This program emphasizes the interdisciplinary study of bioethics through the humanities and the values-oriented social sciences. The goal of the program is a rigorous master's level education in the legal, historical, philosophical, and cultural contexts of medicine. Typically Health Care Ethics M.D./Ph.D. students complete their first two years of medical school and the USMLE Step 1 exam before beginning the Ph.D. program. In the summer between the first and second years of medical school, students take one to two classes in health care ethics. They begin full time work in the Health Care Ethics Ph.D. program after their second year of medical school. Students complete two years of course work in health care ethics, followed by one year of dissertation writing. Following defense of the Ph.D. dissertation in Health Care Ethics, students return to medical school to complete years three and four. Correctional facilities, such as prisons, jails and juvenile detention, are some of the most complex settings in which to provide health services. The difficulty of the environment, poor health status and compromised access to health services add to the complexity and pose confounding legal and ethical issues for all concerned.