Internal Medicine Residency
Stanbury Physician-Scientist Pathway
Explore the Physician-Scientist Pathway
About UsThe Massachusetts General Hospital Stanbury Physician-Scientist Pathway (PSP) continues a longstanding tradition of educating physician-scientists. The Stanbury PSP operates under the leadership of the Stanbury PSP Residency Director Caroline Sokol, MD, PhD, the Stanbury Unit Chief Jayaraj Rajagopal, MD, and Stanbury PSP Fellowship Co-directors, Marc Wein, MD, PhD, and Allan Mullen, MD, PhD. The Stanbury Service’s mission is to develop physician-scientists within the Mass General Department of Medicine. Students with a track-record of both clinical and research excellence who anticipate independent research careers as principal investigators with their own laboratories are encouraged to apply.
Named in honor of John Stanbury, MD, the Stanbury Physician-Scientist Pathway recognizes the life and career of Dr. Stanbury, one of Mass General’s most esteemed physician-scientists. Dr. Stanbury is known for his expertise and contributions to our understanding of the role of iodine in thyroid function, the basis of inherited diseases, and the introduction of dietary iodine supplementation across the world to prevent hypothyroidism and goiter. His important scientific publication, The Metabolic Basis of Inherited Disease, has been used by generations of scientists, and his dedication to research and improving public health is the basis of what the Stanbury PSP is built on.
Research OpportunitiesFor over two centuries, Mass General has been at the forefront of medical and scientific innovation. Mass General currently runs the largest hospital-based research program in the United States, with $760 million in total research expenditures during 2014 among 30 centers and departments under the umbrella of the MGH Research Institute. While this alone affords one a wide array of options, a key feature of Stanbury PSP culture is that trainees are encouraged to pursue the best scientific training possible for their particular goals, no matter where in Boston that might be found. Whether it is Mass General Research Departments, Programs and Centers, and affiliates such as the Ragon Institute, Harvard University and the diverse institutions participating in its Clinical and Translational Science Center (Harvard Catalyst)including the Dana-Farber Cancer Institute, the Harvard Stem Cell Institute, MIT, the Broad Institute and the Whitehead Institute, or any other institution in Greater Boston, Mass General will work with trainees to facilitate connections with all the area has to offer. This flexible and innovative environment places at one’s disposal a collection of mentors and colleagues unparalleled in its breadth, depth and spirit of innovation. Moreover, Mass General actively facilitates your interactions with those mentors in their own labs while making sure you retain your links to Mass General clinically and professionally during your laboratory training.
Pathway StructureThe Stanbury Physician Scientist Pathway (PSP) is designed to develop the next generation of physician-scientist leaders. To accomplish this, we provide rigorous clinical training in residency while also providing the necessary mentorship to guide and prepare our house staff for re-entry back into the laboratory. The Stanbury PSP is designed to train, educate and guide physician-scientists through residency, fellowship and beyond.
ResidencyThe Stanbury PSP is part of the Categorical Internal Medicine Residency Program at Mass General, but it differs from the standard categorical track in three main areas: mentorship, curriculum, and residency structure.
Mentorship:Mentorship is central to the Stanbury PSP mission. Stanbury PSP residents are assigned to Dr. Sokol and Dr. Rajagopal as primary mentors.. Early mentorship is focused on helping our residents choose the optimal residency structure (traditional three year residency or the two year ABIM Research Pathway) and the best fellowship to achieve their specific career goals. We then shift our mentorship focus to help residents identify research mentors and laboratories in the Boston area and beyond. We act as gateway mentors to help Stanbury PSP residents develop their own network for navigating the rich and expansive Boston research environment.
In addition to classical mentorship, the Stanbury PSP provides the opportunity for peer mentorship through its community of physician-scientists at all levels of training – MD/PhD students, residents, fellows. Starting in the 2019-2020 academic year, alumni dinners and research in progress talks will be held to promote a community for physician-scientists at all stages.
Curriculum:As part of the Stanbury PSP, trainees receive a special curriculum targeted for physician-scientists. This curriculum includes talks by Mass General and other local scientists (“Science at the Cutting Edge”), journal clubs, and career development sessions. Much of this curriculum occurs during the two-week Stanbury Rotation that takes place every August. This unique rotation, taken in the junior year of residency, focuses on the re-entry into science and the cutting-edge research that awaits in fellowship. Furthermore, during the Stanbury Rotation all of our PSP residents attend the Stanbury PSP retreat and take part in chalk talks to discuss their prior work and future scientific plans.
Residency Structure:All Stanbury PSP residents are welcome, but not required, to follow the ABIM Research Pathway (so called ‘short tracking’). Trainees have until December 15th of their intern year to decide whether they will short-track. If they decide to short-track, a special schedule combining the rotations of Junior and Senior residents will be generated for their second year. Regardless of which path a trainee chooses, the rigor of the MGH Internal Medicine Residency Program will ensure that they are well-prepared for clinical practice in fellowship and beyond. While short-tracking trainees will not have the benefit of a full senior year, the residency program will work to include in their junior year schedules some of the most popular senior roles, such as Night Teach, Senior On Call, and Consult Senior.
Frequently asked questions about the Stanbury Program
FellowshipThe Stanbury PSP continues to provide mentorship, curriculum and community throughout fellowship. Acceptance to the MGH Stanbury PSP is not automatically coupled to an acceptance into an internal fellowship program, and it does not obligate Stanbury residents, implicitly or otherwise, to continue fellowship training at Mass General. Since 2014, >95% of our trainees have received their first choice in fellowship and 67% of trainees have chosen to stay at MGH or joint Harvard Medical School fellowships. Trainees that choose to remain at MGH for fellowship will continue to be part of the Stanbury PSP community for fellows throughout their clinical and research fellowship training. The rest of our graduates have elected to pursue fellowship training at prominent institutions such as Memorial Sloan Kettering, Stanford, and Johns Hopkins.
An important feature of Mass General fellowship programs is their robust track record in helping to secure funding for fellows during their training and transition to faculty. In 2018, Mass General Department of Medicine divisions held 21 active T32 training grants and approximately 55 active K08/K23 awards held by trainees and faculty. These numbers do not include additional funding opportunities through Harvard Catalyst KL2 awards, which serve as a bridge to K08/23 funding. Funding levels for NIH Loan Repayment Programs are similarly strong, and fellows are encouraged to utilize this avenue to help offset any debts associated with prior medical education. Additional funding for research fellows and early-stage investigators is available via the Mass General Executive Committee on Research, Harvard Medical School, Harvard Catalyst, which also maintains a database of funding opportunities, and the Mass General Department of Medicine. Guidance for K-level awardees on securing R-level funding and leading a lab is available via Harvard Catalyst and designed to teach effective laboratory leadership practices and provide 1:1 feedback on grant-writing. This, and a variety of relevant educational programs are available through the MGH Office for Research Career Development.
ResidencyAll MGH Internal Medicine residents are paid according to the Partners PGY scale. Additionally, they may claim financial support to offset conference expenses, with the flexibility to consider additional needs on a case by case basis. If an individual trainee has particular needs for travel or coverage for academic meetings such as Keystone and Gordon Conferences, the residency program and the Stanbury PSP will do their utmost to promote the activity in question.
FellowshipAll fellowship programs within the MGH Department of Medicine supplement fellows’ income to the Partners PGY scale during their clinical years of fellowship training. During research years it is at the fellowship’s discretion to continue this pay scale or to follow the NIH postdoctoral stipend scale. Fellows with undergraduate or medical school debt are also eligible to apply for one of the available NIH Loan Repayment Programs, as discussed above.
Application ProcessThe MGH Stanbury Physician-Scientist Pathway seeks individuals who have distinguished themselves both clinically and scientifically as students, thus demonstrating strong potential for successful careers as physician-scientists. Although most trainees have a PhD, any individual with a strong research background and an interest in a career as a physician-scientist is encouraged to apply. In particular, Mass General strongly supports the advancement of women and underrepresented minorities in research and clinical careers.
Interested applicants should apply directly to the Categorical Internal Medicine Residency Program via ERAS, but indicate their interest in the Stanbury PSP by checking that box within the Categorical application. ERAS applications will be reviewed by both the categorical residency program and the Stanbury PSP, after which a select number of physician-scientist applicants will be invited to interview on one of our four dedicated 2 day interview sessions. Stanbury PSP interviews take place on the day after applicants’ Categorical Internal Medicine Residency Interview and are an opportunity to discuss your science and learn about the program.
If interviewed by the Stanbury PSP program, you will only be considered for acceptance into the Stanbury PSP track and will not be considered separately for admittance into the traditional Categorical track. If after interviewing you decide that Stanbury PSP is not the right fit, you can request to move your application from Stanbury PSP consideration to traditional Categorical track consideration.
For more information, please see our FAQ or contact us via email.
John B. Stanbury
Memory of John. B Stanbury
May 15, 1915-July 6, 2015
John B. Stanbury died in his sleep on July 6, 2015, in Westwood, MA, seven weeks after his 100th birthday. He was born in Clinton, NC, and went to college at Duke and medical school at Harvard. He married Jean Cook in January 1945 while in the Navy, in which he served during World War II, and raised a family of five in Chestnut Hill, MA. He is survived by Jean, his wife of 70 years, four children (John Jr, Martha, Sarah Stanbury Smith, and David), nine grandchildren, and two great-grandchildren, and was pre-deceased by his youngest daughter, Pamela. Truly both a southern gentleman and a Boston Brahman, John led by discussion and example, and avoided arguments and conflicts. Above all, he loved a family gathering, especially on Isle au Haut, ME. He was an avid tennis player, beekeeper, and gardener.
John became chief resident at the Massachusetts General Hospital (MGH), and his admiration for Fuller Albright influenced his choice for endocrinology. He commenced his own career in medical practice, teaching, and endocrine research when he became Chief of the Thyroid Unit at the MGH in 1949. Teaching was focused in the Thyroid Clinic where trainees and older staff members, including John, saw patients each day. But the main teaching event was the clinic held each Tuesday afternoon, at which several patients were presented in person, and then examined by each of the attendings. Often visitors from clinics around the world were present as well. The discussions that followed by members of medicine, surgery, pathology, and radiology departments were sharp, patient-focused, full of pearls, and provided all present with a living textbook of clinical practice. This model has been emulated in many teaching institutions around the country.
The research environment in the Thyroid Unit was strong at this time, with Jacob Lerman studying immunity to thyroglobulin, Farahe Maloof investigating the metabolism of thioureas, and a partnership between Karl Compton, Robley Evans, and Arthur Roberts at the Massachusetts Institute of Technology (MIT), and Saul Hertz, James Howard Means, and Earle Chapman at MGH using the just developed tool of radioactive isotopes of iodine for studying the metabolism of iodine in the thyroid gland. Studies on iodine metabolism in animals were quickly followed by investigations in man, and the first treatment of Graves’ disease in 1941. These techniques were soon extended by Rulon Rawson for use in thyroid cancer. The idea of studying endemic goiter using this new technology led John Stanbury to organize a famous expedition to Mendoza, Argentina, along with Gordon Brownell and Douglas Riggs. The research was published in 1954 in a landmark publication ‘‘Endemic Goiter: The Adaptation of Man to Iodine Deficiency’’ (1), which opened this field to modern investigation. John ultimately pursued the ‘‘Iodine Trail’’ around the world with associates and studies in Mexico, Ecuador, Venezuela, Brazil, Thailand, the Congo, and Indonesia during the following years (2). Aside from documenting the extent of known endemic goiter and cretinism, these studies defined for the first time the extent of iodine deficiency–associated mental retardation, a previously unrecognized problem adversely impacting the socioeconomic development of millions of people, through the work of Rodrigo Fierro-Benitez. The research also led to treatment programs using iodinated salt, and injections of iodinated oil, which had and still has a significant impact for inhabitants of countries affected by iodine deficiency. This effort culminated in formation of the International Council for Control of Iodine Deficiency Disorders (ICCIDD, now called the Iodine Global Network; http://ign.org/) sponsored by the World Health Organization (WHO), with John Stanbury as its founding chairman and Basil Hetzel as director. This has led to the near worldwide elimination of iodine deficiency.
The diagnostic use of isotopes continued in the clinic with studies on the treatment of hyperthyroidism and iodine kinetics, and studies of individual patients with unusual hereditary disorders of thyroid function. This led John and his associates to develop a totally new and exciting field: ‘‘Inborn Errors of Metabolism’’ as it related to the thyroid (3). First studies done in 1949 defined the ‘‘organification defect’’ in a young patient and other family members. In 1955, John spent a sabbatical year in Leiden with Andries Querido and pursued research on another remarkable clinical phenotype associated with goitrous hypothyroidism. Their studies documented hypothyroidism due to a generalized lack of the enzyme responsible for the deiodination of iodotyrosines, the first time a human thyroid disorder was coupled with a specific enzyme defect (3). Other personal investigations identified a generalized deficiency in iodide trapping, identified the ‘‘coupling defect,’’ and thyroidal resistance to thyrotropin, at the clinical level. Students and colleagues have carried on this research with identification of the Resistance to Thyroid Hormone (RTH) syndrome, and defects involving thyroglobulin synthesis and formation of abnormal iodinated proteins. This deep interest in ‘‘metabolic defects’’ led in time to publication of a prescient volume edited by John Stanbury, James Wyngaarden, and
Donald Frederickson entitled ‘‘The Metabolic Basis of Inherited Disease,’’ which remains a classic (4).
Another research area opened at the Thyroid Unit involved studies on what may be termed ‘‘intermediary metabolism’’ in the thyroid, with Jacques Dumont and others. At that time, knowledge of DNA was little more than the fact that it contains four basic units in long chains and that it is sticky. Moreover, our understanding of the mechanisms governing protein synthesis was non-existent. But studies began on the biochemistry of thyroid hormone synthesis and energy metabolism in the thyroid, and gradually over years developed into what we recognize now as ‘‘molecular biology’’ of the thyroid.
In 1966, John moved to MIT as head of a clinical research center. Over time, the public health problems he had encountered on his ‘‘Iodine Trail’’ led to an interest in problems of overpopulation in Africa and Asia and to a period as director of the Pathfinder Foundation programs. A very large group of fellows from the United States and abroad were trained over the decades in what was the Mecca for aspiring researchers. ‘‘A Constant Ferment: a History of the Thyroid Clinic and Laboratory at the Massachusetts General Hospital: 1913–1990’’ (5), written by John, is full of memories that bring to life people from those productive years. Many became leaders in thyroidology, including Aldo Pinchera, Leslie DeGroot, Jacques Dumont, Geraldo Medeiros-Neto, Augusto Litonjua, Reginald Hall, Korsgaard Christenson, Rodrigo Fierro Benitez, Eduardo Pretell, John Dunn, and (literally) dozens more.
John’s awards included the Prince Mahidol Award from the royal family of Thailand and the Fahrney Medal of the Franklin Institute, honorary degrees from Leiden University, the Netherlands, and the University of Pisa, Italy, and a ‘‘Medal of Merit in Public Health’’ by the Ministry of Public Health of Ecuador. In 2003, John established the Thyroid Pathophysiology Medal, which recognizes outstanding research contributions contributing to a greater understanding of thyroid physiology or the pathophysiology of thyroid disease and is awarded each year at the Annual Meeting of the American Thyroid Association.
John Stanbury was very modest about his contributions to education, research, and human welfare, but his gifts were enormous and richly deserve our recognition.
Submitted in fond memory:
- Leslie J De Groot, MD
- Jacques E. Dumont, MD
- Lewis Braverman, MD
- Rodrigo Fierro Benitez, MD
- Geraldo Medeiros-Neto, MD
- Elias Dow, MD
Excerpt and photo reprinted with permission from THYROID, Volume 25, Issue 11, 2015, published by Mary Ann Liebert, Inc., New Rochelle, NY.
- Stanbury JB 1954 Endemic Goiter; The Adaptation of Man to Iodine Deficiency. Harvard University Press, Cambridge,MA.
- Stanbury JB 1954 2008 Iodine Trail. Oxford University Press, Oxford.
- Medeiros-Neto G, Stanbury JB 1994 Inherited Disorders of the Thyroid System. CRC Press, Boca Raton, FL.
- Stanbury JB, Wyngaarden JB, Fredrickson DS (eds) 1960 The Metabolic Basis of Inherited Disease. First edition. McGraw-Hill, New York, NY.
- Stanbury JB 1991 A Constant Ferment: A History of the Thyroid Clinic and Laboratory at the Massachusetts General Hospital: 1913–1990. Ipswich Press, Ipswich, United Kingdom.