys collections.
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FACULTY-STUDENT INTERACTION?

WE GET IT.

53.

No other school has more intense and sustained interaction between students and faculty. And because faculty work so closely with students, they dont need to quiz students to nd out what they know, and they dont need grades to assess their progress. This in turn means that theres 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.
James Jamieson, M.D., Ph.D. Director, M.D./Ph.D. program

We see not students, but future colleagues.

Dennis D. Spencer, M.D. Cushing Professor and Chair of Neurosurgery

Students connect with faculty during a seminar on palliative care, top, at the White Coat Ceremony, and at the Hunger and Homelessness Auction.

The faculty gets working with students.

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

54

55

Boston New Haven New York Philadelphia

THERAPIES
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 boosting the New Haven economy. Over 30 new companies have been incubated through Yales Oce of Cooperative Research, attracting well over $3 billion in investments. Joseph Schlessinger, Ph.D., the William H. Pruso Professor and chair of the Department of Pharmacology, is a prime example of the biomedical entrepreneurs who are leading Yales eorts in this area. Renowned for his work on the signaling pathways that communicate to a cell whether or not to divide and grow, Schlessinger has started three companies to pursue the therapeutic appli- Joseph Schlessinger is the founder of cations of his basic science three biotechnolresearch. These companies ogy companies, including Kolltan have already produced two Pharmaceuticals in 2008. new cancer drugs.

NEW

56.

54. The Medical

Historical

LIBRARY
Of all the libraries in all the educational institutions of our world, there is none quite like this one. ... That large, comfortable, book-lined room ... is a sanctum containing the lore and the collected reminiscences of the art of healing. It is a museum, a portrait gallery, a storehouse of the literature of medicines past, and a refuge from the hurly-burly of modern scientic technology that surrounds it.
Sherwin Nuland, M.D. from Doctors: The Biography of Medicine, 1988

The Medical Historical Library is the showpiece of the comprehensive Harvey Cushing/John Hay Whitney Medical Library, through which students can access
56

virtually every medical pub- The Medical Library, dedicated lication in the world via its in 1941, was document delivery services. the brainchild of neurosurgeon And the Cushing/Whitney Harvey Cushing. Library is just one part of the 13 million-volume Yale University Library System. Medical students make particular use of the Kline Science Library, but they can also explore unparalleled collections ranging from the law library to the Beinecke Rare Book and Manuscript Library. None of these libraries is more than a short walk from the medical school. The Medical Library is an important component of a Yale medical education. During orientation week, each student is introduced to his or her personal librariana library sta member who will work closely with about 20 students. Throughout the students time in medical school, librarians will recommend resources for thesis research and patient care questions, and provide instruction in the use of relevant technologies. This unique program augments more general seminars on evidence-based practice and information management that are scheduled in all four years.

55.

A GREAT PLACE TO

Im from New York City, and New Haven is close enough that I could go home a lot, and my family could come here. But I found everything I needed here. I got to do lots of community serviceI worked as a patient trans lator, for exampleand still nished in four years. But I liked it so much Im staying for my residency.
Luz Jimenez, Class of 2009

LIVE

57

TRANS PLANTATION SURGERY

Today 18 people will die in the United States waiting for an organ transplant. Thats not a statistic Sukru Emre, M.D., can live with. The internationally known surgeon was recruited in 2008 to build Yales small transplant program into a leading one. The number of organ transplants performed here climbed dramatically, with an outstanding success rate. The transplant initiative creates new hope for patients at Yale and beyond, as Emre and his colleagues advance the eld so that more lives can be saved, even with the limited number of donated organs available. The liver regenerates, as the ancient Greeks already knew, explains Emre. Remember Prometheus, whose liver grew back each time it was eaten by an eagle? We can identify eight segments within the liver, each of which has its own blood supply, bile duct, and venous return. These can all function independently. So what I do is cut the liver into two pieces. Most commonly, we share one liver between one adult and one child. We have recently started sharing one liver between two adults. This split liver technique makes it possible for a living person to be a donor. Both the donors liver and the recipients will grow back to normal size in about eight weeks, and when the recipient is a child, the liver grows along with the child, says Emre. Organ transplants are dicult in part because they aect so many of the bodys systems. By the same token, building a strong transplant program aects departments throughout the medical center.
58
Sukru Emre, These are complicated chief of organ enterprises. I say that transtransplantation. plantation is not a discipline but a complex matrix of disciplines, including surgery, medicine, hepatology, infectious disease, pharmacology, pathology, nursing, and psychology, says Emre. Yale recruited top clinicians and provided other resources in a range of specialties to support its transplant initiative. The section performs liver and kidney transplants, often with minimally invasive techniques. Heart transplants are performed by cardiac surgeons. An active transplant program creates exciting research possibilities. Through collaborations with immunobiology and other basic sciences where the university has a strong base, the section is developing strategies to combat rejection and address the long-term health issues faced by transplant recipients. Emre often talks about his desire to be a complete physician, one who combines deep and broad medical knowledge with compassionate care. Patients are amazed at how quickly he returns e-mails and at the time hell take to carefully explain options. For him, the role of complete physician includes advocacy for his patients. He seizes on opportunities to speak to community groups and the press about organ donation. Dont take your organs to heaven, he urges, because heaven knows we need them here.

57.

COMMUNITY SERVICE
Yale medical students have a strong commitment to social responsibility, and every year they take on important projects, from promoting access to medicines in developing countries to defending torture victims. These are a few of the organizations in which medical students act locally: Anatomy Teaching Program (above) Bio2 Columbus House Walk-In Clinic Committee Overseeing Volunteer Services Downtown Evening Soup Kitchen Educational Care Clinic at Clifford Beers Community Mental Health Clinic Funny Bones at Yale
HAVEN

58.

59.

FIFTH YEAR
Why would you want to spend an extra year in medical school? As you peer ahead down the formidable road into the medical profession, a fth year of medical school might seem like the last thing you would sign up for. But about half of Yale medical students do, and many of them earn a masters of health science research in addition to their m.d. Some are pursuing in-depth research on their thesis topic. Some are exploring clinical electives and subinternships. All are demonstrating how much they love their experience at the Yale School of Medicine. If you do choose to complete your medical education over ve years rather than four, Yale will not charge you tuition for the fth year. In fact, 20 to 25 students each year are awarded fth-year research fellowships from organizations including the Howard Hughes Medical Fifth-year students Ben Erickson and Institute, the nih, the Sarno Foundation, Chris Painter (right and second from the Doris Duke Charitable Foundation, and right) are pursuing the M.H.S. degree. Yale. A living stipend is included.

Free Clinic

Health Professional Recruitment Education Program (HPREP)

HIV Intervention and Prevention Corps

Neighborhood Health Project Nutrition Detectives Youth Science Enrichment Program 59

CANCER HOSPITAL
Yale Cancer Center has long been recognized for its excellence in all facets of cancer research, prevention, and treatment. It is one of only 40 NIH-designated Comprehensive Cancer Centers in the United States, and the new Smilow Cancer Hospital at Yale-New Haven expands Yales ability to integrate all aspects of cancer patient careboth inpatient and outpatientwith the most advanced research facilities. In fact, the ability to achieve new levels of integration brought Thomas Lynch Jr., M.D., back to his alma mater to head Yale Cancer Center and Smilow Cancer Hospital. I think we need to aspire to cure cancers, not just to help people live a bit
60

60.
Smilow

Yale Cancer Center Director Thomas Lynch: I think we need to aspire to cure cancers, not just help people live a little longer.

62.
61.

GREAT DEBATES
Students argue a lot during their clerkship Debating controversial issues helps in Obstetrics, Gynecology, and Reproductive students develop the rigor in their Sciences. In a weekly Controversial Topics thinking they will session, they debate issues such as water birth need to make good decisions and hormone replacement therapy. Each as physicians. side presents studies supporting its position, followed by rebuttal and discussion. Though many students give voice to their inner Perry Masons, the debates are not a test of oratory skill. In the end, we want the evidence to prevail, explained Assistant Professor Jessica Illuzzi, M.D., who directs the clerkship. She devised the format because students often returned from clinical placements curious, even puzzled, about why a physician made a given choice. The Department of Obstetrics, Gynecology, and Reproductive Sciences is a national leader in research and clinical care, so students would expect that their professors could easily answer their questions. But Illuzzi saw that students would learn more by nding their own answers. There are more controversial topics in our eld than in others, said Illuzzi. Without research denitively supporting one side, physicians must be rigorous in evaluating evidence. Debating helps students do just that. Its not unusual for a debater to declare afterward: Im arguing against the side I believe in! That itself is a learning experience, added Illuzzi, as students must challenge their preconceptions. Debaters arrive prepared and passionate. Illuzzi believes this enthusiastic response is linked to the inquiring, independent bent she sees in students who choose Yale. Its in their nature already.
61

longer, Dr. Lynch says. One of the reasons why were not curing cancer today is that we need to better understand the biology of cancer. At Yale, the scale is right for an integrated cancer program between science and clinical medicine. You have laboratories where fundamental discoveries are being madewithin a couple hundred feet of clinics where patients are being treatedand people who are active in the pursuit of both clinical excellence and scientic discovery. Smilow Cancer Hospital includes 112 inpatient beds, outpatient treatment rooms, expanded operating rooms, infusion suites, diagnostic imaging services, and a specialized womens cancer center (including the Yale-New Haven Breast Center and the Gynecological Oncology Center), as well as a oor each for diagnostic and therapeutic radiology. Crucially, the new facility allows information from all departments, including scheduling and billing records as well as the medical records from the variety of specialists a patient might see, to be seamlessly integrated in one system. The new ease of coordination enhances collaboration among clinicians and scientists in the best Yale tradition. Even more important, better communication means a better experience for patients.

GYM
A gym that looks like a cathedral, a hockey rink that looks like a whale (designed by Eero Saarinen!)Yales athletic facilities are in a class by themselves. Medical students have easy access to the score of squash courts, rowing and sailing centers, classes in ballet or judo or yoga, even a golf course ranked by Golf magazine as one of the 100 most difcult in the world.

PAYNE WHITNEY

What would medical school be without a literary magazine, a swing society, and a symphony orchestra? Heres a partial list of student organizations. The list will be different by the time you come to Yale, but the energy level will be the same.

AMERICAN MEDICAL STUDENT ASSOCIATION

63.

STUDENT NATIONAL MEDICAL ASSOCIATION

79.

ASIAN PACIFIC AMERICAN MEDICAL STUDENT ASSOCIATION

64.

THE ULTRASOUNDS ACAPELLA GROUP

80.

ATRIUM LITERARY MAGAZINE

65.

YALE MED PLAYERS

68. 69.

LATINO MEDICAL STUDENT ASSOCIATION

66.

HIV INTERVENTION AND PREVENTION CORPS

71.

YALE HEALTHCARE AND LIFE SCIENCES CLUB

81.

GAY STRIAGHT MEDICAL ALLIANCE

Top: Yale Med Players; bottom: Yale Medical Campus Trafc Safety Group.

COMMITTEE FOR THE WELL-BEING OF STUDENTS

67.

MEDICAL STUDENT COUNCIL

72.

YALE JOURNAL OF BIOLOGY AND MEDICINE

82.

GLOBAL HEALTH WORKING GROUP

70.

MEDICAL STUDENTS FOR CHOICE

73.

ALLIANCE
YALE MED SOCCER

Transatlantic

88.

NEIGHBORHOOD HEALTH PROJECT

74.

83.

NEPAL HEALTH EQUITY INITIATIVE

75.

YALE MEDICAL CAMPUS TRAFFIC SAFETY GROUP

84.

PEER ADVOCATES

76.

YALE MEDICAL STUDENT PSYCHIATRIC SOCIETY

85.

PHYSICIANS FOR A NATIONAL HEALTH PROGRAM

77.

YALE SWING SOCIETY

86. 87.

PHYSICIANS FOR HUMAN RIGHTS 62

78.

YOUTH SCIENCE AND ENRICHMENT PROGRAM

Michael Simons, A unique partnership between the Yale and left, and John University College London was inaugurated Martin head the UCL-Yale in the fall of 2009. Involving the aliated Collaborative in hospitals of the two institutions as well as Biomedicine. the schools themselves, the broad collaboration spans basic biomedical research, medical education, and clinical care. Two distinguished cardiologists, Michael Simons, m.d., professor of medicine and cell biology and chief of cardiovascular medicine at Yale, and John Martin, m.d., professor of cardiovascular medicine at ucl, conceived the arrangement as a way to enhance the capabilities of their institutions, both leading medical research centers. In joint clinical programs, the institutions are exchanging expert physicians to treat patients at both sites and share clinical information. Meanwhile, the universities have begun joint 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 also hope to create a coordinated program for Ph.D. students from the two schools.

63

NO CLASS RANK
No class rank takes completely off the table how well youre doing compared to the person sitting next to you. You dont need to position yourself in a curve; you benet from helping those around you. Its 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

89.

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

64

65

90. SCIENTIFIC
Challenge: Walk two blocks in any direction on Yales campus without passing a building where someone is doing great science. The university is completing a $1 billion program of investment in the sciences, investment that can be seen in a parade of sleek modern buildings, equipped with everything on a researchers wish list. Yale is fortunate to house its graduate and professional schools on one campus, so the medical school is truly integrated with the full spectrum of scientic resources available throughout the university. You may nd yourself working with a professor who is an engineer, environmental scientist, or computational biologist. At Yale, we know that no single discipline has cornered the market on innovation. So our faculty work in interdisciplinary teams and encourage you to do likewise.
The Yale scientic community includes: Combined Program in the Biological and Biomedical Sciences. An interdisci-

COMMUNITY
Peabody Museum. Yales astounding natural history collection, a rich resource for scholars of evolutionary biology. School of Engineering & Applied Science. A world-class biomedical engi-

Science Hill

91. SCIENCE
HILL
Geneticist and NIH Director Francis Collins did his Ph.D. research in the Department of Chemistry. Frank Ruddle, Ph.D., worked on the creation of the rst transgenic mice in Kline Biology Tower. Nobel laureate Sidney Altman, Ph.D., has his lab on Klines fourth oor, just across the quad from fellow Nobelist Thomas A. Steitz, Ph.D. The Biomedical Engineering department occupies a glassy new building a block away. Science Hill, just across campus from the Yale School of Medicine, expands the intellectual reach of the school, and medical students can take courses and conduct research there. M.D./Ph.D. candidates pursue their graduate studies via Yales Combined Program in the Bio logical and Biomedical Sciences (BBS), which is specically aimed at facilitating access to the universitys array of bioscience resources without standard academic boundaries.

Hillhouse

neering program that uses technology to advance medicine, with labs on both sides of campus.

School of Forestry and Environmental Sciences. A graduate

school exploring how the health of the biosphere aects human health.
School of Management. Partner

Cross Campus

in the M.D./M.B.A. Program and in many research eorts focused on health care. Faculty expertise includes health care reform and modeling to estimate and prepare for the impact of various public health emergencies, including bioterrorism. illness research and the birthplace of the hospice movement in America.
School of Nursing. A leader in chronic

Old Campus

New Haven Green

plinary program that oers Ph.D. and M.D./ Ph.D. students access to all the bioscience resources at Yale. to nationally known science departments, including Chemistry; Computer Science; Ecology and Environmental Biology; Molecular Biophysics and Biochemistry (which has a presence on the medical campus as well); and Molecular, Cellular, and Developmental Biology.
66

Faculty of Arts and Sciences. Home

oldest public health schools in the country, with a history of training leaders.
West Campus. Yales largest property acquisition ever, a complex where interdisciplinary teams use the most sophisticated equipment available to advance science. Its a 6 mile shuttle ride from Sterling Hall of Medicine.

School of Public Health. One of the

(6 miles)

Yale School of Medicine/ Yale Medical Center

67

MEDICAL

94.
YALE

CARTS
New Haven has its share of Zagat-rated restaurants. But at lunchtime, Cedar Street is where the sizzle is. About 40 vendors oer fresh fare from sidewalk carts. With that many options you dont ask, Do any of them have pad thai? You ask, Which one has the best pad thai? If Thai isnt your thing, theres Indian, Middle Eastern, Ethiopian, Mexican, and other cuisines. The chefs are international and the food tends to be authentic, with the possible exception of the New Haven Roll at the sushi cart. And, yes, there are places to get a green salad or a grilled chicken sandwich, too. Dining a la carts is a popular way to grab lunch on the run without sacricing taste or blowing your budget. On a warm day, students and faculty turn the lawn outside Harkness into a picnic ground. As spring stretches into summer, you might even get a free side of live music.

THE

92.

SYMPHONY ORCHESTRA

WOMEN
IN MEDICINE
Yale is unique in having an Ofce for Women in Medicine, dedicated to the advancement of women in medicine and the medical sciences. When we started the ofce, the number of women admitted

93. OFFICE FOR

was a fraction of what it is today and the number of women on the faculty could be counted on one hand. Today, like many medical schools, women make up half the student body, but women still face special challenges at med school. We continue to provide neutral, condential counseling to women at YSM, to offer an annual lecture series, and to sponsor various forums to bring women in the school together. And we have a program to match current women students with role models and mentors.
Merle Waxman, M.A. Associate dean and director of the Ofce for Women in Medicine

In medical school dormitories across the country, violins gather dust at the back of closets. Medical students who had been serious musicians through college cannot nd opportunities to play. Lynn Tanoue, M.D., professor of pulmonary and critical care medicine, thought it was high time to dust off her own violin. She invited students and faculty throughout the school to do likewise. When she sent out a mass e-mail about starting up a medical school symphony orchestra, the response was overwhelming. About 50 musicians from the schools of Medicine,

Nursing, Public Health, and the medical community at large now form the orchestra. A Yale School of Music doctoral student conducts the group, which practices weekly. The orchestra performs regularly at a packed Harkness Auditorium and has plans to do community concerts as well. As the medical school prepares for its Bicentennial, the symphony program will include an original work commissioned for the schools 200th birthday. There clearly is a musical soul to the medical center, says Tanoue, that was waiting to be discovered. 69

68

Yale
Any course at Yale is open to you. When I rst 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 professorand he was so happy to speak with me. Awesome people. Awesome access.
Yale medical students

95.

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

70

71

The passion that drives us is the knowledge and experience of what the cost is to individuals. This isnt an academic abstraction; its about real people who have to live with something that people dont see.
Sally Shaywitz, M.D. Ratner Professor of Learning Development

fMRI
Cutting-edge
Nothing requires more scientic ingenuity than studying the workings of the brain. How can you tell what a boy with autism is seeing when the disorder is, foremost, an inability to communicate? How can you examine, much less operate
72

96.

on, a brain in seizure? Scans produced by fMRI show the How can you examine the brain of a patient with epilepsy. biological underpinnings of schizophrenia? Yale researchers are making progress on all these questions, and one tool is functional magnetic resonance imaging (fMRI), which allows you to watch the brain in action. Yale has the most advanced equipment available and a cadre of talented, skillful, and knowledgeable experts to develop new ways to use such technology. The Autism Program at Yale brings together professionals from the elds of clinical psychology, neuropsychology and neuroimaging, child psychiatry, speechlanguage pathology, social work, genetics, psychopharmacology, and psychiatric nursing. Recognized by NIH as an Autism Center of Excellence, the program is

headed by Ami Klin, Ph.D., Harris Associate Professor of Psychology and Psychiatry. Klin and his colleagues have created investigative techniques that have led to current understanding of autism as an impairment of the social brain, the structures and 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 neurosurgeons, neurologists, neuropsychologists, neuroradiologists, neuropathologists, epidemiologists, pediatricians, biomedical engineers, and specialist nurses. The team has been able not only to improve surgery but has developed novel imaging tools to co-register many kinds of functional data and use this data to direct the placement of electrodes, as wells as special catheters to analyze chemical changes. Functional MRI not only advances our understanding of the brain; it can change societys judgments of individual character. Take, for example, dyslexia. Generations of children with dyslexia have been seen as lazy or stupid as they struggled to learn how to read. No one can continue to hold that view in light of the ndings of Sally Shaywitz, M.D., Ratner Professor of Learning Development, and Bennett

A. Shaywitz, M.D. professor of pediatrics and neurology. The Shaywitzes discovered functional lesions in the left occipitotemporal and parietotemporal regions of the brain, which correspond exactly with physical lesions in people who have lost the ability to read because of a stroke or brain tumor. Overcoming these functional decits requires eort and assistance beyond the normal. Sally Shaywitz sums up the impact of their ndings, The passion that drives my husband and me is really the knowledge and experience of what the cost is to individuals. This isnt an academic abstraction; its about real people who have to live with something that people dont see. Thats why its a wonderful thing that we now have the ability to see the brain at work, to actually see what is happening at the most basic levels.

97. POWER
DAY
Its not about getting power; its about questioning it. Just before they start on the wards, rising third-year medical students and advanced-practice nursing students spend a day in discussions of power and control in health care relationships. We dont want them to assume that the patterns they nd in their clinical rotations are the way its supposed to be, says Associate Dean for Student Affairs Nancy Angoff, M.D. , M.P.H. , who directs Power Day. We want them to recognize the misuse of power and to be prepared to deal with it. We want them to think about relations between members of the hospital staff, between care providers and patients especially when race or gender are added to the mix. We want them to be ready to make changes. 73

HUMANITIES 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 person is through the humanities. In the last century, the science of medicine has been the focus of medical education, says Thomas Duy, M.D., Director of the Program for Humanities in Medicine at Yale. We are trying to bring the art of medicine back into the balance.
A few examples:

98.

MAINE
This course has the potential to encourage people who otherwise might not think about a research career. Some students have never run a gel, ground up tissue, or looked at cells under a microscope in a research mode before. The idea of hands-on work is often so illuminating that it leads people to say, This is what I want to do for the rest of my life.
John N. Forrest Jr., M.D. Director of the Ofce of Student Research and director of the Mt. Desert Island Biological Laboratory.

THE COAST OF

99.

> A yearlong biweekly lecture series brings a humanistic perspective to medicine. A recent series opened with Akhenaton: The Androgynous Pharoah and ended with a presentation by residents in the writers workshop conducted by physician-authors Richard Selzer, M.D., and Lorence Gutterman, M.D.

> An art elective has encouraged students to explore anatomy through drawing, painting, and photography, capturing something that is missed in the process of dissection and analysis. > The Yale Journal for Humanities in Medicine, an online journal that publishes essays (The Leaf Blower as Metaphor); poetry (Emotional Fugue in a Supermodel World); and book reviews and has a companion blog (http://blog.yjhm.org).

> Atrium, the student literary and arts journal.

> West Campus. In Yales West Campus, a portion of the space is devoted to the most advanced medical research technologies and another portion to the arts. Call it planned

> Workshop on Observational Skills. Over a decade ago, Professor of Dermatology Irwin Braverman, M.D., began using paintings to train Yale medical students to pay close attention to detail. Today, a mandatory class for rst-year students meets in small groups at the Yale Center for British Art each spring. The class aims to jump-start the special diagnostic skills that usually take physicians years to develop, according to Dr. Braverman. Taking students out of their familiar setting removes some of the assumptions that might limit perception and lets them notice particulars

serendipity: interactions between the two domains are expected to be productive and inspirational.

that they would otherwise miss. Students hone their powers The eectiveness of the program of observation by looking at has been demonstratedand paintings at the published in JAMAand the Yale Center for course has been adapted by other British Art. medical schools, business schools, and police departments, including the NYPD and Scotland Yard, training their ocers to be more astute observers. The Yale Medical Humanities and the Arts Council ensures that projects such as these are sustained and expanded, engaging people throughout the university and beyond at the intersection of health, culture, and society.

You might choose Yale for its location close to the bustle of Manhattan and Boston, but Yale will give you the opportunity to study molecular biology for a week in a quieter localethe coast of Maine. The Intensive Pedagogical Experience in Laboratory Research Techniques is a weeklong elective for up to 28 students held each June at the Mt. Desert Island Biological Laboratory. Its an immersion in strategies and methods of laboratory research, but theres time for hiking, relaxing, and a lobsterfest in one of the most beautiful places in America.
75

74

100.
THE OTHER 99 100 REASONS

PEOPLE AND THEIR OWN

Yale med students are the most amazing group of people youll 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 toneas 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
Advanced Clinical Elective in Law and Psychiatry 36 Advisors 24 AIDS Care Program 23 Alumni 52 Anatomy class 8 Art elective 74 Articial heart pump prototype 19 Asian Americans in Yale Medicine 37 Antibiotics 21 Autism 19, 72 Biomedical Engineering 42 Breakthroughs 19 Cadaver Ball 29 The carts 68 Cell sorting/ ow cytometry 25 Cell, molecular, MR, and PET imaging 25 Cellular Neuroscience, Neurodegeneration, and Repair, 18 Chemotherapy 19 Child Study Center 16, 28 Class Size 10 Clinical care 22
13, 36 38

BY PAGE NUMBER
fMRI 72 Genetics 19, 43 Global health 12, 32 Grades 6 Great debates 61 HAVEN Free Clinic 14, 17, 59 Health teams 17 Heart disease/ metabolic syndrome 43 High-end instrumentation 25 Howard Hughes Medical Institute
34, 50, 59

Clinical electives Clinical research 16 Clinical Skills Training Program Combined Program in the Biological and Biomedical Sciences 66 Community 46, 59, 66 Core facilities
25, 48

Intracranial aneurysms 43 Joint degrees 34 Latino Medical Student Association 37, 62 Level 1 Trauma Center 27 LGBTQ resources 37 Lighthouse Point 44 Macular degeneration 43 Match Day 33 MD/JD 34 MD/MBA 35 MD/MDiv 34 MD/MHS 34 MD/MPH 34 MD/PhD 40 Medical Library 56 Medical Outdoor Orientation Trip 9 Medical Scientist Training Program 40 Mentors 45, 68 Modules 12 Mount Desert Island Biological Laboratory 75 Multi cultural affairs 37 Museums & galleries 51

National Center for Children Exposed to Violence 28 Neuroscience 38 New England 44 New Haven
44, 51, 57

Robert Wood Johnson Clinical Scholars Program 17 Rudd Center for Food Policy and Obesity 36 Sarnoff Foundation 59 SAY, Service at Yale 9 School of Engineering & Applied Science 66 School of Forestry and Environmental Sciences 36, 66 School of Management 66 School of Nursing 14, 17, 66 School of Public Health
14, 17, 32, 66

Student organizations
59, 6263

Yale Center for British Art 74 Yale Center for Clinical Investigation 16 Yale Center for Genome Analysis 25 Yale Craniofacial Center 23 Yale Epilepsy Surgery Program 73 Yale Medical Group 22 Yale Medical Symphony Orchestra 69 Yale Program on Aging 49 Yale System 6 Yale-New Haven Hospital
20, 27, 49

Student research
6, 24, 34, 45, 75

Summer research stipends 45 Super-resolution imaging 48 Technology 25, 48 Thesis 6, 45 Theatre 51 Tissue engineering 42 Tourette syndrome 43 Transatlantic alliance 63 Translational research 18 Transplantation surgery 58 Uganda 13 VA Connecticut Healthcare System 39 Vascular Biology and Therapeutics 18, 42 West Campus 53, 66 Women in medicine 68 The World 12 Yale 70 Yale Cancer Center 17

New therapies 57 No class rank 65 Outpatient para thyroid surgery 23 Patients 9, 16, 38 Payne-Whitney Gym 61 Peabody Museum 66 Physician Associate Program 14, 17 Pizza 44 Polycystic kidney disease 43 Post-traumatic stress disorder 38 Power Day 73 Primary Care Clerkship 14 Protein folding 19, 39 Proteomics 25 Recognition 24 Residencies 33 Ribosome 21

Crohns disease 43 Culture 51 Diversity 36 Downs Fellowships 12, 13 Dyslexia 43, 73 East Rock Park 44 Emergency Medicine 27 Faculty of Arts and Sciences 66 Faculty-student interaction 54 Farr Lecture 45 Fellowships 12,
13, 45

Human and Translational Immunology 19 Humanities in Medicine 74 Hunger and Homelessness Auction 14 Hypertension 43 Immunobiology 50 Innate immunity
19, 50

Science Hill 67 Scientic community 66 Second Year Show 21 Service of Gratitude 8 Smilow Cancer Hospital 20, 60 Stem Cell Center 29 Student National Medical Association 37, 63

Festivals 51 Fetal heart monitoring 19 Fifth year 6, 45, 59 Financial aid 32

Interdisciplinary Center for Bioethics 36 Interdisciplinary Studies 36 Interest groups 49 International Medical Student Education 13

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Contact Ofce of Admissions 367 Cedar Street New Haven, CT 06510 Tel: 203.785.2643 Fax: 203.785.3234 medical.admissions@yale.edu Produced by Institutional Planning and Communications 300 George St, Ste. 773 New Haven, CT 06511 Tel: 203.785.5824 Fax: 203.785.4327 Project editor: Michael Fitzsousa Design: Michael Bierut and Yve Ludwig, Pentagram Text: Catherine Iino, Colleen Shaddox Photography (by reason): Associated Press, 37; Heidi Brown, 29; Julie Brown, 25, 39, 51, 94; John Curtis, 3, 5, 8, 11, 13, 16, 27, 30, 32, 44, 53, 58, 62, 99, 100; Terry Dagradi, 1, 2, 6, 10, 12, 17, 35, 36, 40, 46, 48, 53, 88, 89, 98; Courtesy of Division of Medicine and Science, Smithsonian Institution, 19; Derek Dudek/ www.visitNewHaven.com, 44; Antonio Giraldez, 41; Arthur Horwich, 38; Haifan Lin, 26; Robert Lisak, 7, 14, 16, 19, 20, 22, 23, 24, 45, 54, 56, 57, 59, 92, 93; Michael Marsland, 42, 43, 52, 95; Alex Marzuka, 4; New Haven Register/Brad Horrigan, 60; Nobel Foundation, 18; William Sacco, 32; Harold Shapiro, 49; United Press International, 33; Yale Repertory Theatre, 50; Yale University Art Gallery, 50 Photo research: Charles Gershman Copy editing: Cheryl Violante Printing: Finlay Printing

Equal Opportunity Statement The Yale School of Medicine is committed to contributing to a health-care workforce that reects the diversity of the patients it serves. We seek to enroll students from a range of ethnic and economic backgrounds, including from communities that have been historically underrepresented in the medical profession. The medical school abides by Yale Universitys Equal Opportunity Statement, which is as follows: Yale University is committed to basing judgments concerning the admission, education, and employment of individuals on their qualications and abilities and afrmatively seeks to attract to its faculty, staff, and student body qualied persons of diverse backgrounds. In accordance with this policy and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of sex, race, color, religion, age, disability, status as a special disabled veteran or veteran of the Vietnam era, or national or ethnic origin; nor does Yale discriminate on the basis of sexual orientation. University policy is committed to afrmative action under law in employment of women, minority group members, individuals with disabilities, special disabled veterans, and veterans of the Vietnam era. Questions about these policies should be referred to: Ofce of the Provost 118 Hall of Graduate Studies Phone: 203-432-4440 or Ofce for Equal Opportunity Programs 104 William L. Harkness Hall Phone: 203-432-0849

Bicentennial Year The School of Medicine is celebrating its Bicentennial in 20102011 with a series of lectures and special publications, a documentary lm, a community fair, and a symposium exploring the biomedical sciences. An illustrated book about the school, Medicine at Yale: The First 200 Years, will be available from Yale University Press in November 2010. The Bicentennial provides an opportunity to reect on the achievements of the past two centuries and the ways in which medicine has changed since 1810. Then, life expectancy in New Haven was less than 40 years, and medical knowledge was derived from concepts that have long since been discounted. During the schools evolution, a largely unscientic occupation handed down through apprenticeship has become one of the most education-intensive, rigorously scientic, and highly regulated professions. As American medicine looks ahead to improving health care, unraveling the mysteries under lying disease, and optimally preparing the doctors of the coming decades, Yale will continue to meet the challenges of a changing medical landscape. For information, see medicine.yale.edu/ysm200

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