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For over 60 years, MD–PhD programs have provided integrated clinical and research training to produce graduates primed for physician–scientist careers. Yet the nature of this integrated training is poorly characterized, with no program theory of MD–PhD training to guide program development or evaluation. The authors address this gap by proposing a program theory of integrated MD–PhD training applying constructs from cognitive psychology and medical education. The authors argue that integrated physician–scientist training requires development of at least three elements in trainees: cognitive synergy, sense of self, and professional capacity. First, integrated programs need to foster the cognitive ability to synergize and transfer knowledge between the clinical and research realms. Second, integrated programs need to facilitate development of a unique and emergent identity as a physician–scientist that is more than the sum of the individual roles of physician and scientist. Third, integrated programs should develop core competencies unique to physician–scientists in addition to those required of each independently. The authors describe how programs can promote development of these elements in trainees, summarized in a logic model. Activities and process measures are provided to assist institutions in enhancing integration. Specifically, programs can enact the proposed theory by providing tailored MD–PhD curricula, personal development planning, and a supportive community of practice. It is high time to establish a theory behind integrated MD–PhD training as the basis for designing interventions and evaluations to develop the foundations of physician–scientist expertise.

Purpose: Radiation oncology is often overlooked in US medical school curricula, with few opportunities for most students to learn about the specialty or the value of radiation therapy in cancer care. Tumor boards represent a potential avenue not only to increase students' exposure to radiation oncologists but also to provide a fundamental understanding of the multidisciplinary nature of cancer care and effective collaboration in clinical practice. Methods and Materials: In this study, we evaluated a novel radiation oncologist-driven tumor board shadowing experience at 3 medical schools in the United States and Canada. A total of 323 first-and second-year medical students participated, of whom 77.4% completed a follow-up survey assessing the effectiveness of the program as a learning tool. Results: Compared with traditional clinical shadowing, students were more likely to believe that tumor board shadowing provided a similar or better experience in terms of educational content (85%), exposure to a new field (96%), and overall experience (89%). Forty-eight percent of students perceived a greater amount of multidisciplinary collaboration in oncologic care than they thought existed prior to attending. Forty-eight percent of students also felt more competent interacting with oncologists after participating, whereas 21% felt more competent interacting with patients with cancer. Students' perception of increased competence was correlated with the amount of time their assigned physician mentor spent answering their questions after the tumor board (P < .01). Second-year medical students also had a more favorable overall experience than first-year medical students did (P = .04).