To the Editor: Beginning in 2005, the University of Pittsburgh School of Medicine has offered an Area of Concentration in Neurosciences (AOC-N) as a way of encouraging medical students to consider careers in clinical or academic neuroscience.

Some physicians have bemoaned the difficulty in developing physician-scientists interested in neuroscience (1), while shortages of physicians in specialties such as child psychiatry have sparked great concern within the field (2). Previous experience has suggested that providing medical students with opportunities to do research, especially early in their careers, may increase interest in academic medicine, enhancing the likelihood that they will become physician-scientists (3). We also know that specialty recruitment, especially in clinical neuroscience, is associated with the strength and quality of curricular offerings, and an early and continuous exposure to topics and mentors (4). To address both these concerns—specialty recruitment (especially psychiatry, neurology, and neurosurgery) and physician-scientist development (neuroscience research, broadly defined)—several neuroscience departments at our institution decided in 2003 to develop the AOC-N. The program opened in 2005, and in 2009 we graduated our second set of scholars. This milestone led to the current examination of program components and outcomes as a way of assessing whether areas of concentration can be successful in attracting students to neuroscience.

The AOC-N is a voluntary program for medical students who wish to obtain a more in-depth and longitudinal exposure to neuroscience. Some choose our medical school partly because of the AOC-N, but most students discover the program in first year and apply; if accepted, they join a cadre of AOC-N student-scholars who serve as peers and informal mentors as they begin their own projects and experiences. The key components of the program include (a) a scholarly project with ongoing faculty mentoring, (b) a longitudinal clinical experience, (c) monthly educational workshops, and (d) a humanistic experience.

Scholarly projects must touch on some aspect of broadly defined brain and behavior; research can be basic, translational, or clinical; and projects are often multidisciplinary. An area of concentration faculty steering committee suggests and/or screens faculty mentors and approves projects. While students usually work within the research domains of their mentors, projects themselves must be the independent work of the student. Students and mentors meet at least quarterly over 4 years, usually monthly. Completed projects include prevalence of ADHD in a detention center and rat models of brain injury.

About 7% of each medical school class (currently 35 total students) participates in this academic program, making it the largest of nine areas of concentration currently active at our institution (outpacing geriatrics, underserved, etc.). Six of our current students are in the M.D./Ph.D. program, while another three will be taking a research year off.

Our first two classes of 18 AOC-N graduates produced 10 peer-reviewed scientific publications; nine invited publications; 22 conference presentations, posters, or abstracts; and seven awards for outstanding work. Other area of concentration students added nine more publications, nine presentations, and two awards in the last 2 years alone. Students have generally chosen humanistic projects that grow out of their scholarly work (e.g., a multiple sclerosis walk-a-thon or depression screenings at a shelter).

Educational workshops have been attended regularly by one-third of the students in the program, with attendance limited by competing demands on student time (especially clerkships and exams). The most popular sessions have been student-suggested, clinically oriented topics, such as a neuro-ophthalmology practicum and interviewing a patient with Prader-Willi syndrome; faculty members are chosen because of their teaching skill or expertise. Overall, 83% of AOC-N students found the workshops extremely or very helpful (4.3 on a 5-point scale, 5=best; n=30 respondents).

Although one-half of our initial 18 AOC-N graduating seniors chose non-neuroscience specialties (e.g., anesthesiology), most active members are interested in one of the clinical neuroscience specialties, with psychiatry topping the list at 40%. Student satisfaction has been quite high, with overall AOC-N quality rated as 8.7 out of 10, among nine respondents (23%) to our most recent annual survey. Perhaps not surprisingly, the most popular and helpful program component is the connection with other people, especially faculty mentoring.

It is very difficult to determine the true value of this kind of program. Students who join self-select; some students pursue similar opportunities (e.g., neuroscience research or shadowing) independently, even without the AOC, raising questions about how those students compare to AOC-N students in outcomes. Many factors influence recruitment and neuroscience interest (e.g., funding, admissions decisions), and we cannot say how the AOC might affect longer-term career development. Student feedback has been based on a small response rate, and all students have struggled to balance program demands with other curricular responsibilities. Finally, there are costs to the program in administrative time, food, and so forth.

Nevertheless, we believe that the AOC-N is a viable educational intervention that has yielded positive results among medical students interested in neuroscience. Placing psychiatry squarely in the neuroscience realm may ultimately enhance the discipline's standing. Allowing medical students early and ongoing exposure to scholarly, clinical, and educational experiences in neuroscience can serve to develop student interest in the field; this process may ultimately increase the number of medical students becoming physician-scientists or clinicians within neuroscience-related specialties. This program can serve as a model for other schools interested in expanding student involvement with an interest in neuroscience.

At the time of submission, Dr. Rosenstock reported no competing interests.