D.M.D./Ph.D. Program Description

• Introduction
• Objectives and Specific Aims
• Admissions
• Detailed Program Description
• Doctoral Programs in Biomedical and Behavioral Sciences

Introduction

Among the existing training programs at the University of Connecticut School of Dental Medicine (SDM), we offer an integrated dental and graduate research training program culminating in the awarding of both a D.M.D. and a Ph.D. in Biomedical Science (DSTP). The program was the first of its type in the United States, and currently has four students enrolled.

The Combined D.M.D./Ph.D. Program is modeled after a similar combined degree program for medical students that has been offered by the University of Connecticut School of Medicine since 1978. The Medical School program has graduated 29 students with combined M.D. and Ph.D. degrees. Currently, in the M.D./Ph.D. program, there are 20 students in the three phases of that combined degree program. The Dental School program has graduated 1 student with combined D.M.D. and Ph.D. degrees. Currently, in the D.M.D./Ph.D. program, there are 4 students in the three phases of that combined degree program.

Because students enrolled in the SDM take the same basic medical science program as the medical students for the first two years of the dental curriculum, and because the Graduate School recognizes the basic medical science courses as graduate level courses for the Ph.D. component, it is has been convenient to mirror many aspects of the medical school combined degree program while still formulating a unique SDM combined D.M.D./Ph.D. program. The same general tripartite curriculum has been invoked. The differences between the medical school and dental school combined programs arise in developing a plan to complete the unique clinical requirements for the D.M.D. degree. Achieving adjustments in the various parts of the program has been expedited by the training history of the SDM and the relationship developed over the years between the basic science and clinical departments.

The training experience and accomplishments of the SDM are the foundation for this new program. The SDM has graduated a total of eight dentist scientist/clinical scholars as part of an institutional DSA program, is presently training 3 DSA scholars, and four additional clinical scholars were trained on individual DSA/PSA awards. Almost all of these dentist scientist clinical scholars have been associated with the Oral Biology Graduate Program (OBGP) in the SDM. Ten other graduates, funded though other sources, and a current roster of twelve graduate students brings our program training history to a total of thirty-four trainees since the OBGP was begun. All of the graduated clinical scholars are funded, productive, and influential contributors to dental research, education and administration.

The academic atmosphere at the University of Connecticut SDM is one of universal respect and cooperation between the basic science and clinical scientists. Because of this collegial environment in which the highest standards of research and patient care are achieved, devising programs for our combined degree candidates has been readily accomplished. Programs are tailored to the students' interests and the programs, both clinical and graduate, to ensure an efficient and successful progress through the program.

Because of the universality of oral disease, training at this institution has emphasized the basic biological problems related to the oral cavity in health and disease. The organization of a faculty of basic scientists and dental and medical clinicians into a SDM training program, the OBGP, has permitted us to offer a full range of opportunities for students of dental health and disease to participate in this endeavor. A strong oral biological focus is ensured by the ongoing course, "Contemporary Topics in Oral Biology", that is mandatory for our students. In addition, research centers in chemosensory systems, dental and general clinical research and biomaterials have fostered the active participation of the faculty in the clinical and scientific education of clinician scholars. Involvement of our faculty in Health Center-wide in program projects similarly offers potential resources to students enrolled in this program.

Because the faculty are engaged in multidisciplinary collaborations, individually and through research centers and program projects, the faculty of the graduate faculty is diverse, being drawn from all segments of the Health Center. Consequently, the programs devised for our students have reflected a similar breadth and scope of research projects.

Objectives and Specific Aims

Objectives
We offer a program that produces highly qualified clinical scholars competent in both as clinicians and as independent scientists able to initiate and maintain funded research programs. The presence of these clinical scholars will improve and enhance the quality of teaching and research in the nation's dental schools.

In addition, we provide a program that is tailored to each individual trainee, while maintaining a focus in the oral biological sciences through seminars, courses, clinical research centers and collaborative research activities. In that regard, our training is multidisciplinary in scope and composition. The mix of clinical programs and research opportunities provides a dynamic and stimulating training environment in which the clinical scholars come to appreciate the overall inter-relationships of biomedical science and clinical dentistry.

Specific Aims
The specific aims of our DST program are to:

• enroll a total of six DSTP trainees, during the five years of the grant, in a combined program leading to the simultaneous awarding of a D.M.D. and a Ph.D. degree;
• provide an integrated basic science, graduate research and dental school curriculum and clinical program that will build on and enhance the talents and dental backgrounds of the DSTP trainees;
• ensure that the curriculum and program is sufficiently flexible to permit advisory committees to construct programs specific to each trainee while maintaining a biological research focus and clinical identity for each clinical scholar's overall program;
• exploit our interdepartmental faculty from both schools who provide a broad range of research opportunities in a variety of multidisciplinary collaborations and settings;
• provide opportunities to apply basic science research methods to clinical problems; and,
• continue our efforts to recruit women into the program and to increase our efforts to enroll minority individuals.

Admissions

The admissions process for the combined degree program is a two step process and does not link acceptance to both programs. A candidate indicating interest in the combined program is first considered for acceptance into dental school. Consideration for graduate school admission occurs after acceptance into the dental school; failure to be admitted to the graduate school portion of the combined program does not jeopardize acceptance into the predoctoral program of the SDM.

Candidates
We seek individuals who have the potential and strong desire to become fully independent scientists and academic dentists who, as a consequence of their interest and training, can make substantial contributions to the resolution of clinical problems of interest to dental medicine and fundamental problems of oral biology. Such individuals, in addition to being excellent students, should possess the following attributes: initiative, intelligence, perseverance, maturity, creativity, collegiality and cooperativeness. These candidates should manifest a strong understanding of and commitment to the rigors of developing strong independent research programs and the attributes of a career in academic dentistry rather than private clinical practice. Evidence of previous research experience during pre-baccalaureate studies will be advantageous as this manifests an understanding of and a feeling for the real work of experimentation with attendant frustrations and rewards.

The DSTP trainees will devote 100 percent of their time to their combined D.M.D./Ph.D. programs. The mix of effort with the three main components of basic science education, clinical education and research will necessarily vary with the individual student and specific program since we stress individually tailored programs. Journal club and seminar presentations in a broad range of topics related to oral biology are integral components of our DSTP programs since the mission of this program is to educate future faculty and scholars for dental education.

Admissions Process
Our process requires that the applicant be accepted sequentially by the SDM Admissions Committee for entry into the predoctoral D.M.D. program, the Graduate School and, then, the DSTP Advisory Committee. Each member of the Advisory Committee has the opportunity to screen the completed applications and the committee collectively determines who shall be interviewed. Those invited are interviewed by members of the Advisory Committee generally at the time they are interviewed by the SDM Admissions Committee. The Committee then meets to discuss the evaluations and by majority vote of a quorum (2/3 of membership present) determines who shall be accepted and appointed to the DSTP, if there are multiple candidates for the DSTP positions.

Detailed Program Description

The Combined Pre-D.M.D./Ph.D. Program Plan
The combined D.M.D./Ph.D. program is the tripartite model modified after the medical school's successful program. The first two years of basic sciences study and the research requirements mandated by the graduate school are the same in both programs. The third phase is specific to the SDM requirements to complete the D.M.D. degree and to maintain research activity during the final phase of the program.

There are several aspects of the curriculum at this SDM that permit efficient use of curricular time and structure to construct a combined D.M.D./Ph.D. program. First, the intense basic science curriculum offers a firm background in biomedical sciences for these trainees. Our performance in the NBDE Part I (always in the top three in the country) attests to the excellence of this program.

Secondly, the curriculum consists of preclinical dental courses concentrated in the last part of the second year. This reduces the competition of time with the basic science curriculum and provides an intense exposure just before entry into the clinic at the beginning of the third year. This arrangement permits our combined-degree trainees freedom to pursue the biomedical science preparation without excessive competition from the preclinical courses. Lastly, the number of hours of preclinical education at the SDM is far less than that experienced at other schools further traducing the strain of negotiating both aspects of the program. Entry in to Phase three (see below) is similarly expedited by this arrangement.

Phase One: The First Two Years: The Basic Science Curriculum
All dental students participate with the medical students in the basic medical science (BMS) program as provided by the faculties of the medical, dental and graduate schools. The Graduate School recognizes and credits the basic medical science courses. The combined degree students are held to a higher standard of academic performance than the medical or dental students. Grades awarded are based on performance of the M.D. class in the BMS program, and on performance of graduate students in other graduate courses. The courses taken are listed below.

During the summer between the first and second year of phase one, summer research/laboratory rotation is mandatory for these trainees.

The D.M.D./Ph.D. student will enroll in two years of Contemporary Topics in Oral Biology, and will enroll in Graduate Seminar (Skeletal, Craniofacial and Oral Biology Journal Club) throughout the remainder of the course of study. Additional courses will be taken as needed during years 3 and 4 to satisfy the requirements for the Ph.D. degree in Biomedical Sciences/Oral Biology. The clinical practicum to satisfy the requirements for the D.M.D. degree will be taken during years 5-7.

In addition, during Phase one, the DSTP trainee will take the full complement of preclinical dental courses with the exception of Operative Dentistry in the second year. This course requires demonstration of manual skills. If this course is taken in the usual sequence and then is interrupted by Phase two for two or three years, the laboratory exercise and practice will have to be repeated. Thus, it was considered prudent to delay this course until entry into the clinical phase of the dental curriculum is imminent.

Grading
Grading of D.M.D./Ph.D. students in specified sections of the BMS I and BMS II Curricula taken for Graduate School credit is shown below: the reference group is the MD class, which serves as the reference group for all Ph.D. students in the Health Center.

• A D.M.D./Ph.D. student must have scored at least 1 standard deviation above the mean of the evaluation group in order to receive a grade of A- or better.
• A D.M.D./Ph.D. student scoring near the mean of the evaluation groups shall receive a letter grade of B. Scores between the mean and 1 standard deviation above the mean would be assigned grades of either B or B+.
• A D.M.D./Ph.D. student scoring 1 standard deviation below the mean shall receive a letter grade of C. Scores between the mean and 1 standard deviation below the mean would be assigned a grade of B of B-.
• A D.M.D./Ph.D. student scoring below the deficiency score shall receive a letter grade of F. Scores between the deficiency score and 1 standard deviation below the mean would receive grades of C or D.
• Grading of D.M.D./Ph.D. students for the remaining portions of the BMS and clinical curricula will be on the pass-fail system used for students in the D.M.D. program.

The National Board Dental Examination is taken in the summer of the second year. By the end of the second year a graduate program has been selected, entry into a graduate program has been approved and a major advisor selected (this may be done earlier but not later than the end of the second year).

Phase Two: Full Time Graduate School Activities: Additional Coursework/Research Training for the Ph.D. Degree
In Phase two, the trainees take a leave of absence from the SDM to enter the Graduate School graduate programs as full time students to fulfill the requirements of the graduate school and the specific graduate programs selected for their research training. These requirements are prescribed by the Graduate School and are common to all doctoral-level programs at the University of Connecticut. In addition, there are program-specific requirements unique to each of the seven areas of concentration. These programs offer a Core Curriculum of graduate courses in addition to the basic medical science courses completed in years 1 and 2 during Phase one. The specific program requirements can be found in their respective homepages. However, trainees in the combined program in consultation with a major advisor, the advisory committee and the DSTP Advisory Committee, arranges a flexible program suited to the background, training needs and mandated requirements of the Graduate School and the specific graduate program.

Seminars, Journal Clubs and the Oral Biology Core curriculum are available to keep the DSTP involved in current biomedical/clinical dentistry issues. For trainees who have elected a graduate program area of concentration other than the OBGP, Contemporary Topics in Oral Biology is still required. Informal meetings and seminars will be arranged to provide the DSTP trainees contact with more advanced role models for their future career goals and with an identity in the SDM.

Phase Three: Completion of Didactic and Clinical D.M.D. Degree Requirements
In Phase three, the trainee will enter a status of "Continuous Registration" in the Graduate School which holds the trainees' status as bone fide degree candidate in the Graduate School but permits work on the D.M.D. requirements.

During the end of Phase two, the trainee will take the necessary preclinical courses (e.g., Operative Dentistry) or remedial preclinical work to bring their clinical skills up to the level necessary to undertake patient care which begins in the SDM at the beginning of the third year of the dental curriculum.

The third and fourth year of clinical training at the SDM is a continuum that is monitored on a frequent cycle of meetings by the Academic Performance Committees III and IV. A series of published competencies, numerical, and behavioral requirements have been established to monitor progress toward graduation.

Supplemental Research Activity
Because the clinical phase is more flexible in terms of scheduling patients and related activities, this program will require continued involvement with research and continued activity beyond that necessary for the Ph.D. dissertation.

This supplemental research activity will be accomplished in the laboratory in which the thesis research was performed or in other laboratories on a quasi post-doctoral arrangement. The need to present and publish the results of thesis research, to generate pilot data for grant applications, and to submit applications for funding beyond the training period make this requirement essential to the future performance of these trainees. We strongly support this activity as well as the following intellectual pursuits.

• Supplemental Course Work
  During this time, courses in Scientific Writing and Higher Education Teaching Methods will be highly recommend to these trainees. Both of these courses are currently being offered, are taken by DSA and post-D.M.D. certificate students and accrue additional graduate credit. Active participation in Journal Clubs, Seminars and In-Service training at the SDM is also encouraged.
• Institutional Support for Additional Years of Study
  Phases two and three remain the most unpredictable components of this program. A seventh year is a certainty and a eighth year a very likely possibility. Our experience recently has shown that the requirements for a Ph.D. can be completed in three years. This has occurred twice – once with a foreign student (despite initial language difficulties) and a DSA candidate (despite additional clinical responsibilities). However, these were unusually capable persons. The SDM is committed to funding for the eighth year should this become necessary.

The Proposed DSTP Time Table
This time table is offered as a rough guide to the major events in the DST Program. The program will be tailored to the needs of the trainee, the interests and requirements of the specific graduate program, and the clinical education of the trainee

Candidate Supervision and Evaluation

Supervision
All students, regardless of the specific combination of programs, are assigned an interim or temporary advisor (DSTP-PD) and an advisory committee (DSTP Advisory Committee) upon matriculation. It is the committee's responsibility to assist the student in developing the best mix and balance of clinical and didactic activities and oversee the student's progress through the program requirements.

Evaluation
Students are evaluated differently in the three essential components of their programs. In the graduate courses taken under the auspices of the graduate school, they are evaluated from performances on examinations, seminar and journal club presentations and laboratory exercises and are graded on a four point (A = 4.0/credit). Students are evaluated against the performance of the M.D. students in BMS courses taken for graduate credit, and are evaluated against graduate students in other graduate level courses. Students are expected to maintain at least a B (3.0) average; a student falling below that average will be evaluated by the advisory committee to determine if the student should be allowed to continue in the program. Graduate students are not allowed to take undergraduate courses for credit on a pass/fail basis. In addition some graduate courses may be evaluated on a pass/fail basis in certain courses so designated by the Executive of the Graduate School. The grade average is calculated without consideration of an S (pass) grade in pass/fail courses while a U (fail) is averaged in as an F (0).

The School of Dental Medicine evaluates students in those courses taken to complete the clinical requirements (not for credit in the Graduate School) on a pass/fail basis. For students (such as DSTP trainees) enrolled in the combined D.M.D./Ph.D. programs, two transcripts are developed; one by the School of Dental Medicine and the other by the Graduate School. In addition, the clinical program faculty independently evaluates the students clinical progress along with the other students. However, the expected rate of progress of the combined-program student may vary depending upon the current mix of the student's activities in the basic science, graduate and clinical components of their program. Hence, the trainee's advisory committee will be able to evaluate progress in all three phases of the program in the context of the plan of study the committee has approved for that student.

The trainee's advisory committee shall evaluate continually the student's performance. Any student whose performance does not meet the minimum standards of the Graduate School may be asked by the Dean to withdraw. However, the committee may insist on more than minimum scholastic standards and may take other factors into consideration in deciding whether or not to recommend to the Dean that the student be permitted to remain in the combined degree program.

For the DSTP Clinical Scholars, the PD collects the evaluations from each pertinent advisory committee and presents these findings to the DSTP Advisory Committee at one of its two annual meetings. This Committee upon consideration of the student's progress recommends by majority vote whether a student shall be continued as a DSTP Clinical Scholar for the succeeding academic year.

General Examination
The general examination shall be taken after completion of the basic supporting course work, satisfaction the foreign language requirement, naming of the permanent committee and submission of the plan of study. In most of the areas of concentration in the biomedical sciences, students have completed their laboratory rotations prior to taking the general examination. The examination may be oral, written or both at the discretion of the particular program, and may occur in stages, e.g., a written general followed by a more specific oral. The examination is under the jurisdiction of the advisory committee and all members must be present during any oral component.

The examiners shall include at least one faculty member representing each of the major areas included in the examination (usually not exceeding five in number). All participating faculty will be invited to submit questions and to evaluate answers, but the final decision as to whether or not the student has passed the examination shall rest solely with the advisory committee unless the members of the Graduate Faculty in a student's field of study vote to assign this authority to an examining committee.

Dissertation Prospectus
A prospectus is prepared before the work directly pursuant to the dissertation is well underway. The prospectus is submitted to the chair of the appropriate area review committee at least six months prior to the filing of the dissertation at the Graduate Records office. The prospectus must be approved by the Executive Committee at least three months prior to the filing of the dissertation.

Candidacy and Dissertation Preparation
A student becomes a candidate for the Doctor of Philosophy degree upon passing the general examination, completing all required course requirements, fulfilling any language requirements and having the prospectus accepted by the Executive Committee. The Graduate School sends each successful student a letter of candidacy.

Final Examination
The final examination must be oral and under the jurisdiction of the advisory committee. It shall deal mainly with the field of the dissertation. No fewer than five faculty members including the advisory committee must be present.

Decision as to whether a candidate has passed, conditionally passed, or failed the examination rests solely with the advisory committee, which shall take into account the opinion of other participating faculty members and other experts. The official report is sent to the Graduate Records office and the student is then eligible to apply for the degree through the same office. Conferral of degrees is done by the University three times each year, August 31, December 31 and during general university commencement ceremonies in May of each year.

Doctoral Programs in Biomedical and Behavioral Science

The majority of DSTP trainees choose Skeletal, Craniofacial and Oral Biology as their area of concentration. Occasionally, a student will elect to do research in an area that is not offered by the Oral Biology Graduate Faculty. Current trainees have elected Immunology and Developmental Biology (which has strong ties to the Oral Biology Program). Each program is a bone fide graduate program and emphasizes the wisdom of maintaining programmatic flexibility built around a core curriculum to best serve the educational needs of individual students from diverse backgrounds. All programs listed are currently active and have substantial track records in graduating independent scientists. These programs accept qualified undergraduate students and dentists as graduate students.

• Biomedical Science Graduate Programs (UConn Health Center)
• Cell Biology
• Cellular and Molecular Pharmacology
• Genetics and Developmental Biology
  Immunology
• Molecular Biology and Biochemistry
• Neuroscience
• Skeletal, Craniofacial and Oral Biology

Behavioral Science Graduate Program (UConn Storrs)
The purpose of the program is to provide doctoral level graduate education for dental students and dentists in the behavioral sciences. It will thus help develop a cadre of dentists with advanced clinical specialty education and full academic qualifications to become independent scholars in the behavioral sciences. As faculty members of dental or other professional schools, the graduates will be carrying out research in the important interdisciplinary area of dental sciences and behavioral sciences, as well as educating undergraduate and graduate level students in this field.

The students will enter a course of study leading to the Ph.D. in one of the following: Economics, Psychology, Anthropology, or Sociology. Students will enroll in a program of graduate study in one of these departments in the main campus of the University of Connecticut at Storrs. They will fulfill all regular requirements of the graduate department for the Ph.D., including the completion of a doctoral thesis. Thus, on completion of studies, each of the graduates will be qualified as a professional in dental medicine as well as in one of the behavioral sciences.