"The M.D.-Ph.D. program was very demanding, in part, because of the time pressure for students to complete the Ph.D. portion and get back to medical school. In the early years, we lost some students because it was too difficult," Dr. Clapham said. "We became better at selecting students whose expectations aligned with those of our faculty. We attracted really academically gifted top-notch students, and our labs competed to get them. The students were very productive in publishing their research."

In the early days, the graduate school didn't have activities where M.D.-Ph.D. students encountered each other.

"They met each other at the beginning of the Ph.D. portion of the program and then usually only related to the people in their chosen labs," said Dr. Clapham. "Then they saw each other again at graduation."

As the program matured, its leaders worked to better engage and re-integrate the students into the medical school portion of the program.

In 1997, Dr. Clapham returned to Harvard Medical School and Boston Children's Hospital, where he was the Aldo Castañeda Professor of Cardiovascular Research and became a Howard Hughes Medical Institute investigator, and later, vice president and chief scientific officer. Dr. Clapham received the Mayo Clinic Distinguished Alumni Award in 2010.

Milestone and cause for celebration

Moses Rodriguez, M.D., now an emeritus member of the Mayo Clinic staff, was director of the M.D.-Ph.D. program from 1994 until 2006. Dr. Rodriguez worked side by side with Richard "Rick" McGee, Ph.D., who was recruited to Mayo Clinic in 1991 to be associate director of the program and help it secure National Institutes of Health funding. Mayo's program had already applied for NIH funding without success.

It was a big deal — a celebratory occasion across the institution, he said. "Now, we were seen as a legitimate program and could participate in the National Association of MD-PhD Programs."

The designation covered students' costs for the medical and graduate school portions of the program plus a stipend for the duration. Until then, Mayo Clinic had covered those costs.

The initial five-year funding award led more applicants to the program — doubling in only one year. Today, the program gets 450 applications for nine slots in Rochester and two slots in Arizona.

Impressions of the first students

Preceding Dr. Clapham's arrival at Mayo Clinic by at least four years were 17 students in various stages of the M.D.-Ph.D. program.

Bradley Erickson, M.D., Ph.D., Division of Neuroradiology and Department of Quantitative Health Sciences at Mayo Clinic in Rochester, was in what is considered to be the first official group of M.D.-Ph.D. students at Mayo Clinic — starting medical school in 1983.

"Dr. Franklyn Prendergast (Mayo Clinic emeriti staff) was instrumental in my making the decision to pursue an M.D.-Ph.D.," says Dr. Erickson. "I had done some work in his lab. It's an honor to be among the first in the program."

As the first group of students was starting its last two years of medical school, William Morice II, M.D., Ph.D., Division of Hematopathology at Mayo Clinic in Rochester and president and CEO of Mayo Clinic Collaborative Services/Mayo Clinic Laboratories, entered the M.D.-Ph.D. program.

"The newness of the M.D.-Ph.D. program created challenges for the early students," he shared. "But it also makes it gratifying to have fumbled through and helped the institution build something great. Getting a Ph.D. is a significant time commitment and requires a high level of maturity. With medical school, the hard part is getting in. With graduate school, the hard part is getting out."

Daniel Brat, M.D., Ph.D., the Magerstadt Professor and chair of Pathology at Northwestern University Feinberg School of Medicine in Chicago, was in the program with Dr. Morice. He explains his perspective about the difference in science and clinical medicine cultures, which he says is vital for students considering an M.D.-Ph.D. program to understand.

"Clinical medicine is structured and protocol-driven and hierarchical and has short-term gratification. Physicians go home at the end of the day knowing they did their best to advance someone's health by providing patient care," he reflected. "The scientific world has a relatively flat organizational structure, with everyone on a first-name basis, and a looser environment with differing work habits but still requiring teamwork."

This story was originally published in Mayo Clinic Alumni magazine. Mayo Clinic's medical school marked its 50th anniversary in 2022. Each issue of the magazine this year explores a facet of the school, known as Mayo Clinic Alix School of Medicine since 2018.