MD or MPH, or both?

[laurafaber]

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This is kind of a long post, but please bear with me 🙂

I am going into my Junior year of undergrad, I am currently enrolled in an MCAT course, and plan to take it in August. The problem is that I am not 100% sure med school is for me. I have always been very interested in the field of public health, and my ideal job would be working in international health and community development programs with a nonprofit organization. My goal has been to complete an MD/MPH program, but lately I've been considering doing an MPH first and then deciding if I still want/need to go to med school--which would mean taking the GRE and essentially having wasted my time and money on preparing for the MCAT this summer...no refunds 🙁

I suppose my first question is for anyone currently in an MD/MPH program--what do you hope to accomplish with both degrees? What sort of things did you consider in deciding to do both rather than one or the other?

Secondly, are there significant advantages to having an MD in the field of public health? I have not completely given up on the idea of practicing medicine, but I also do not want to commit myself to 8+ years of school/residency when I could be spending that time practicing public health and doing something I enjoy early on.

Really any sort of feedback would be helpful 🙂

 

[incredibad]

I'm very interested in hearing about this as well - I'd love to be in a leadership position in a public health organization or nonprofit and I know an MD would help a ton (most high up officials in WHO have MDs), but I dont know if that's essential.. plus it's just soooo much training. I'm also considering PA/MPH programs but I dont think PAs can practice abroad or get leadership positions as easily. Any information would be awesome!

 

[CopperStripes]

If you do a residency in preventive medicine, you get a MPH as part of the program (in most programs). This is a year less of training than if you do a MPH before or after medical school; plus, it's usually free.

 

[incredibad]

Are the opportunities for preventive medicine physicians that much greater than that of MPH graduates? Wouldn't they probably be working in similar positions?

 

[364462]

This is kind of a long post, but please bear with me 🙂

I am going into my Junior year of undergrad, I am currently enrolled in an MCAT course, and plan to take it in August. The problem is that I am not 100% sure med school is for me. I have always been very interested in the field of public health, and my ideal job would be working in international health and community development programs with a nonprofit organization. My goal has been to complete an MD/MPH program, but lately I've been considering doing an MPH first and then deciding if I still want/need to go to med school--which would mean taking the GRE and essentially having wasted my time and money on preparing for the MCAT this summer...no refunds 🙁

I suppose my first question is for anyone currently in an MD/MPH program--what do you hope to accomplish with both degrees? What sort of things did you consider in deciding to do both rather than one or the other?

Secondly, are there significant advantages to having an MD in the field of public health? I have not completely given up on the idea of practicing medicine, but I also do not want to commit myself to 8+ years of school/residency when I could be spending that time practicing public health and doing something I enjoy early on.

Really any sort of feedback would be helpful 🙂

I would go back to the drawing board and reflect on what hope to do in the short-term and long-term. While some in public health leadership roles do have MDs, this varies across the field (e.g., communicable versus non-communicable diseases; health policy versus community health, etc.). Also, it has been my impression that holding both degree do not have necessarily make you any more competitive, both as a prospective employee or as a prospective student in a graduate program. For instance, graduating physicians with MPH degrees are no more competitive for residency than those without it. If you feel that you can do what you want without one of the degrees, then why not stick to the other and go for it. And if you feel you need more time to reflect, take the MCAT and save your score. Are they not still valid for a number of years? Perhaps this will give you sufficient time reflect.

 

[Stories]

This is kind of a long post, but please bear with me 🙂

I am going into my Junior year of undergrad, I am currently enrolled in an MCAT course, and plan to take it in August. The problem is that I am not 100% sure med school is for me. I have always been very interested in the field of public health, and my ideal job would be working in international health and community development programs with a nonprofit organization. My goal has been to complete an MD/MPH program, but lately I've been considering doing an MPH first and then deciding if I still want/need to go to med school--which would mean taking the GRE and essentially having wasted my time and money on preparing for the MCAT this summer...no refunds 🙁

I suppose my first question is for anyone currently in an MD/MPH program--what do you hope to accomplish with both degrees? What sort of things did you consider in deciding to do both rather than one or the other?

Secondly, are there significant advantages to having an MD in the field of public health? I have not completely given up on the idea of practicing medicine, but I also do not want to commit myself to 8+ years of school/residency when I could be spending that time practicing public health and doing something I enjoy early on.

Really any sort of feedback would be helpful 🙂

I highlighted the most critical part of your dilemma. In what capacity do you want to work in that organization? If you want to be a clinician, you need the clinical degree. If you want to be an administrator, a clinical degree is unnecessary. Your training (and networking) should be focused on your goals--you shouldn't get a MD just because you think you should. It needs to be a part of your plan to get where you need to go, otherwise it'll just be time that you could have spent doing something to get closer to your goals.

I'd begin with looking for internships and opportunities to work with organizations like this. This is the best way to find a way in. Informational interviews are also great for this type of opportunity!

 

[gprice1832]

I went through this same thing: I took the MCAT (twice), applied and interviewed for med school, and then decided in December of my senior year that I didn't really want to go medical school. For me, it came down to the kinds of questions that each discipline asks. I realized that the more individual focused clinical questions of medicine were not as interesting to me as broader "sociological" questions of public health. For example, I don't really find the biochemical basis for diabetes to be that interesting, but I do find it interesting that certain populations are more prone to develop the disease.

Of course, questions about health and wellness do not admit of clear distinctions between the clinical and non-clinical aspects, and MD's do deal with non-clinical questions in their day-to-day practice. What I would suggest is sitting down and really thinking about what attracts you to medicine or public health. Are you more interested in affecting large changes in an individual's life, or are you more interested in population-level interventions?

When I was considering my options, I was also told that if I could see myself doing anything other than being an MD, I should thoroughly explore that option. Let's be honest, it is a huge investment (both monetarily and temporally) to go through medical training. If you're waffling on your decision to go to medical school, it's not going to hurt your chances of admission to have an MPH already under your belt.

As an aside, I wouldn't worry too much about taking the MCAT and then not using the scores. Most schools accept scores that are 2-3 years old, so they may not go to waste in the end.

 

[laurafaber]

Thanks everyone for your feedback! I was not familiar with the residency in preventive medicine, but I've been reading about it online and I'm quite excited, as it sounds very close to what I would be interested in doing 🙂 I've also been doing more general research about global and international health-related residencies, which I have also found really interesting. I know I am interested in population-based medicine, but I haven't abandoned the idea of being a doctor--I just need to make sure I'm doing it because it's really what I want to do and not because it's always what I've wantED to do or think I should do if that makes sense. I really do think that having clinical training would enhance my ability to affect change in the public health sector in terms of giving me better perspective and also by giving me more options in how I can be involved...is this true?

 

[CopperStripes]

Are the opportunities for preventive medicine physicians that much greater than that of MPH graduates? Wouldn't they probably be working in similar positions?

The field of preventive medicine is quite broad. As a result, yes, some positions end up being similar to those held by those with just MPHs; however, many positions are quite different given the medical and clinical background/training of a MD. Many MPHs have no clinical experience, and they are not taught to health at the individual level. The combination of MD and MPH or an MD trained in preventive medicine provides the unique perspective of both individual medical and population/community health. Positions that commonly look for this background include medical officers in state or county health departments, governmental organizations such as the CDC or FDA, health insurance companies, pharma/biotech companies, and academia in schools of public health or medical schools' departments of community/family/population medicine.

 

[CopperStripes]

I really do think that having clinical training would enhance my ability to affect change in the public health sector in terms of giving me better perspective and also by giving me more options in how I can be involved...is this true?

Yes, I believe that to be true. Additionally, for many positions and fields of work, clinical experience legitimizes you. This is especially true if you oversee, work with, or are expected to influence clinicians.

 

[274631]

This is kind of a long post, but please bear with me 🙂

I am going into my Junior year of undergrad, I am currently enrolled in an MCAT course, and plan to take it in August. The problem is that I am not 100% sure med school is for me. I have always been very interested in the field of public health, and my ideal job would be working in international health and community development programs with a nonprofit organization. My goal has been to complete an MD/MPH program, but lately I've been considering doing an MPH first and then deciding if I still want/need to go to med school--which would mean taking the GRE and essentially having wasted my time and money on preparing for the MCAT this summer...no refunds 🙁

I suppose my first question is for anyone currently in an MD/MPH program--what do you hope to accomplish with both degrees? What sort of things did you consider in deciding to do both rather than one or the other?

Secondly, are there significant advantages to having an MD in the field of public health? I have not completely given up on the idea of practicing medicine, but I also do not want to commit myself to 8+ years of school/residency when I could be spending that time practicing public health and doing something I enjoy early on.

Really any sort of feedback would be helpful 🙂

I know that I am a bit late to respond to this but as a current MSPH student in the process of applying for medical school I figure I can weigh in a bit. I had a similar experience during undergrad about not being sure medicine was for me. I love the population level approach to health I get from public health and knew that I at least wanted to do that degree. So I did that. I realized over the past couple years that I still wanted the one on one clinical experience so am still applying to medical school. As others have said if you want the clinical aspect you will have to do medicine. If not, its not worth the money or time. You can definitely be a public health leader without an MD. Furthermore, I think the MPH would still be beneficial even if you get an MD. For me, I want to do public health research work and my masters degree would allow me to do that.

And to the bold I did not take the GRE. I only applied to schools that would accept my MCAT scores. So that's something else to consider.

 

[laurafaber]

Thanks for your input! It just seemed as if there weren't too many mph programs that accepted mcat scores but I probably didn't look extensively enough...out of curiosity, do you know what sort of residency you might be interested in and how you might like to incorporate your public health background into your work? Also did you have any work experience in public health before deciding to apply to medical school?

 

[pattr]

Hello, I'm a fourth year DO/MPH student.

I did MPH classes concurrently with my DO coursework (4 years for both degrees). Public health was always my first love (I took the GRE, scored well with minimal prep, and got accepted into MPH-only programs too) and in college I was debating my career path much in the same way that you are now. I chose to go the medical route because I enjoy caring for individual people just as much as I like the population aspect. I still get the latter in medical school by participating in population-based research. Also, public health is naturally a small part of medical school; by taking MPH classes though you are going above and beyond what physicians normally learn in school with respect to health policy and community health, research design, etc.

I am planning to go into an internal medicine residency and then considering a preventive medicine residency afterwards. I would highly recommend a preventive medicine residency (it's 2 years: 1st year is the MPH which is paid for by the program and you also get your normal salary as a resident; 2nd year is the practicum year where you do rotations in different settings eg. WHO, HMO's, health departments, public agencies, etc.)

I will say that a lot of the practical nuances of patient care become very important in thinking about public health issues, and a physician's perspective is definitely needed in designing effective policy, studies, and interventions. In public health we talk a lot about "bridging the gap between public health and medicine," something which is sorely needed, especially with the passing of the ACA, and physicians who have experience in both fields can fill this need.

 

[Solara]

Take a look at this link where some people talk about MD vs PhD in global health. As someone said above, it depends on what you want to do, though this is never an easy, simple question to answer.
http://forums.studentdoctor.net/showthread.php?t=605284

It's important to note that the medical training is much more difficult to obtain separately than is the public health training. If you can get an MD and obtain the necessary knowledge in public health through other means, that would be much more desirable as the MD degree opens up more doors and also gives you more legitimacy with your work.

Also, keep in mind the high cost of medical school. As a physician, you may have a $150,000 debt out of med school, but your starting salary will be more than $150,000 if you actually practice medicine. Public health on the other hand, doesn't pay so well. Are you prepared to pursue a career in global public health with a $150,000 debt and make $50k-$70k a year and spend decades of your life paying that debt off? Of course, salary ranges in public health, and though MDs may get paid more often depending on where you work, don't expect to make too much. You should think about this, where you want to work, how much money you'll realistically be making, and how much debt you'll have.

 

[HSUReddie]

Also, keep in mind the high cost of medical school. As a physician, you may have a $150,000 debt out of med school, but your starting salary will be more than $150,000 if you actually practice medicine. Public health on the other hand, doesn't pay so well. Are you prepared to pursue a career in global public health with a $150,000 debt and make $50k-$70k a year and spend decades of your life paying that debt off? Of course, salary ranges in public health, and though MDs may get paid more often depending on where you work, don't expect to make too much. You should think about this, where you want to work, how much money you'll realistically be making, and how much debt you'll have.

This isn't really true. Technically, your first salary out of med school will be that of a resident (followed by a fellowship position salary if that is something you choose to pursue), and those are usually no where near what a typical physician makes. After that it all depends on what specialty you choose. Specifically, from personal experience, I know pediatric infectious disease physicians who may be near retirement, working full time, and still not making $150,000. While others in the middle of their career are making around $80k-$90k.

To the OP, I'm finishing up an MSPH this month and starting medical school in August. I personally decided to do the degrees separately because it allowed me to attend the best possible school for the speciality I wanted to pursue for my public health degree, while also allowing me to save money later on by attending medical school in my home state. It also gave me time to make sure pursuing an MD was right for me, instead of pursuing a PhD.

 

[Solara]

This isn't really true. Technically, your first salary out of med school will be that of a resident (followed by a fellowship position salary if that is something you choose to pursue), and those are usually no where near what a typical physician makes. After that it all depends on what specialty you choose. Specifically, from personal experience, I know pediatric infectious disease physicians who may be near retirement, working full time, and still not making $150,000. While others in the middle of their career are making around $80k-$90k.

To the OP, I'm finishing up an MSPH this month and starting medical school in August. I personally decided to do the degrees separately because it allowed me to attend the best possible school for the speciality I wanted to pursue for my public health degree, while also allowing me to save money later on by attending medical school in my home state. It also gave me time to make sure pursuing an MD was right for me, instead of pursuing a PhD.

Indeed, you first make resident salary before making the physician salaries--I was thinking more along the lines of medical training as a whole. I was also looking at this list (*average* salaries).
http://www.forbes.com/sites/jacquel...e-best-and-worst-paying-jobs-for-doctors-2/2/

But based on what the OP was saying, I don't think s/he wants to practice medicine full-time. Don't forget, there are many physicians who spend part of their time practicing medicine and part of their time doing global health research and work. You'll need to talk to more people, especially MDs who do global health work and MDs who are doing the things that you want to be doing. That will give you the best perspective.