MPH during or after med school?

[doorner]

I was planning on doing a dual degree MD/MPH program, as I am interested in primary care, community health, and preventive medicine. I was discussing this with a student interviewer yesterday, and he mentioned that he advised people to wait until after residency and maybe get the MPH during a fellowship. Med school just prepares you for residency, and residency will really define your practice. Because residency is so clinical-heavy, you'll probably forget a lot of the pub health material you learned way back in med school, and it's only really useful to you in the context of the type of medicine that you will practice. Another reason is that if you have a fellowship that would benefit from you having an MPH, they might pay you to take a year and get the MPH...and getting paid to do something sounds a bit better than taking out more loans to do it.

Anyone have any experience or thoughts on this? How have other people timed the dual degree?

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[wholeheartedly]

Well, I'm doing an MPH before medical school with a focus on epidemiology and global health (I chose this route for a variety of reasons due to my unique circumstances) I hope to keep doing something related to that during training, but how that plays out is really going to depend on where I wind up.

I have people in my program from all points in training. Some of the med students are using what they've learned in their MPH to guide the direction they go career-wise and to work on interesting projects and some who are doing it in residency and fellowship are using their careers to guide how they use the MPH. I'm sure I'll forget some of what I'm learning, but I don't think I'll forget a ton of what's really useful. It's not going to become irrelevant when I start clinical training, MPH stuff and clinical medicine aren't completely dichotomous, they compliment each other, and people will keep encountering situations during their clinical training that tie in with their MPH training.

The biggest advantage of doing it later, after medical school, is that you can often get it paid for or bundled in certain fellowships. If you do it during your med school you usually add another year of being an unpaid student + tuition, but if you do it during a later program you often can get paid as PGY-whatever at a lot of places and tuition might be waived.

Whatever you decide, I don't think it's going to be absolutely critical what point you do it at, other than financing it and which program you wind up doing it through (ie maybe your fellowship doesn't co-op with a strong MPH program in what your area of interest is, but maybe your medical school has an awesome MPH or vice versa).The best thing would probably be to talk people who've done an MPH at different points and see what they suggest

 

[Lollygag]

I don't have an MPH or plan on getting one so take this with a grain of salt but just another advantage that I could think of at the top of my head with doing it later is that if you do it later you will probably have a better idea of what career path you want to take and you will know for sure that an MPH would definitely be useful to you.

If you are absolutely positive that you want to practice medicine in a public health kind of way then by all means go for it. But I know that some people do an MPH before or during medical school and then realize that they want to go into a field of medicine that an MPH wouldn't be particularly useful for and then you have a wasted degree and extra loans to pay back. Who knows, maybe you'll wind up wanting a global health degree instead. That may not be a deciding factor but it's something to consider if you are unsure.

 

[SolarLuminosity]

Something that's important here is what you value:

Extra year of med school: If you do it during med school, you will most likely have an extra year of school. One notable exception is Tufts MD/MPH which is only four years long (one of the main reasons I am going to do mine there).

Public Health: If you love public health and could see yourself working a job in the field, I would say do it. Because even if you don't end up working that job, you will still have the knowledge you care about.

Cost: Sometimes its vastly cheaper to do it during school (~24k at Tufts) then later (~60k).

Free time/ time to study for MD: You will obviously by its very nature have less time free during school. Granted its a much smaller burden than the MD portion and the professors know that you have limited time.

Final note: I heavily favored the MD/MPH dual degree here. However, there are also pros to waiting. You can really excel in research and other areas as a med student if you aren't studying MPH stuff for an hr a day or whatever. You may never "use" the degree and you probably wont know if you will until during residency or beyond. And MDs learn a lot about public health, plenty to get a job in it without an MPH. One notable example is Paul Farmer.

Good luck whatever you choose!

 

[FSU2013]

Something that's important here is what you value:

Extra year of med school: If you do it during med school, you will most likely have an extra year of school. One notable exception is Tufts MD/MPH which is only four years long (one of the main reasons I am going to do mine there).

Public Health: If you love public health and could see yourself working a job in the field, I would say do it. Because even if you don't end up working that job, you will still have the knowledge you care about.

Cost: Sometimes its vastly cheaper to do it during school (~24k at Tufts) then later (~60k).

Free time/ time to study for MD: You will obviously by its very nature have less time free during school. Granted its a much smaller burden than the MD portion and the professors know that you have limited time.

Final note: I heavily favored the MD/MPH dual degree here. However, there are also pros to waiting. You can really excel in research and other areas as a med student if you aren't studying MPH stuff for an hr a day or whatever. You may never "use" the degree and you probably wont know if you will until during residency or beyond. And MDs learn a lot about public health, plenty to get a job in it without an MPH. One notable example is Paul Farmer.

Good luck whatever you choose!

I think an mph would have more value after you've been in practice. Plus, several fellowships will pay you while you get an mph.

 

[doorner]

I think an mph would have more value after you've been in practice. Plus, several fellowships will pay you while you get an mph.

I tend to agree with you on this. It seems like the value of the degree would be heightened if you're taking the courses with the skills that you want to get out of it, and apply towards your practice, already in mind. Two years of med school isn't much of a clinical context for your public health work, but residency sure is. Even if you're sure you want to work in a public health capacity, you may be better off seeing where you land after residency and having a better sense of what skills you really need to focus on. Public health is a vast field and only a 1-year degree, so you really need to be able to hone in on one or two specific areas to get the most bang for your buck.

 

[Guero]

. . . The biggest advantage of doing it later, after medical school, is that you can often get it paid for or bundled in certain fellowships. If you do it during your med school you usually add another year of being an unpaid student + tuition, but if you do it during a later program you often can get paid as PGY-whatever at a lot of places and tuition might be waived.
. . .

This is exactly what the Director of our Institute of General Internal Medicine and Public Health told me and recommended. But I still applied to 4 year MD/MPH programs, trading time for a bit of money. Apparently, the majority of these 4yr programs still charge you tuition. But at least my loans won't accrue more interest as a result of pursuing an MPH. Plus, I hope to land an HPSP scholarship.

I also echo what others have said: It depends on each person's unique circumstance. Take everything we say with a grain of salt, including me. Good luck!

 

[Barcu]

I agree with many other posters.

Do it after med school. You might get it paid for, and you will know for sure whether you need it or not. You can do a lot with an MD degree, so you don't always need the extra degree to accomplish your goals (plus, goals change).