PhD Is Public Health still attractive in the U.S. ?

[Melezour]

Hey there!

I'm a French med student (5th year), and I'm planning to get a PhD in Public Health in France (within 5 years or so), and I'll probably try to specialize into health politics and management. Public Health has a bad reputation among med students in France, and many people choose this speciality by default when they fail at the national exam. The best students often choose oncology/ cardiology or radiology. The salaries in public health are also very low most of the time compared to the clinical specialities, although some people incorporate government fonctions or private laboratories and make much more I guess!

I've heard it was the exact opposite in the US: public health is a respected field where only the best could apply. Is it true? What is your opinion on the subject? Do US doctors become public health specialists once they've been working as clinicians for some years or do you have a specialized course in Med School like we do in France ? I am just curious to get some feedback on this subject.

Also, my ultimate goal would be to get the opportunity to work for a few weeks/ months in a west coast university public health program (my absolute dream would be UCLA's Fielding School of Public Health, in health management ). Have you ever met/ do you know/ are you someone who has worked for summer public health programs ? How did they incorporate their US experience into their carreer plans? How did they finance their program?

I feel like a french PhD with a conjoint US degree would be very beneficial as our Public Health policies are radically different (although Obama's reform seems to model on French public health system), and learning from both worlds could be such a great experience!

Any advice/ reaction? Maybe I'm dreaming waaay to big, and only the best students from Harvard or Yale get these summer courses oportunities? I can't find any relatable info on the faculty's websites, and we don't have "GPA" in France so it's hard to relate to your scores.

(P.S.: I'm trying to improve my english everyday but I still make many mistakes! Sorry for that !)
Have a great day everyone!

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[Stories]

An important distinction: in the US, medical students can choose to focus on preventative medicine (which is essential a public health discipline) as their medical specialty (so during residency right after graduating from medical school). Another option for students without clinical training is to get a MPH/PhD and become researchers or health department workers. I'll tailor the response to those with a clinical background.

I would say that overall, MDs will go onto a clinical career. Some may cross over and do public health, as well, but the vast majority do not. As to whether or not public health is only the best students, I would say that's not entirely true. Admission into a medical school is decidedly more competitive. If I remember correctly, something like 5-10% averaged across all programs (most competitive programs like Harvard and Duke are closer to 2-3%). Whereas the most competitive programs in public health is around 10% admit rate. Granted, there are far far far fewer applicants to a PhD in public health (~100 versus 5000+ for medical school).

The career path of a clinical physician and a public health researcher are also very very different. Salaries in the US, for a clinical physician are also probably 2-3x higher, depending on specialty. I have a few friends who took the MD/PhD route because they wanted to practice medicine AND do research. I don't personally know any with just MD who became public health researchers. Most who cross over usually get a MS or MPH to supplement their medical training.

I think you'll get a solid research training background as someone with a medical background. I knew several friends who had an international MD and got a 1-year accelerated MPH--they got solid research training and took it back to their home countries (I went to Yale). Many schools do offer these types of programs: some keywords to look for: accelerated MPH for advanced degree holders, advanced professional MPH.

 

[Solara]

Hey there!

I'm a French med student (5th year), and I'm planning to get a PhD in Public Health in France (within 5 years or so), and I'll probably try to specialize into health politics and management. Public Health has a bad reputation among med students in France, and many people choose this speciality by default when they fail at the national exam. The best students often choose oncology/ cardiology or radiology. The salaries in public health are also very low most of the time compared to the clinical specialities, although some people incorporate government fonctions or private laboratories and make much more I guess!

I've heard it was the exact opposite in the US: public health is a respected field where only the best could apply. Is it true? What is your opinion on the subject? Do US doctors become public health specialists once they've been working as clinicians for some years or do you have a specialized course in Med School like we do in France ? I am just curious to get some feedback on this subject.

If you're talking about MDs, really anyone can go into public health. Like Stories said, most MDs go into clinical medicine. The MDs who go into public health are ones who really love it enough that they're willing to give up the lucrative salaries they can make in clinical medicine. Sometimes very well qualified MDs go into global health, sometimes those at the bottom of the pack do. It's really variable. MDs can sometimes get MPHs and then go into public health, or go into public health after they experience. It's really variable, and I wouldn't say that every MD gets clinical experience before going into public health.

Also, my ultimate goal would be to get the opportunity to work for a few weeks/ months in a west coast university public health program (my absolute dream would be UCLA's Fielding School of Public Health, in health management ). Have you ever met/ do you know/ are you someone who has worked for summer public health programs ? How did they incorporate their US experience into their carreer plans? How did they finance their program?

Not sure here, sorry

I feel like a french PhD with a conjoint US degree would be very beneficial as our Public Health policies are radically different (although Obama's reform seems to model on French public health system), and learning from both worlds could be such a great experience!

Any advice/ reaction? Maybe I'm dreaming waaay to big, and only the best students from Harvard or Yale get these summer courses oportunities? I can't find any relatable info on the faculty's websites, and we don't have "GPA" in France so it's hard to relate to your scores.

Try and see if you can email some admissions people at these schools, or get a $3/month Skype plan to call any US phone number unlimited (even from France) and just call admissions people at these schools to ask them.

(P.S.: I'm trying to improve my english everyday but I still make many mistakes! Sorry for that !)
Have a great day everyone!

My replies are within my quotation of your post

 

[kisekira]

Hey there!

I'm a French med student (5th year), and I'm planning to get a PhD in Public Health in France (within 5 years or so), and I'll probably try to specialize into health politics and management. Public Health has a bad reputation among med students in France, and many people choose this speciality by default when they fail at the national exam. The best students often choose oncology/ cardiology or radiology. The salaries in public health are also very low most of the time compared to the clinical specialities, although some people incorporate government fonctions or private laboratories and make much more I guess!

I've heard it was the exact opposite in the US: public health is a respected field where only the best could apply. Is it true? What is your opinion on the subject? Do US doctors become public health specialists once they've been working as clinicians for some years or do you have a specialized course in Med School like we do in France ? I am just curious to get some feedback on this subject.

Also, my ultimate goal would be to get the opportunity to work for a few weeks/ months in a west coast university public health program (my absolute dream would be UCLA's Fielding School of Public Health, in health management ). Have you ever met/ do you know/ are you someone who has worked for summer public health programs ? How did they incorporate their US experience into their carreer plans? How did they finance their program?

I feel like a french PhD with a conjoint US degree would be very beneficial as our Public Health policies are radically different (although Obama's reform seems to model on French public health system), and learning from both worlds could be such a great experience!

Any advice/ reaction? Maybe I'm dreaming waaay to big, and only the best students from Harvard or Yale get these summer courses oportunities? I can't find any relatable info on the faculty's websites, and we don't have "GPA" in France so it's hard to relate to your scores.

(P.S.: I'm trying to improve my english everyday but I still make many mistakes! Sorry for that !)
Have a great day everyone!

I'm a resident training to become a public health specialist physician and I'm familiar with this career path. Just wanted to clarify on a few things -- people are often unclear about my role and training, including others working in public health, because it is so unique.

I would disagree with you that public health is considered a respected field even in the US (among fellow physicians at least). It is not a unpopular career path; most people go into it for personal satisfaction and really believing in the work that they do, or those that have become so burned out from clinical work that they need something different. As mentioned before, we have extremely good medical students/residents choosing this career but we also have people who are poor clinicians and realizing that they don't want to waste their medical training (aka not make a physician's salary) but likely will not function well as an attending clinician. Ultimately, the sentiment from other physicians is often that we are not "real doctors."

Salaries are low compared to physicians despite us typically having more training. For example, I am also qualified as a family physician and will have done 4 extra years of public health training on top of that, but when I'm staff I will make a lower salary than if I went back and worked as full-time family physician. Routes to make more money include being a consultant but that is often at ends with the mindset of physicians who pick public health.

In my opinion, most clinicians that say they went into "public health" are really just blending clinical epidemiology/research (maybe a bit of advocacy work) with their specialty, rather than public health work that a public health specialist physician does (e.g. coordinate outbreak response in communities). This is becoming more and more true now that the field isn't grandfathering clinicians into a public health physician's role without the requisite training like back a decade or two ago. Also, most of us do not practice much clinical work, if any at all.

In the US, you can enter the preventive medicine residency program after a minimum of 1 year of clinical training; you cannot enter straight from graduating medical school. It's a 2 year training program that includes an MPH, meaning you are only really doing 1 year of public health practical rotations. The training program in Canada is more robust (just mentioning because I'm Canadian trained), being a 5-year direct entry program after medical school including an MPH/MSc. Because our training program is one of the longest in the world, we tend to be sought-after job applicants because of our set of skills. I'm not sure how it is in France, but here you do not need a PhD and honestly I don't really know how much it would help unless you want to go into academia.

I'm a bit confused about what you mean by working a few weeks/months in a US public health program... did you mean like practical experience or studying? Practical would probably be close to impossible because of the security requirements here in working for a government-related organization. Studying is more doable, e.g. summer-only MPH programs such as at Harvard (not sure if they will remain after their revamping for the upcoming academic year). Expect minimal funding opportunities against very high tuition though for international students.