Public Health vs. Psychology

[psychoptimist]

I am considering applying to public health PhD programs because it seems like clinical psych is geared more toward those who want to practice than those who want to do research. Have other people chosen public health or have any opinions on this topic?

I love psychology and the study of behavior and creating interventions/prevention programs but it seems like things are changing a lot right now. My primary focus is research.

I saw Brown has a public health program that seems to have the same format as a clinical program but I think it's new. It's a PhD in Behavioral and Social Health Sciences offered through the public health department. The faculty in this program are AMAZING and people I would have thought would be in clinical programs.

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[473912]

Is Public Health under a psychology or educational program? I'm wondering if you can still practice with it if you want.

I was thinking about Community Health PhD. I'm not sure if that's the same thing as Public Health, but it was a non-practicing, research degree. Definitely interesting. Epidemiology is so fascinating. I'd like to hear from people also. I think a degree in psychology and PhD in community health would be pretty neat.

 

[CApsych]

hi! I have an MPH in community health sciences and am heading to internship next year to finish up my PsyD. I, too, considered a PhD in Public health, but found that without a clinical degree, it was hard to initiate mental health programming with a solid understanding of how treatment might work as a provider. Of course this isn't always true, but I found that lots of people who work in public health are practitioners (are at least licensed) in clinical fields (nursing, medicine, psychology, social work), and I think that's because this allows them to understand the ins-and-outs of providing treatment, while the public health education allows them to design interventions and programming around that specialty on a larger scale. I plan to do primarily public health-focused prevention programs with my PsyD. The public health-focused organizations and individuals I work with seem to appreciate my clinical training thus far because I can speak to whats happening in the treatment realm while designing studies and large scale programming. Conversely, my public health experience constantly shapes the way I work clinically, both in thinking about how to expand existing programs and in considering how to adapt clinical treatment for people of different backgrounds.
The program at Brown sounds awesome. When I was at this decision point, I googled the jobs I wanted (public health department, VA research positions, medical center program evaluation jobs) and worked backwards to see what they required and to see what people who already had them had pursued educationally. I'm extremely happy with my choice to follow my MPH with a clinical degree and would love to talk more. There are lots of paths to public health though!

One note- getting licensed in something helps with job stability because you are qualified for a particular set of jobs. One frustration I had was that, while I loved the work I did during my public health degree, the path to employment was less clear.

 

[Ollie123]

I had a somewhat similar debate when applying. I ultimately went for clinical because my impression at the time was that it would be easier to be a clinical psychologist doing public health work than a public health person doing clinical psychology. Eight years later, I still feel that is true though there are definitely days I regret choosing the clinical path (today is one of those days...) since it certainly involves me doing a lot more day-to-day that I don't enjoy.

I do agree with the above poster that the path to employment is less clear for public health. That said, they have a lot of flexibility and I think its actually more clear for them than it is for psychologists looking for positions outside traditional settings (i.e. clinic/hospital or academia). It also depends very much what area of public health you study...biostats or epidemiology have tremendous flexibility and it is very easy to find "a" job no matter what. Policy? Way more difficult and limiting.

I know many, many, many of the people affiliated with the Brown program. A huge portion of their faculty actually are clinical psychologists by training. I'm sure the training would be stellar. I also suspect it would be heavily focused on preparation for a research career - I know that is what you want, but its worth putting out there that its probably not going to be a program that provides much room for deviating from that path (or guidance in doing so if you were to change your mind down the line).

 

[deleted343839]

I am considering applying to public health PhD programs because it seems like clinical psych is geared more toward those who want to practice than those who want to do research. Have other people chosen public health or have any opinions on this topic?

I know plenty of clinical psychologists who do research, maybe teach a bit, but do no clinical work. In my clinical PhD program some faculty weren't even licensed. If you want to go this route, you will be looking at an extremely competitive job market and therefore should focus on programs that will emphasize your research training. The Academy of Psychological Clinical Science lists programs that are geared toward training clinical scientists (though I'm sure this list is not exhaustive): https://www.acadpsychclinicalscience.org/

I have a few colleagues with a DrPH, one of whom is a collaborator. My observation is that there is some overlap in our training (especially when it comes to basic research methods and statistics), but public health leans more toward the big picture view of health and behavior. Think about the scale of the phenomena or problems that interest you. If you want to really delve into the nuts and bolts of behavior and clinical phenomena, or if you want to design psychological interventions and do clinical trials, a clinical psych doctorate is the way to go. However, if your interests are in large-scale observational studies, policy analysis, or design of health promotion interventions for the general public, a public health doctorate could serve you well.

Regardless of degree, it is hard to land a research career or tenure track faculty position. One advantage of clinical psychology is that you can always use your clinical training to help fund your salary. For instance, if you work in an academic medical center (eg, medical school, teaching hospital, etc.), you might "pay your way" in part by taking on some clinical responsibilities. And it's not unusual for university faculty to do a little private practice. Ideally, you can align at least some of your clinical duties with your research interests (though doing both can be a lot to juggle regardless).

It also depends very much what area of public health you study...biostats or epidemiology have tremendous flexibility and it is very easy to find "a" job no matter what. Policy? Way more difficult and limiting.

This is excellent advice. If you are leaning toward public health, you should think about a strategy to keep your options open when it comes time to finding a job. For instance, a solid biostats background will open doors for you, while you can still pursue behavioral research.

 

[HPB2015]

You might also want to consider looking into Community Psychology programs. UIUC clinical/community might be a good fit for you, it's quite research-focused and addresses the issues you seem to be interested in. UMBC psychology might also be a good fit, though it's more evenly balanced research-clinical, their "Human Services Psychology" perspective integrates clinical, community, and health psych perspectives. I interviewed with both programs, feel free to PM me for more details!

 

[sockit]

This is excellent advice. If you are leaning toward public health, you should think about a strategy to keep your options open when it comes time to finding a job. For instance, a solid biostats background will open doors for you, while you can still pursue behavioral research.

I had the impression that the streams within public health were mostly separate, but you're suggesting it'd be possible to straddle two?

Epidemiology would be great, but it'd be amazing to have a hand in some qualitative work too (as well as policy and program development...).

I'd read that MDs with MPH lead on most research - true?

Also - would psychologists working in public health be limited to clinical psych (re populations)? Because it is easy to see how social-cognitive and organizational psych principles are relevant to - well basically everything in public health - research, planning and delivery of health care systems, healthcare organization - all those usability factors.

 

[deleted343839]

I'd read that MDs with MPH lead on most research - true?

On most research? I don't know about that. But since MDs receive minimal research training, those who want an academic career often pick up an MS or an MPH during a fellowship after residency. In my experience, the most productive academic medical researchers do a lot of "team science" and collaborate with a statistician and/or methodologist. It's a little different from the solo PI model you see more often in academic psychology.

 

[deleted343839]

I had the impression that the streams within public health were mostly separate, but you're suggesting it'd be possible to straddle two?

Also - would psychologists working in public health be limited to clinical psych (re populations)? Because it is easy to see how social-cognitive and organizational psych principles are relevant to - well basically everything in public health - research, planning and delivery of health care systems, healthcare organization - all those usability factors.

Sure. You could develop statistical models of population health behaviors, for instance.

Psychologists working in public health-related areas don't always study clinical (ie, mental illness) populations. Peruse some articles in Health Psychology or Annals of Behavioral Medicine to get a flavor for what this looks like. But if the articles you see in, say, HSR or Medical Care excite you more, then you are probably tipping toward public health or health services research.

 

[sockit]

Thank you for the leads! I have a bit of a problem, in that it's all interesting. Some of the things I'm thinking about (in no particular order):

- It would be marvellous to try to address disparities in health outcomes and access to health care. My sense is that 99% of the time, though, the bottom line is going to be... the bottom line. Economics (and politics). I imagine it would be frustrating to continually point to this fact without being able to do much about election outcomes.

- Similarly, it's up to politicians to draw from or ignore evidence-based recommendations (another possible source of frustration).

- It seems (from the outside, to me) that it might, in a way, be more gratifying to work in health services - designing, delivering and evaluating particular programs. This seems scaleable, in that you might be able to find a way to efficiently deliver an amazing program that makes a real difference to users of a particular hospital or to a particular community. Qualitative work is appealing, as well. (I really dig talking to people; and more than that, I think those using and delivering services know important things about those services). I'm hearing you about the team-based approach to research, but just scanning, and from what CAPsych is saying, it seems that nurses and other clinicians are most heavily involved in this kind of work. Would an MPH alone limit opportunities to get into this kind of thing?

- My target salary is $60K + within two years of graduating, and it would be wonderful if there were potential for growth. (Not ashamed to say that.) Job security is important, too. Quant-focused work (epi and biostats) seem to be the ticket, as far as these issues go. I'm definitely interested in crunching data - however, I would be pretty unhappy chained to a computer all day.

It is hard for me to get a sense of job security and employment prospects for health psychologists. (I'd be into that, though. Community psych too, potentially.)

 

[deleted343839]

I'm hearing you about the team-based approach to research, but just scanning, and from what CAPsych is saying, it seems that nurses and other clinicians are most heavily involved in this kind of work. Would an MPH alone limit opportunities to get into this kind of thing?

- My target salary is $60K + within two years of graduating, and it would be wonderful if there were potential for growth.

An MPH will qualify you for jobs that fit with your general description and salary requirements (though there is probably some regional variation in the latter). The growth opportunities may be there, but they will most likely involve moving up the administrative ladder. If you want to design and carry out research as a principal investigator you will need a doctoral degree. The trade-off is that in this field a lot of the PI positions are soft money, so you will probably have to pursue grant funding (practically a full time job in itself).

The question of "who works where" honestly depends on the setting you work in. Psychologists do find jobs at health services research centers, policy groups, think tanks, etc. and those settings are more friendly to team science. The positions look very different from university faculty jobs. If you really want to look at health through a predominantly social cognitive or behavioral lens, though, you could find a psychology degree to be useful in that setting. It's considered a "non-traditional" path and so you have to be very careful about how you proceed with your training. A fellowship in population health or health services research would be a good springboard into this kind of career. But remember, you're talking about 5-6 years for the doctoral degree (if you go clinical) and then maybe a couple of years of fellowship training, so.... it's a long road and there may be less complicated paths to doing similar work.

Another alternative is dipping your toe in by getting a research assistant-type job in a setting that does the kind of work that interests you. If you advance in an organization that provides some tuition assistance you might be able to work toward an MPH through a weekend or evening program. Some very strong programs have these more flexible options, which cater to people who are already working full-time.

 

[bcliff]

Look at joint clinical psych PhD/MPH programs like UAB & USC

 

[sockit]

Thank you, MamaPhD. I really appreciate your taking the time to address my questions.