Two Gates Medical Education

Certificate programs for licensed clinicians

Two gates stand between a molecule and a patient.

The evidence for it, and a lawful route to it. This curriculum grades every agent it teaches on both — independently, with dates, including where the grade is unflattering. That discipline is the whole program.

See the evidence tableThe programs

The framework

Every agent is graded twice

Two scores, assigned independently. Collapsing them into one judgment — is this legitimate? — is the central error in this field.

Gate one · Evidence

E1
Approved indication, randomized evidence
E2
Meaningful human evidence — off-label, other population, or foreign approval
E3
Early or unreplicated human data
E4
Preclinical or mechanistic only

Gate two · Access

A1
Approved and commercially available for this use
A2
Approved product, off-label use
A3
Lawful compounding pathway exists
A4
No lawful US pathway today

The two axes are independent. Kisspeptin has good randomized human data and no lawful route to a patient (E2/A4). A gray-market repair peptide has neither (E4/A4). Tesamorelin used outside HIV lipodystrophy has real trial evidence and a lawful off-label route (E2/A2). Collapsing these into one judgment — 'is this legitimate?' — is the central error in this field, and separating them is the most useful habit this program will give you.

— Tier 1, Evidence & Access Framework

The grades are published. All of them.

Sixty agents, graded per indication — the same molecule can carry six different rows. Free to read, no account. Here is a fair sample, not a flattering one:

Six of the sixty graded agents, showing evidence and access grades with their verification date
AgentGraded forGradeVerified
SemaglutideobesityEvidence tier 1, access tier 1 — graded as clearing both gatesAugust 2026
Tesamorelinbody composition, non-HIVEvidence tier 2, access tier 2 — graded as clearing both gatesAugust 2026
Kisspeptinhypoactive sexual desireEvidence tier 2, access tier 4 — graded as not clearing both gatesAugust 2026
Topical GHK-Cuphotoaging (cosmetic)Evidence tier 3, access tier 1 — graded as not clearing both gatesAugust 2026
BPC-157tissue repairEvidence tier 4, access tier 4 — graded as not clearing both gatesAugust 2026
Melanotan IItanning, libidoEvidence tier 4, access tier 4 — graded as not clearing both gatesAugust 2026

The full table, with the rule that decides the color →

Why this exists

The gap this was built to fill

Much of the peptide education available to physicians reaches them through channels with a commercial stake in what gets prescribed. Two Gates has none: no relationship with any peptide seller, compounder or pharmacy. Nothing here is sold but the teaching — which is why the grades can afford to be published, and why half of them are unflattering.

You will find the evidence here graded honestly, including where the honest grade is unflattering to something you may already be prescribing.

— the Tier 1 welcome, as every learner reads it

Three programs

  • Applied Peptide Therapeutics

    Three tiers, foundations to capstone

    Seven modules · 28 hours · Eight weeks · Two live case sessions

  • GLP-1 Therapeutics

    The incretins, after the outcome trials

    Six modules · 8 hours · Self-paced · For licensed MDs and DOs

  • Peptide Therapy & BHRT

    Twenty sessions built around recall

    Twenty sessions · Four weeks · Self-paced

What each covers, and what a certificate attests →

Enrollment is currently by inquiry

Tell us what you practice and what you are trying to get right, and the course director will reply. No mailing list, and your details go nowhere else.

Inquire about a program