[Advice] Getting Cold Feet About Medical School Because Of Public Health Interests, Any Input?

Feb 21, 2018
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I have been accepted into medical schools (in NC, Va, and NY) which I was very excited about. However, at the same time, over the past year or so I have been accumulating an increasing interest in public health and epidemiology. I've worked as a scribe and MA for 3-4 years, have done wet lab work while in school for 3 years, and have been working in a infectious disease computational epidemiology lab for the past 6-8 months. I wasn't the biggest fan of wet lab research. However, working in the epidemiology lab has been wonderful! Some days are boring data entry, but I feel like I am constantly learning and being intellectually challenged. Finished a project that I have been working on feels amazing and I love how I can make an impact, however small, in places like Africa from my desk.
Scribing was interesting so long as there was something new to work on, but got boring very fast. Same with the MA position. I got specifically tired with the repetitive nature of clinic flow (ouch...I know). That being said, I only worked in a few particular departments and wasn't given chance to work in medical fields that I imagine that I would be more interested in (like internal medicine or ID).

I decided to apply to MPH programs and have been accepted to those as well. I now face the immediate decision of choosing between them. My long term career goal has shifted to working with global populations. Positions such as with the CDC (EIS fellowship especially) seem to be highly in accordance with my changing interests. I still do value the individual perspective of medicine. I could see myself potentially working with the CDC far in the future and still seeing patients. It seems like a full-picture scenario with knowledge flowing from the big picture down to the individual and back. I don't like how epidemiology programs lack biological concepts of disease. I also don't want to be stuck on the big picture and have individual people become just numbers (this is something that I highly fear). However, I will admit that at this point, I really do find the "big picture" stuff more interesting. That's discouraging for me as I approach my acceptance into medical schools.

I am friends with many doctors, residents, and medical students. I know the process and its stakes well. I have been advised by some that if I could think of any other way to meet my career interests, then 100% do that instead of medical school. I have also been advised by some (including CDC and EIS personnel) that medical school would be a great way to meet my goals in public health and medicine.

It does seem true that many of the positions that I am most interested in seem to weigh MD's much higher than PHD's (I would plan to follow with PHD after MPH due to interest in doing so and because of gatekeeping). I am willing to put in as much time and work to achieve a successful and satisfying career, whether it be MD or otherwise. I see a connection with medical school and my career interests, as have other reputable individuals. However, I am very nervous about pursuing this path as mentioned above and for reasons other reputable individuals have pointed out to me. I want to make the best decision for myself as well as those who would be affected by future career.

I think receiving input from those going through medical school (and any current doctors too!) would be valuable as I head into my decision. Some fresh and honest perspective would be good. I also would love to hear from any who may share interests similar to mine!
 

Dro133

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Currently an MS3 here.

When I was in your shoes, I was also deciding between a medical school acceptance and a job that would have required considerably less of my time, but also been less "impactful" and also less lucrative. Ultimately, I (obviously) chose medical school, in large part because I wanted to make an impact, and I held the belief that my level of satisfaction in my career would be the *primary* determinant in my happiness.

I'm finally starting to realize that this is not the case, and that the primary determinant in my happiness is the time I spend with friends, meeting new people, and doing the activities I love. Ultimately, I think I'm starting to see that for me, a job is ultimately a way to pay the bills and support my interests outside of work. Now, I don't think that means that one shouldn't enjoy their work; ultimately we have to spend a large portion of our waking lives at work, and to be miserable there, I think, is a recipe for disaster. However, that being said, I think that if you're the type of person (like me) who derives enjoyment mostly from experiences outside of work, the benefits of having a more "impactful" job may not make up for the sacrifices that have to be made.

I don't write this to discourage you from going to medical school; heck, I may end up working part time as a physician and still make more than enough to make ends meet, which I think is an enviable position that would be difficult (if not impossible) to pull off in most other career paths. I just want to advise you to think long and hard about the experiences in your life that have brought you the most joy. Is it time that you've spent with your friends and family? Is it going on dates and meeting new people (of course, none of these things are impossible to do in medical school, but it is going to be harder and more limiting than some other career paths). If so, it would be worth it IMO to seriously consider the less time-consuming path.
 

getdown

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If you don't want to actually practice medicine and just want to leverage the MD to a better academic/epidemiology position than I don't think it's worth it. You will have to go through the rigors of med school and residency for all that. If you're interested in just crunching numbers then you should just do the Phd
 
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AlbinoHawk DO

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Go for a residency in preventive health. That way, you can have the best of both worlds of medicine and public health.
Pretty much this. Most (all?) of these residencies encourage obtaining an MPH. I feel that the MD can be a good fallback plan too. The only way I see that MD would not be a good idea is if OP doesn't have a strong interest in medical sciences or want to treat patients at all
 
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Feb 21, 2018
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If you don't want to actually practice medicine and just want to leverage the MD to a better academic/epidemiology position than I don't think it's worth it. You will have to go through the rigors of med school and residency for all that. If you're interested in just crunching numbers then you should just do the Phd
Well I did say that I was still interested in the individual. I want to interact with people and don't want to just crunch numbers. I will admit that my interest isn't as focused on the individual as many people going to medical school so M3 and residency may indeed be very tough for me.

Pretty much this. Most (all?) of these residencies encourage obtaining an MPH. I feel that the MD can be a good fallback plan too. The only way I see that MD would not be a good idea is if OP doesn't have a strong interest in medical sciences or want to treat patients at all
This is something that I have highly considered. Maybe even getting a MPH in residency. As I told user "getdown" above, I may not have AS much interest in treating patients as other individuals going into medical school, but I still have an interest, both intellectually and professionally. I want to have a full picture view of public health and medicine which includes the big picture as well as the patient. My interests aligns more so on the side of public health as I said, but still exists for the individual. I will admit that if I was working at a place like the CDC, my preferred patient work to epi work would be around 30% patient to 70% epi work. I could even see myself phasing out clinical eventually (maybe...after like years or so) if I wanted to focus more on epi/public health work. However, even if I did that my belief is that the clinical training and experiences would be very useful and important to my career.

Does it still sound like I'm a good MD candidate to you? Either via preventative medicine residency or otherwise?
 
Feb 21, 2018
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What is the job market for MPH?
There is a market, more for those who focus on computational epidemiology and hard skills. I got into the top MPH programs (easy to do compared to MD schools) so market would look more optimistic for me. That being said, the MPH field is very over saturated and the MPH is often considered an entry level position for public health. I would likely pursue a PHD in infectious disease epidemiology or something like that if I went down that route because 1. I have an interest in pursuing more than just two years of education but also importantly 2. Position gatekeeping at places like the CDC would prevent me from working there with just a MPH.
 

puahate

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Are you at all interested in the MD curriculum?
There is a market, more for those who focus on computational epidemiology and hard skills. I got into the top MPH programs (easy to do compared to MD schools) so market would look more optimistic for me. That being said, the MPH field is very over saturated and the MPH is often considered an entry level position for public health. I would likely pursue a PHD in infectious disease epidemiology or something like that if I went down that route because 1. I have an interest in pursuing more than just two years of education but also importantly 2. Position gatekeeping at places like the CDC would prevent me from working there with just a MPH.
 
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nimbus

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Scribing and medical assisting is nothing like practicing medicine. Medicine is much more engaging. You might find it more engaging than public health. I was ambivalent about medicine myself but I succumbed to family pressure. Honestly it’s one of the best decisions I’ve made.

Go to medical school, the cheapest one you got into. It is one of the best jobs out there. If you don’t care about income, you will have incredible flexibility. Go into a decent paying specialty, work part time and do whatever rocks your boat with your free time. EM and anesthesia work well for this. Thank me in 10 years.
 
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Feb 21, 2018
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Are you at all interested in the MD curriculum?
Yes. Some parts more than other (but again, who doesn't feel that way). The clinical information taught in the first two years of medical school is interesting, important, and relevant to my conceived careers in public health. I just think that this information is amplified and made so much more interesting when broadening it with the additional perspective of applied epidemiology if that makes sense. As long as we are just talking about the curriculum, I would say that many epidemiologists lack proper understanding of biological concepts of disease, especially for infectious diseases.
 
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mistafab

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I would look at a few people that you want to be like - their job and their life.
1. Do these people have MDs?
That’s what I would seek out.
 
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wholeheartedly

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Normally I would agree with those that say if you don't want to practice clinical medicine skip the MD. However, things like the CDC's EIS fellowship heavily favors physicians over other ed backgrounds. For public health and Epi especially, I do think there's value in having both even if you don't practice clinical medicine long term.

I do think it's worth noting that there might be a better job market for computationally trained epi types, but the pay isn't that great for having a masters for a lot of these jobs. You'd definitely want the PhD most likely.

Finally, there are several residencies/fellowships that will allow or require you to get an MPH or Epi MS or similar. MPH is usually part of preventive med programs. Epi is also common for ID. I've also seen everyone else from gen surg to obgyn do an MPH during training. Often these are funded for you so it's cost saving to do them later rather than sooner. At that point in the game you've also likely focused your interests more and can tailor your MPH that way.
 

EspressoDrip42

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Normally I would agree with those that say if you don't want to practice clinical medicine skip the MD. However, things like the CDC's EIS fellowship heavily favors physicians over other ed backgrounds. For public health and Epi especially, I do think there's value in having both even if you don't practice clinical medicine long term.

I do think it's worth noting that there might be a better job market for computationally trained epi types, but the pay isn't that great for having a masters for a lot of these jobs. You'd definitely want the PhD most likely.

Finally, there are several residencies/fellowships that will allow or require you to get an MPH or Epi MS or similar. MPH is usually part of preventive med programs. Epi is also common for ID. I've also seen everyone else from gen surg to obgyn do an MPH during training. Often these are funded for you so it's cost saving to do them later rather than sooner. At that point in the game you've also likely focused your interests more and can tailor your MPH that way.
This.

I was in a similar position as you OP when I was getting ready to apply. I have a strong interest in population medicine (as well as healthcare policy) and I ultimately decided to go for medical school, now, then get the MPH during fellowship. A lot of fellowships (in particular fields, ID for example) will fund most if not all of your fellowship. And if you were to go into ID (something I'm highly interested in), a lot of programs and hospitals look favorably towards those who have both MD/DO and MPH. Also with both degrees, you'd have the option to practice clinically and also spend time doing research/etc that uses the MPH more.

They always say if you have any doubts about medical school, don't do it. And I generally agree. However, I don't think it's wise to just forget what made you want to go into medicine in the first place. I think it's silly for incoming medical students to basically have to forgo all other non-medical interests once they go to medical school. And in your case, if other interests include population health, epidemiology, there are ways to make both work. At least that's what I'm working towards.

But this is just my 0.02.
 

EspressoDrip42

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Yes. Some parts more than other (but again, who doesn't feel that way). The clinical information taught in the first two years of medical school is interesting, important, and relevant to my conceived careers in public health. I just think that this information is amplified and made so much more interesting when broadening it with the additional perspective of applied epidemiology if that makes sense. As long as we are just talking about the curriculum, I would say that many epidemiologists lack proper understanding of biological concepts of disease, especially for infectious diseases.
IMO this response here says you should do medical school and then the MPH. Unless one of those med schools you got accepted to has a joint MPH program that you can maybe retroactively get accepted to as well and make it a 5 year program. If so, do that!
 

wholeheartedly

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The other option might be to start med school and ask for a deferment for the MPH, do 2 years of MD then take a leave of absence to do the MPH. Return and finish MD.
 
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Feb 21, 2018
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This.

I was in a similar position as you OP when I was getting ready to apply. I have a strong interest in population medicine (as well as healthcare policy) and I ultimately decided to go for medical school, now, then get the MPH during fellowship. A lot of fellowships (in particular fields, ID for example) will fund most if not all of your fellowship. And if you were to go into ID (something I'm highly interested in), a lot of programs and hospitals look favorably towards those who have both MD/DO and MPH. Also with both degrees, you'd have the option to practice clinically and also spend time doing research/etc that uses the MPH more.

They always say if you have any doubts about medical school, don't do it. And I generally agree. However, I don't think it's wise to just forget what made you want to go into medicine in the first place. I think it's silly for incoming medical students to basically have to forgo all other non-medical interests once they go to medical school. And in your case, if other interests include population health, epidemiology, there are ways to make both work. At least that's what I'm working towards.

But this is just my 0.02.
Thank you for your reply! I'm curious to hear what your interest level in patient is compared to population medicine? Are you going to medical school as a means to achieve your goal for a career in public health or are you invested/interested in patient care as a career?