Just my 2 cents, but I hope you'll take some consideration since I went through the same debate and have been through the experience of deciding on what kind of career to pursue within medicine. I ended up doing my MPH during residency.
I would suggest not doing a combined MD/MPH program unless you think you might go for a very competitive specialty (but even then there are probably better ways to be a competitive applicant). MPH degrees, in the US at least, are too expensive to be worth it when funding opportunities are so limited. However, when you are a resident/fellow a lot of funding opportunities open up. As a resident I obtained full external funding with stipend, and my peers who weren't funded had opportunities to moonlight in clinical practice during their MPH which helped them keep their skills up and make decent money.
Pros of 5yr MD/MPH:
Don't need further training after residency
Possible advantage during residency application
Makes med school easier by breaking it up
Delay "MD salary" by 1 year vs 2
Might be less competitive to get into than a fellowship?
-Yes, you don't need further training after residency, but it doesn't actually shorten your training (unless the fellowship is longer) so you won't be done any faster. This means you delay your staff salary by the same amount, but take a big hit on tuition plus any interest that might accrue if you're doing this on loans.
-I actually view breaking up med school as a significant con. Your skills drop surprisingly quickly, and you want to be as strong as possible right before you apply for residency. In general I've heard that the more training you've had in your specific field, the easier it is to pick up again because the scope is something you're familiar with.
-I suppose specific fellowships might be competitive, but hypothetically if you're willing to take an unpaid year off of training as a resident/fellow to do an MPH, you'll be in the same position as doing a combined MD/MPH financially, without the additional interest, and also not be behind in years in training.
-Also note: it becomes quite a lot easier to get into top MPH programs when you have an MD. Perhaps a bit unfair to other MPH applicants since MDs aren't by definition more experienced or have more potential in public health, but that's just how it works out.
-In my experience, the majority of medical students are too early in their training to take full advantage of an MPH education, and spending 1-2 years dedicated to learning is not a small investment. There are so many factors that you can't predict, which can be simply discovering something other than global health that you want to dedicate your career to (which is perfectly fine even on this forum!), deciding on another specialty that might not mesh as well with public health (e.g. you might do emerg and realize shift work is not what you're looking for after all), or perhaps meeting a partner that has an inflexible career limiting your own career options if you want to stay together... my point is that a
lot can change. As a fellow, hopefully more of these will have figured themselves out.
One pro that I don't think you have for doing a combined MD/MPH: if you're going to specialize in research methodology/epidemiology/biostats, getting these skills early is really useful since you'll be publishing more, earlier, and of better quality. Never a bad thing for your career.
Also, things change if you can find funding for the MPH during med school. Then it might be worth it.
Good luck, and don't underestimate how much your life plans can change within just a few short years of med school -- I see it happen all the time! And, of course, congratulations on your acceptance to join our profession this year. Some of the hardest but most rewarding years await you
