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

[Cadbery]

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!

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[Kuratz]

If your primary interest is not to practice clinical medicine then do not go to medical school.

 

[Dro133]

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]

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

 

[cantankerous]

Go for a residency in preventive health. That way, you can have the best of both worlds of medicine and public health.

 

[AlbinoHawk DO]

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

 

[Cadbery]

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?

 

[puahate]

What is the job market for MPH?

 

[Cadbery]

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]

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.

 

[nimbus]

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.

 

[Cadbery]

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.

 

[mistafab]

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.

 

[wholeheartedly]

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.

 

[Espressso]

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.

 

[Espressso]

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]

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.

 

[Cadbery]

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?

 

[Mad Jack]

Do a preventive medicine residency, best of both worlds

 

[ed*26]

I'm a current medical student getting my MPH as a dual degree. I worked at my city's department of public health during undergrad and took several public health classes, so I knew I wanted social/public health to be an important part of my life. That being said, I knew that being a full-time public health professional wasn't for me and was completely confident that my career would lean much more clinical than public health. I came in with the idea that I could dedicate a decent chunk of my time towards public health. I should note that I'm an M2 (read: Step 1 is coming), but looking back I was wildly optimistic about being able to maintain any sort of robust activity in public health.

It's definitely possible to combine the two. However, there's a lot of yardage between "I want to know more about the biology of disease" and "I want to spend every day for the next four years memorizing every transporter in the kidney." The reality with medical training is that it will dwarf all other aspects of your life. Even with the best intentions and time management, as a medical trainee everything else comes after; no amount of time management or good intentions will change the fact that, for many years of your life, >85% of your free time will be dedicated to learning medicine and participating in clinical care. You can definitely participate in research (there will be no shortage of opportunities and your epidemiology skills will be highly valued), but only as a side project, and sometimes you won't have time even for that.

If you want to dedicate the next 7+ years of your life to learning the ins and outs of disease and clinical care, go MD. There will be plenty of opportunities to do epidemiology/public health even during medical school--the CDC has summer fellowships and rotations for your clinical years for example--and down the line you will be well suited to a leadership position in agencies like the CDC and can model your career to your choosing; there are also residencies which focus on global health or preventative care. If you are truly passionate about public health and lukewarm about clinical care, though, I would consider the MPH/PhD route instead. I'm completely confident that MD is the degree for me, yet even with the MPH I'm often frustrated at the lack of the "big picture" perspective in my daily life.

 

[aafisahar]

public health don't pay for a house on the hill

 

[Cadbery]

public health don't pay for a house on the hill

Going to use your comment as a launch board to echo some more thoughts that I'm having as the deadline looms.

I don't need a house on a hill, but I do need a house...I do know that MD's doing the same job as an epidemiologist PHD at the CDC could expect to receive up to $ 30,000 more per year (even more if the MD continues to see patients part time which is an option). Surprisingly, the MD program is only $100,000 more expensive than the MPH!!!! AKA the MPH costs > $100,000 (for all expenses) and the MD program costs ~$230,000 for all expenses. I hella wish a solid MPH program didn't cost that much, but they all do. I will note that I will have time to work part time while in the MPH program which I obviously would not in medical school However, part time entry work ain't doing **** on a $ 100,000 loan. Pretty sure the stipend for a PHD program ($20-30 k) wouldn't either.

It's all not about money though, if it was I would never have thought about public health. I just want to like what I do and have a meaningful impact while I do it.

Other Things:

I do think the MD program, however, will have a more personal cost on me. I'm not looking to take the easier route. I know the MPH-PHD route may indeed be easier in at least the # hours I would have to consistently work, but (hopefully) that's not why I would choose it (if I do choose it). My concern is just being stuck in medical school and residency working those all consuming hours IF I don't love what I am doing. If I don't love it, it would be really hard to get through, for a career in standard medicine or public health.

I could see myself appreciating the diversity of pathology in internal medicine. Going through rounds and being able to collaborate with so many other specialists and allied workers could be pretty engaging. Being able to sit down and evaluate labs and make consult calls sounds stimulating.

I might end up actually liking it, who knows, but that's just it, I don't know even after working in clinical medicine for 2-3 years. Unfortunately for me, most of my shadowing, scribe, and MA work have been in outpatient specialties/clinics that I quickly found to be boring. I didn't mind MA work, neither did I certainly didn't love it. As a scribe, I've gotten tired and bored as I follow the doctor around doing the same thing day in and day out for 30-45 patients each day. There's no time to evaluate and think about the patient. There's no consulting or collaboration. The only team work I see is the constant aggravating passive aggressive tension between the staff, nurses, and physicians. I did a short stint in the ED when I started as scribe, but it was a bit much for me at that point in time. I also shadowed a rural Heroin family care clinic. They do good work, but dang I don't think that I could do that, was very depressing.

I tried to shadow internal medicine, ID, and pathology but I was never allowed. I was told that it was too much clearance work to get me though even though I work in the hospital. So here I am, knowing that I don't like some parts of medicine and unclear if I will like any other parts of medicine. Meanwhile, my work at a computational epidemiology lab has been a positive and interesting experience. At the very least, I like the concept material and over arching ideas. Having an effect (however micro-sized) on the response to the current Ebola outbreak in the Congo is kinda legit, more so than how I feel in my scribe job. I'm just started with computer coding and it seems 'aight. I'm not suuuper thrilled about all my work being on a computer. I left wet lab research because I didn't get to talk to anybody while working in a fume hood for 6 hours. I think I'd survive however and I know that in the working world, epidemiologists do a lot of meetings rather than pure number crunching.

Last thoughts: I think MD's help people, just on a personal level, more than an epidemiologist can and it would somewhat suck to give up that ability. I think MD epidemiologists are probably more equipped to deal with disease outbreak response which is something that I am interesting in pursuing (but not set on).I do know that PHD's can get involved, I just don't see them being able to diagnose the situation at the moment as well as the MD's can. I see the PHD's as more bringing their laptop around and pulling data sets to help get a circumferential perspective of the situation. I could be wrong about this though, it's hard to get a real perspective on how MD and PHD epidemiologists function (aside from the clinic patient care side of things).
I also think that MD's who work as epidemiologists did a lot of learning and training that is not relevant to their profession (think anatomy, the kidney, and the copious amount of pharmacology). I know that I am going to like and enjoy this MPH program. I'm pretty sure I could at least tolerate the PHD process (I know plenty people going through it). For medical school...dunno. However, medical school could get me farther in my career (and as above farther along financially).


Sorry for the rant! Typing this down was more for me than expecting anyone to actually read it haha.

 

[nimbus]

I thought clinic was boring too, which is how I ended up in anesthesia.

 

[afib123]

you can't go wrong with either as long as a degree in public health will provide you with a decent job and living. Having said that, definitely shadow in the hospital and the OR to see if you like those things. If you don't like clinic (primary care), hospital (inpatient medicine fields), or OR (surgery), your options will be very limited as a physician. You are left with pathology and radiology.

Having said that, not liking clinic work does go against your public health field interest because primary care especially family medicine is probably the most involved field with population medicine. All fields go into this, but none as much as family medicine.

Also, evaluate your academic prowess and your goals in medicine. If you are set on going to a primary care field, medical school will certainly be a much easier process. If you want be an orthopedic surgeon, expect medical school to be very tough.

If you are also not strong academically and struggled in undergraduate science classes, medical school will be much harder and will require lot more time and effort regardless of the field you want to go into.

 

[Obnoxious Dad]

Cadbery, have you looked at the job market for MPH grads. My understanding is that it's miserable. Jobs are hard to find and the pay is miserable.

 

[Osteosaur]

are there really that many jobs where its like criminal minds but instead of serial killers they call you up during an outbreak and you run some stats and make it all better? I mean it sounds cool. however, It just sounds like you're a tech to THE place that does this. if you love your work keep doing it. just consider how many of these jobs are open for the taking.

of the people i know with MPHs one went to medical school, the other is working a $35k/year clinical research coordinator job. maybe that won't be you. but everyone who works as a lab tech feels like the research they are doing is going to be saving the world and the most important thing ever... and then you start coming in weekends and never want to go to another conference again.

Being friends with many post-docs, PhDs, and graduate students myself... PhD is far, far worse and more uncertain than medical school.

 

[ed*26]

How many practicing public health professionals have you spoken to? How many graduating students, about to get their first jobs? For MPH more than medical school, the school itself will have an impact on the jobs you'll be competitive for. My school is definitely geared towards producing community-based professionals (think people working with the city and nonprofits to advise on local policy, develop health programming at schools, use grants to create community gardens, etc) rather than serious researchers, but I'm also int he MPH program rather than the PhD. They also place a lot of people within the local giant hospital system. One of the most popular professors works as a staff epidemiologist for the hospital and probably has a few hundred publications midway through her career from advising on all the clinical research.

are there really that many jobs where its like criminal minds but instead of serial killers they call you up during an outbreak and you run some stats and make it all better? I mean it sounds cool. however, It just sounds like you're a tech to THE place that does this. if you love your work keep doing it. just consider how many of these jobs are open for the taking.

Most of the time it isn't like criminal minds, but every local health department is required to track a number of infections and staffs field epidemiologists to do so. Every syphilis and HIV case, for example, needs to be reported and close contacts need to be followed to prevent spread. Every major hospital has someone to advise on global disease trends. And epidemiology isn't just the on-the-ground infectious disease stuff--there's also a lot of interest in tracking burden of chronic disease based on SES or zip code or what have you. Especially with all the new anti-vax outbreaks, I wouldn't be surprised if more cities are looking to hire field epidemiologists. This is pure speculation, though--I generally don't go to the MPH career events.

 

[Cadbery]

you can't go wrong with either as long as a degree in public health will provide you with a decent job and living. Having said that, definitely shadow in the hospital and the OR to see if you like those things. If you don't like clinic (primary care), hospital (inpatient medicine fields), or OR (surgery), your options will be very limited as a physician. You are left with pathology and radiology.

Having said that, not liking clinic work does go against your public health field interest because primary care especially family medicine is probably the most involved field with population medicine. All fields go into this, but none as much as family medicine.

Also, evaluate your academic prowess and your goals in medicine. If you are set on going to a primary care field, medical school will certainly be a much easier process. If you want be an orthopedic surgeon, expect medical school to be very tough.

If you are also not strong academically and struggled in undergraduate science classes, medical school will be much harder and will require lot more time and effort regardless of the field you want to go into.

I've worked as a scribe and MA (and have shadowed) in settings most like Primary Care. My overall evaluation of PC is neutral. I don't hate it, but I find it boring often and repetitive. My exposure has been imperfect though. Inpatient (hospitalists and ID) holds a much stronger interest for me (always has), but I have not been allowed to shadow (even at the hospital I work at...). I don't see myself doing ortho. So, as you say, that is kind of a narrow scope and I would really just be hoping that I like internal med (or path)

My academics are fine and science /math classes were not overwhelming. I am confident there. I wouldn't be shooting for top specialties as far as I am aware.

Cadbery, have you looked at the job market for MPH grads. My understanding is that it's miserable. Jobs are hard to find and the pay is miserable.

You are not wrong. However, I got into the top 5 programs (not hard coming from a medical school orientated application) which would help me. I also don't see myself stopping at the MPH, but rather pursuing a PHD right away. Pay at the PHD level isn't amazing...but it suffices for my projected needs, at least to the point where I wouldn't change my career path solely based on this.

are there really that many jobs where its like criminal minds but instead of serial killers they call you up during an outbreak and you run some stats and make it all better? I mean it sounds cool. however, It just sounds like you're a tech to THE place that does this. if you love your work keep doing it. just consider how many of these jobs are open for the taking.

To be clear, I mention my job as tech to highlight what I like about it solely on an interest level. The subject matter is engaging and how we approach the problems is cool. Much better than my other lowly positions as a MA and scribe. Obviously I haven't done sh** in terms of actually making a difference. I'm not sure that my lab has either TBH on our current project, not yet at least. However, compared to my other research experience in a cell-bio lab (4 yrs), this research is applied epi work which is more exciting to me. We/they do long term research as well, but the projects are mostly focused on providing results to government agencies for things going on right now. So much cooler and interesting in my opinion.

I will say though, that I think that there is something to be said about physicians in public health. Able to make real tangible differences to the individual and also potentially make a difference in the population level. However, this image also seems idealistic to me sometimes. Who could possibly be a rockstar physician and epidemiologist at the same time. One side has to give over, if at least a little bit, to the other.

Being friends with many post-docs, PhDs, and graduate students myself... PhD is far, far worse and more uncertain than medical school.

I am unfortunately familiar with this as well. Its as the saying goes right? "For medical school, getting in is the hard part. For PHD programs, getting out is the hard part." I've heard this a lot and while it underplays how hard medical school, it highlights the absolute uncertainty that PHD programs have. Its scary, yes, and is something that I am aware of.

 

[Obnoxious Dad]

I know a Columbia MPH and a Michigan MPH and each of them had lousy luck in the job market. The Michigan grad eventually went to medical school. There are simply too many MPH graduates given the number of jobs. If you are passionate about health care, you ought to go to medical school.

You are not wrong. However, I got into the top 5 programs (not hard coming from a medical school orientated application) which would help me. I also don't see myself stopping at the MPH, but rather pursuing a PHD right away. Pay at the PHD level isn't amazing...but it suffices for my projected needs, at least to the point where I wouldn't change my career path solely based on this.

 

[Path1221]

I had the same dilemma as you a few years ago, and my career goals are very similar to yours. You are welcome to PM me if you want.

 

[Osteosaur]

The question you need to ask, in addition to "what is being an epidemiologist like" is "if I give up medical school to get an MPH, what is my likelihood of getting the job I want in that field". For my friend, n=1, they had trouble and got discouraged.

Your experience may vary, but unless you love it and are sure this is a very big opportunity to give up.

 

[Cadbery]

I had the same dilemma as you a few years ago, and my career goals are very similar to yours. You are welcome to PM me if you want.

I tried to PM you but it looks like your profile is private so it wouldn't let me.

 

[Splenda88]

If you have any doubt, go to med school and do preventive medicine or ID.

If you don't have any doubt, go to med school.

Next question...

 

[flapjack3d]

Do the MPH. Ask to defer med school. Med school's a big commitment. The average job you can get with an MPH isn't all that exciting. With an MD you are guaranteed flexibility in career and more stability. If you're highly motivated and talented you'll do well in either.

 

[slik nik]

I am currently a 4th year medical student, and I was in a very similar dilemma as you 4 years ago. Though I now envision my career to be more clinical after residency, I was initially very interested in working at the intersection of medicine and public health, especially on environmental health/toxicology issues at a state public health department or a federal agency like the CDC. For leadership positions in public health, it's beneficial to have a PhD or MD/DO/DVM in addition to the MPH. The MPH by itself does not open as many opportunities. I wasn't as interested in research and liked the clinical job versatility offered by pursuing medical school (and had many family members who were physicians), so I went the MD route and I will be graduating at the end of this month before starting residency. I was initially worried that I made the wrong decision, but honestly, medical school is not as bad as most people make it out to be, especially if you have at least some interest in helping people and taking care of patients. While preventive medicine may not be as competitive as specialties like dermatology, orthopedics, or some of the IM subspecialties, leadership positions for MDs/DOs in public health agencies are competitive to obtain, as there are only so many and funding is often limited for public health efforts at the state and local levels. However, that is probably also the case if you decide to go the MPH and PhD route, as working for the CDC is a dream job for many MPH candidates (also meaning it will be competitive).

If you decide to go the medical school route, you may not have as much exposure to public health during the first 3 years, but you can do an epidemiology/preventive medicine elective during your 4th year at the CDC and public health/epidemiology research during the summer after your first year of medical school. Or you can look into getting a MPH during medical school, if your medical school allows it.

I just completed the CDC medical student epidemiology rotation and it was a great experience rotating at the CDC in Atlanta! Ironically though, I kinda missed being in the clinic, so oddly enough, this elective reinforced to me that I made the right decision to go to medical school, albeit 4 years later. Keep in mind though, just because I was in a similar situation as you, it doesn't mean that you should pursue the same path as me... everyone is different.

Additionally, I would also suggest looking into the CDC's Epidemic Intelligence Service (EIS) program, which takes MDs/DOs/DVMs/PharmDs (as well as PhDs) and trains them to become applied epidemiologists. To be competitive, it is recommended that you at least complete a PGY-1 intern year and ideally a residency in internal medicine, pediatrics, family medicine, or any other clinical specialty before applying, if you decide to go to medical school. Keep in mind this is a competitive program (about 1 out of 10 applicants get accepted), but completing research or a a rotation at the CDC during medical school as well as showing an interest/commitment to public health will definitely help.

Here are the links to the CDC programs I mentioned:
- CDC Medical/Veterinary Student Epidemiology Elective: Epidemiology Elective Program Homepage | CDC
- CDC Epidemic Intelligence Service (EIS) Program: CDC’s Epidemic Intelligence Service (EIS)

Alternatively, outside of the CDC training opportunities, you can pursue a PGY-1 year in IM, Family Med, Peds, or really any clinical specialty and then pursue a preventive medicine residency afterwards. Because most preventive medicine jobs at state and federal agencies seem to prefer candidates who have residency training in a clinical specialty, I would recommend completing a full IM, FM, Peds, or other clinical specialty first. Additionally, occupational medicine is another field where you can combine an interest in medicine and public health, but keep in mind that a large proportion of the work clinically in occ med is worker's compensation evaluations.

Feel free to PM me for further questions. Good luck with your decision!

 

[Cadbery]

Do the MPH. Ask to defer med school. Med school's a big commitment. The average job you can get with an MPH isn't all that exciting. With an MD you are guaranteed flexibility in career and more stability. If you're highly motivated and talented you'll do well in either.

Higgggghly doubt med schools would let me defer for two years to get a MPH when they offer one year MPH programs themselves. Not likely. I could try though, I just don't want to tick anyone off. Also, I think that if I go the MPH route, it would be better to just do the PHD (and get funded) rather than the additional costs of getting the MD. The costs combined would be significant. I think MD-MPH makes most sense when getting the MPH funded via residency/fellowship, which I hear is not TOO hard to do.